ABSTRACT
To evaluate the preschool motor skills of children born prematurely, we examined 90 children who were participating in a longitudinal follow-up program at 4 1/2 years corrected age. Children with major neurological impairments, such as cerebral palsy, were excluded from this investigation. Study subjects' gestational ages ranged from 24 to 36 weeks. Both gross and fine motor function were assessed with standardized instruments. Overall, the later motor development of these children was reassuringly intact and within the average range on all measures. Nevertheless, extremely low birth weight (less than 1000 g) children as a group displayed significantly inferior skills in all motor functions. Symptomatic intracranial hemorrhage was also associated with significantly poorer motor performance.
Subject(s)
Infant, Low Birth Weight , Infant, Premature , Motor Skills , Cerebral Palsy , Child, Preschool , Female , Follow-Up Studies , Humans , Infant, Newborn , Longitudinal Studies , Male , Wechsler ScalesABSTRACT
Greater numbers of preterm, low birth weight ("high risk") infants are surviving than ever before. It has become increasingly important for physicians and other health care professionals to become familiar with the many real and potential problems seen in this population of children during the first years of life and beyond. The residue of illnesses that are presented in the neonatal intensive care nursery and major health vulnerabilities of the early years are discussed in this article. Normal variations in neurodevelopmental patterns unique to preterm infants and neurodevelopmental disabilities which have a higher prevalence in this population are presented. The impact of a high risk infant on the family unit is described. Finally, resources and interventions available to the child, family, and health care provider during and following the transition from the hospital to home are reviewed.
Subject(s)
Child Development/physiology , Family , Infant, Low Birth Weight , Infant, Newborn, Diseases , Child , Child, Preschool , Follow-Up Studies , Humans , Infant , Infant, Low Birth Weight/physiology , Infant, Low Birth Weight/psychology , Infant, Newborn , Infant, Premature/physiology , Infant, Premature/psychologyABSTRACT
Intracranial hemorrhage (ICH) was detected in 38 preterm neonates, using cranial ultrasonic (US) scanning. Forty-three preterm neonates examined during the same period but who had no cranial US evidence of ICH were also identified. Neurodevelopmental follow-up was performed at a mean age of 22.3 months on these 81 children. As a group, children with ICH demonstrated developmental indexes in the normal range but about ten points lower than children without ICH. The outcome in survivors of grade III ICH was quite similar to the outcome in survivors of grades I and II ICH. Survivors of grade IV (intraparenchymal) hemorrhage had a worse outcome. Cerebral palsy was significantly more prevalent in children with ICH. Only two thirds of children without ICH had a completely normal outcome, reinforcing the concept that factors other than ICH alone contribute to neurodevelopmental morbidity in this population.
