Neurosensory outcome and growth at three years in extremely low birthweight infants:: follow-up results from the Swedish national prospective study

A prospective national investigation comprising 633 extremely low birthweight (ELBW) infants born alive in the 2-y period 1990-1992 with a birthweight of less than or equal to 1000 g and gestational age of greater than or equal to 23 completed weeks was conducted regarding neurosensory outcome and growth, Three-hundred and sixty-two (98%) surviving ELBW infants were assessed at a median age of 36 months, using a specially designed protocol. At follow-up, mean height, weight and head circumference in both boys and girls were significantly lower than the reference values. The incidence of cerebral palsy was 7% among all children and 14%, 10% and 3% in children born at 23-24, 25-26 and greater than or equal to 27 gestational weeks, respectively. At least one obvious handicap was present in 14%, 9% and 3% of these three groups of children, respectively. After adjustment for gestational age, a significantly increased risk of handicap was found in children with intraventricular haemorrhage grade greater than or equal to 3 and/or periventricular leucomalacia and in children with retinopathy of prematurity stage greater than or equal to 3. The results show that more than 90% of ELBW children born at greater than or equal to 25 completed gestational weeks were without neurosensory handicap at 36 months of corrected age. In infants born at 23-24 weeks of gestation, both survival and long-term outcome were less favourable.