%0 Journal Article %1 Monset-Couchard1996 %A Monset-Couchard, M. %A de Bethmann, O. %A Kastler, B. %D 1996 %J Biol Neonate %K Brain Diseases; Cerebral Palsy; Child Behavior Disord; Dwarfism; Female; Follow-Up Studies; Gestational Ag; Hearing Disorders; Humans; Infant, Newborn; Very Low Birth Weight; Language Male; Mental Retardation; Motor Skills; Vision e; ers %N 6 %P 328--338 %T Mid- and long-term outcome of 89 premature infants weighing less than 1,000 g at birth, all appropriate for gestational age. %V 70 %X OBJECTIVE: Advances in obstetrical and neonatal care have achieved dramatic reductions in the mortality of extremely low birth weight infants, but concerns regarding the long-term neurodevelopmental prognosis have increased. The study was performed to assess the physical and developmental status of premature infants weighing < 1,000 g at birth who were appropriate for gestational age (AGA). METHODS: A follow-up study including school level, physical and developmental examination and/or interviews of parents, pediatricians, teachers and social workers was carried out from January 1, 1981 to December 31, 1991, on 176 subjects who had been AGA premature neonates weighing < 1,000 g and were admitted to the Port Royal Neonatal Intensive Care Unit. Eighty-nine survived (50 girls, 39 boys). Five children were lost to follow-up after 3 years of age. Neurological sequelae, developmental and/or intellectual quotients, school level and results, vision, hearing, language, weight, height, and behavior were evaluated. RESULTS: At the last evaluation, 37\% of children were completely normal (24\% had always been normal); 52\% were normal in the 4th year of life, decreasing to 31\% in the 8th year. Minor disabilities increased from 31\% in the 4th year to 53\% in the 8th year. Moderate disabilities ranged yearly between 8 and 14\%. Five children had major handicaps diagnosed before 3 years of age (4 cerebral palsies following severe neonatal brain lesions and 1 severe retardation with renal dwarfism). No difference was found between children with or without bronchopulmonary dysplasia. Twelve children (14\%) had hearing loss (3 deafness) and 27 (32\%) had visual deficits (no blindness). Nursery school begins at 3 for French children: 86\% of the followed survivors were at nursery school at 3 years of age, 74\% of 6-year-olds were in the first grade, primary school, and 50\% of 7-year-olds were in second grade. Half the children with high socioeconomic/cultural risks had some school difficulties. Similar results were collected from various cross-sectional studies in the recent literature. CONCLUSIONS: While 20\% of the children had moderate to severe disabilities, an increasing number of minor deficiencies appeared with age. Socio-economic/cultural factors had a deleterious effect even in structurally normal children, but they had an even worse effect in children with minor deficiencies, owing largely to the frequent lack of proper management at home.

@article{Monset-Couchard1996, abstract = {OBJECTIVE: Advances in obstetrical and neonatal care have achieved dramatic reductions in the mortality of extremely low birth weight infants, but concerns regarding the long-term neurodevelopmental prognosis have increased. The study was performed to assess the physical and developmental status of premature infants weighing < 1,000 g at birth who were appropriate for gestational age (AGA). METHODS: A follow-up study including school level, physical and developmental examination and/or interviews of parents, pediatricians, teachers and social workers was carried out from January 1, 1981 to December 31, 1991, on 176 subjects who had been AGA premature neonates weighing < 1,000 g and were admitted to the Port Royal Neonatal Intensive Care Unit. Eighty-nine survived (50 girls, 39 boys). Five children were lost to follow-up after 3 years of age. Neurological sequelae, developmental and/or intellectual quotients, school level and results, vision, hearing, language, weight, height, and behavior were evaluated. RESULTS: At the last evaluation, 37\% of children were completely normal (24\% had always been normal); 52\% were normal in the 4th year of life, decreasing to 31\% in the 8th year. Minor disabilities increased from 31\% in the 4th year to 53\% in the 8th year. Moderate disabilities ranged yearly between 8 and 14\%. Five children had major handicaps diagnosed before 3 years of age (4 cerebral palsies following severe neonatal brain lesions and 1 severe retardation with renal dwarfism). No difference was found between children with or without bronchopulmonary dysplasia. Twelve children (14\%) had hearing loss (3 deafness) and 27 (32\%) had visual deficits (no blindness). Nursery school begins at 3 for French children: 86\% of the followed survivors were at nursery school at 3 years of age, 74\% of 6-year-olds were in the first grade, primary school, and 50\% of 7-year-olds were in second grade. Half the children with high socioeconomic/cultural risks had some school difficulties. Similar results were collected from various cross-sectional studies in the recent literature. CONCLUSIONS: While 20\% of the children had moderate to severe disabilities, an increasing number of minor deficiencies appeared with age. Socio-economic/cultural factors had a deleterious effect even in structurally normal children, but they had an even worse effect in children with minor deficiencies, owing largely to the frequent lack of proper management at home.}, added-at = {2014-07-19T20:48:38.000+0200}, author = {Monset-Couchard, M. and de Bethmann, O. and Kastler, B.}, biburl = {https://www.bibsonomy.org/bibtex/253e64dcb98eb86d6efe46d75f23f3e9a/ar0berts}, groups = {public}, interhash = {31e53f26d2131a8b9eeffe7668f0ccd8}, intrahash = {53e64dcb98eb86d6efe46d75f23f3e9a}, journal = {Biol Neonate}, keywords = {Brain Diseases; Cerebral Palsy; Child Behavior Disord; Dwarfism; Female; Follow-Up Studies; Gestational Ag; Hearing Disorders; Humans; Infant, Newborn; Very Low Birth Weight; Language Male; Mental Retardation; Motor Skills; Vision e; ers}, number = 6, pages = {328--338}, pmid = {9001694}, timestamp = {2014-07-19T20:48:38.000+0200}, title = {Mid- and long-term outcome of 89 premature infants weighing less than 1,000 g at birth, all appropriate for gestational age.}, username = {ar0berts}, volume = 70, year = 1996 }