All issues > Volume 37(7); 1994

Original Article

J Korean Pediatr Soc. 1994;37(7):937-945. Published online July 15, 1994.

Meta-analysis of Impact of Neonatal Intensive Care on Neurodevelomental Outcome of Very Low Birth Weight Infants

Beyong Il BI Kim¹, Jung-Hwan JH Choi¹, Chong Ku CK Yun¹

¹Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea

Abstract

We analyzed neurodevelopmental outcome data of 36 selected studies. Data of individual studies were pooled by birth weight group: <800g, <1,000g, <1,500g and by time period of birth year: Period I(pre-intensive care era), 1960-67:Period II(beginning period of intensive care), 1968-76:and Period III(established period of intensive care), 1977-87. In all weight groups, survival and intact outcome rates based on live birth have progressively improved over the three period. The major neurodevelopmental handicap rate of the <1,500g decreased in Period III vs. Period I and Period II(66, 70, and 45 per 1,000 live births in I, II, and III, respectively). However, the major handicap rate in the<800g and the<1,000g live births increased: in the<800g, from 48 per 1,000 live births in Period II to 101 In Period III and, in the<1000g, from 28 per 1,000 live births in Period I to 67 in Period II and 73 In Period III. Increases in major handicap rate in two lower weight groups were predominantly the effect of increasing number of survivors over these periods and had little to do with the change in handicap rates in the survivors. In the<1,500g, the magnitude of reduction in handicap rate in the survivors was sufficient to overwhelm the effect of increased survival, resulting in a reduction in the number of major handicapped children. We conclude that based on the currently available reports, neonatal intensive care has provided very low birth weight infants with a reduction in mortality, an increase in intact outcome, and decrease in the number of major neurodevelopmentally handicapped children. We try to estimate the trend of major neurodevelopmental handicap and intact outcome of infants with birth weights<1,500g in Korea and speculate that major handicap rate have progressively increased over the three period in spite of increase in intact outcome.

Keywords :Neurodevelopmental outcome, Major Handicap, VLBW infants