%0 Journal Article %1 Palta2000 %A Palta, M. %A Sadek-Badawi, M. %A Evans, M. %A Weinstein, M. R. %A McGuinnes, G. %D 2000 %J Arch Pediatr Adolesc Med %K Bronchopulmonary Dysplasia; Cerebral Palsy; Child Development; Child, Preschool; Cohort Studies; Disability Evaluation; Female; Follow-Up Humans; Infant, Newborn; Very Low Birth Weight; Intensive Care Units, Neonatal; Male; Pulmonary Surfactants; Self Care; Socioeconomic Factors; Time Factors %N 1 %P 23--30 %T Functional assessment of a multicenter very low-birth-weight cohort at age 5 years. Newborn Lung Project. %V 154 %X BACKGROUND: Very low-birth-weight newborns (birth weight < or = 1500 g) experience serious neonatal complications, but long-term outcomes are not completely known. Most studies reflect an era of neonatal care that was fundamentally different from the present. OBJECTIVES: To compare the functional level of very low-birth-weight children before and after surfactant introduction and to relate functional level to clinical and socioeconomic factors. DESIGN: Inception cohort followed up from birth to an average age of 5 years. SETTING: Six regional neonatal intensive care units in a contiguous geographic area. PARTICIPANTS: Four hundred twenty-five very low-birth-weight children, born between August 1, 1988, and June 30, 1991, of 438 located among 626 whose parents provided follow-up information before neonatal intensive care unit discharge. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Diagnosis of cerebral palsy and standardized scores for self-care, mobility, and social function from the Pediatric Evaluation of Disability Inventory. RESULTS: Cerebral palsy was present in 12.6\% of the children, with no change after surfactant introduction. Intraventricular hemorrhage (odds ratio, 2.3 per grade; 95\% confidence interval, 1.8-2.8) and bronchopulmonary dysplasia (odds ratio, 2.3; 95\% confidence interval, 1.2-4.6) were independently predictive of cerebral palsy and of functional outcome. For self-care, mobility, and social function, 11.7\%, 29.5\%, and 10.7\% of the children, respectively, scored at least 2 SDs below the normative means. Social function was 0.25 to 0.50 normative SDs lower after general surfactant availability than before general surfactant availability. Conclusions: While there was no increase in major disability after surfactant introduction, there may have been a decrease in social function associated with the lower neonatal mortality. Most very low-birth-weight children functioned within the normal range in everyday tasks. Several predictors of outcome were identified.

@article{Palta2000, abstract = {BACKGROUND: Very low-birth-weight newborns (birth weight < or = 1500 g) experience serious neonatal complications, but long-term outcomes are not completely known. Most studies reflect an era of neonatal care that was fundamentally different from the present. OBJECTIVES: To compare the functional level of very low-birth-weight children before and after surfactant introduction and to relate functional level to clinical and socioeconomic factors. DESIGN: Inception cohort followed up from birth to an average age of 5 years. SETTING: Six regional neonatal intensive care units in a contiguous geographic area. PARTICIPANTS: Four hundred twenty-five very low-birth-weight children, born between August 1, 1988, and June 30, 1991, of 438 located among 626 whose parents provided follow-up information before neonatal intensive care unit discharge. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Diagnosis of cerebral palsy and standardized scores for self-care, mobility, and social function from the Pediatric Evaluation of Disability Inventory. RESULTS: Cerebral palsy was present in 12.6\% of the children, with no change after surfactant introduction. Intraventricular hemorrhage (odds ratio, 2.3 per grade; 95\% confidence interval, 1.8-2.8) and bronchopulmonary dysplasia (odds ratio, 2.3; 95\% confidence interval, 1.2-4.6) were independently predictive of cerebral palsy and of functional outcome. For self-care, mobility, and social function, 11.7\%, 29.5\%, and 10.7\% of the children, respectively, scored at least 2 SDs below the normative means. Social function was 0.25 to 0.50 normative SDs lower after general surfactant availability than before general surfactant availability. Conclusions: While there was no increase in major disability after surfactant introduction, there may have been a decrease in social function associated with the lower neonatal mortality. Most very low-birth-weight children functioned within the normal range in everyday tasks. Several predictors of outcome were identified.}, added-at = {2014-07-19T20:58:54.000+0200}, author = {Palta, M. and Sadek-Badawi, M. and Evans, M. and Weinstein, M. R. and McGuinnes, G.}, biburl = {https://www.bibsonomy.org/bibtex/2a6e7a7fa94c36a6f0eb7d3c51f9d37fa/ar0berts}, groups = {public}, interhash = {b3209c8476de2981309cd24dee8cf69d}, intrahash = {a6e7a7fa94c36a6f0eb7d3c51f9d37fa}, journal = {Arch Pediatr Adolesc Med}, keywords = {Bronchopulmonary Dysplasia; Cerebral Palsy; Child Development; Child, Preschool; Cohort Studies; Disability Evaluation; Female; Follow-Up Humans; Infant, Newborn; Very Low Birth Weight; Intensive Care Units, Neonatal; Male; Pulmonary Surfactants; Self Care; Socioeconomic Factors; Time Factors}, month = Jan, number = 1, pages = {23--30}, pmid = {10632246}, timestamp = {2014-07-19T20:58:54.000+0200}, title = {Functional assessment of a multicenter very low-birth-weight cohort at age 5 years. Newborn Lung Project.}, username = {ar0berts}, volume = 154, year = 2000 }