Differential Outcomes Associated with Early Medical Complications in Premature Infants

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Abstract
This study evaluated the effects of several early medical complications on the intellectual and motoric development of premature very low birth weight (VLBW) infants. A large cohort of premature infants was grouped according to the following complications at birth: (a) intraventricular hemorrhage with respiratory distress syndrome (IVH-RDS); (b) respiratory distress syndrome without intraventricular hemorrhage (RDS-no IVH); (c) bronchial-pulmonary dysplasia without IVH (BPD); (d) bronchial-pulmonary dysplasia with IVH(BPD-IVH); and (e) hydrocephalus (HYD) secondary to IVH. These complications are frequently associated with prematurity and were hypothesized to have differential effects on later developmental outcome. Premature infants in the five diagnostic groups received the Bayley Scales of Infant Development at 6, 12, and 24 months of age. Results reveal that the IVH-RDS and RDS-no IVH infants perform similarly and show performance in the average range for their chronological age by 24 months. In contrast, the infants in the BPD and HYD groups have generally lower scores, which remain in the delayed range throughout the follow-up period. These results show that IVH is associated with poorer intellectual outcomes only when it is accompanied by BPD or progressive hydrocephalus. In addition, longer periods of hospitalization, which are associated with BPD, have a significantly negative effect on later outcome. The implication of these results for early intervention is discussed.