Related Factors Of Neurodevelopmental In Extremely Low And Very Low Birth Weight Infants

Objective: To study developmental outcomes of extremely low birth weight infants(ELBWI) and very low birth weight infants(VLBWI) at correct age of 18 months, and to investigate risk factors of neurodevelopmental outcomes.Method: Selected ELBWI and VLBWI in Hunan Children's hospital neonatal intensive care unit from January 2013 to June 2014. Patients were followed up to correct age of 18 months, observing head circumference, weight and assessing neuraldevelopment by Neonatal Behavioral Neurological Test(NBNA) at correct age of 40 weeks, or Infant intelligence development scale at correct age of 1, 3, 6, 12 and 18 months. The patients were divided into neurodevelopmental normal group and abnormal group, risk factors of neurodevelopmental impairment(NDI) were analyzed with Logistic regression.Results:1. A total of 338 ELBWI and VLBWI were included in the study,15 cases died during hospitalization.There were 323 cases who weresurvival and dischanged and were followed up to correct age of 18 months. And there were 75 patients(23.2%) died, 145 patients(44.9%)survived and completed follow-up, 103 patients(31.9%) were lost.There was no significant difference in clinical data of patients between follow-up group and lost group(p>0.05).2. Among the 145 cases, the incidence rate of head circumference and weight growth retardation were the highest at correct age of 3 months,then decreasing as the age growing. Totally 71 cases(49%) got NDI, 3cases(2.1%) diagnosed with cerebral palsy, one of them with cerebral palsy and epilepsy. Blind in eyes and hearing damage requiring hearing aid were not found in any of the babies.3. Neurodevelopmental abnormal group had longer mechanical ventilation time, oxygen time(t=5.370,p<0.001;t=4.330,p<0.001)and higher proportion in dexamethasone(?2=6.808,p=0.012)and rate of head circumference growth retardation(?2=9.154,p=0.004) than normal group.Neurodevelopmental abnormal group had higher proportion in Bronchoplumonary Dysplasia(BPD) and sepsis than normal group.Logistic regression showed BPD and sepsis were both independent risk factors to NDI(OR=3.479,p<0.001;OR=2.622,p=0.029). The more severe BPD was, the higher risk of NDI.Conclusions:1. ELBWI/VLBWI are in high incidence rate of NDI.2.BPD and sepsis are risk factors of neurodevelopmental impairment in ELBWI and VLBWI, especially severe BPD.