Long-term morbidity of extremely preterm born infants

Background. The limit of viability in extremely preterm born infants has decreased over the last few years. However, the focus on treatment concepts has now been put on life quality and morbidity. Due to a great variability of development in early childhood, follow-up tests are necessary. Methods. The data of 6-8 year olds were collected retrospectively and compared to existing follow-up data at the age of 24 months. Neurodevelopmental disability was categorized into four groups (normal, mild, moderate, severe); cerebral palsy was assessed according to the GMFCS (Gross Motor Function Classification System) score. A total of 43 preterm infants born at 23 (0/7) to 26 (6/7) weeks gestational age were included. They were born between 1996 and 2001 and admitted to the neonatal intensive care unit in Graz. Results. At the age of 6-8 years, 30% showed normal development, 39% mild, 5% moderate, and 26% severe developmental delay. Compared to the age of 2 years, 33% of the children improved in development from a moderate to a mild developmental delay. Five children (12%) were diagnosed with a cerebral palsy (GMFCS I-IV) at the age of 6-8 years. However, in two of them diagnosis was confirmed only after the age of 2 years. 38% of the children attended an elementary school, 13% remained an extra year in the kindergarten or at preschool level. In all, 36% attended an integrative school class and 13% were sent to a school for mentally and physically disabled children. Conclusion. The majority of extremely pre-term born infants showed normal development or a mild developmental delay with, however, good quality of life and normal school enrollment.