Differential Outcomes Associated with Early Medical Complications in Premature Infants

This study evaluated the effects of several early medical complicationson the intellectual and motoric development of premature verylow birth weight (VLBW) infants. A large cohort of prematureinfants was grouped according to the following complicationsat birth: (a) intraventricular hemorrhage with respiratory distresssyndrome (IVH-RDS); (b) respiratory distress syndrome withoutintraventricular hemorrhage (RDS-no IVH); (c) bronchial-pulmonarydysplasia without IVH (BPD); (d) bronchial-pulmonary dysplasiawith IVH(BPD-IVH); and (e) hydrocephalus (HYD) secondary toIVH. These complications are frequently associated with prematurityand were hypothesized to have differential effects on laterdevelopmental outcome. Premature infants in the five diagnosticgroups received the Bayley Scales of Infant Development at 6,12, and 24 months of age. Results reveal that the IVH-RDS andRDS-no IVH infants perform similarly and show performance inthe average range for their chronological age by 24 months.In contrast, the infants in the BPD and HYD groups have generallylower scores, which remain in the delayed range throughout thefollow-up period. These results show that IVH is associatedwith poorer intellectual outcomes only when it is accompaniedby BPD or progressive hydrocephalus. In addition, longer periodsof hospitalization, which are associated with BPD, have a significantlynegative effect on later outcome. The implication of these resultsfor early intervention is discussed.