| Improved survival rate with decreased neurodevelopmental disability in extreme immaturity |
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Ga Won Jeon1, Myo Jing Kim1, Sung Shin Kim2, Jae Won Shim3, Yun Sil Chang1, Won Soon Park1, Mun Hyang Lee1 |
1Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
2Department of Pediatrics, Bucheon Hospital, Soonchunhyang University, College of Medicine, Bucheon, Korea
3Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea |
| 초극소저출생체중아의 생존율 향상에 따른 장기 신경발달 장애의 감소 |
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전가원1, 김묘징1, 김성신2, 심재원3, 장윤실1, 박원순1, 이문향1 |
1성균관대학교 의과대학 삼성서울병원 소아청소년과
2순천향대학교 의과대학 부천병원 소아청소과
3성균관대학교 의과대학 강북삼성병원 소아청소과 |
Correspondence:
Won Soon Park, Email: wspark@smc.samsung.co.kr
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| Abstract |
Purpose
: The aim of this study was to determine whether improved survival of extremely low birth weight infants (ELBWI) was associated with decreased neurodevelopmental disability later in life, and also to identify the factors influencing this disability.
Methods
: ELBWI admitted to the neonatal intensive care unit of Samsung Medical Center, survived, and followed up until the corrected age of 18 months were enrolled. They were divided into two groups according to admission time: period I (1994-1999, n=36) and period II (2000-2004, n=98). Clinical data were collected retrospectively from the medical records.
Results
: Survival rates increased from 60.0% to 74.7%, cerebral palsy rates decreased from 22.2% to 8.2% and catch-up growth rate increased from 25.0% to 51.0% during period I and II. Despite less gestational age and birth weight, ELBWI during period II had less periventricular leukomalacia (PVL), sepsis and bronchopulmonary dysplasia compared to period I. The highest risk factors for cerebral palsy were intraventricular hemorrhage (IVH) (≥Grade III), failure of catch-up growth and PVL.
Conclusion
: In summary, improved viability was associated with decreased neurodevelopmental disability in ELBWI. Improved neonatal care with resultant decrease in PVL and IVH, and better nutritional support seem to be primarily responsible for this improved outcome. |
| Key Words:
Cerebral palsy, Developmental disabilities, Infant, Premature |
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