Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Republic of Korea,
Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Neonatology. 2024;121(1):74-80. doi: 10.1159/000534194. Epub 2023 Oct 20.
This study aimed to investigate the outcomes of infants at 18-24 months born in the Korean Neonatal Network with a birth weight <500 g.
The anthropometric and neurodevelopmental data of infants with a birth weight <500 g at a gestational age of ≥22 weeks who were registered in the Korean Neonatal Network 2013-2017 and followed up at a corrected age of 18-24 months were reviewed. Neurodevelopmental impairment was defined as the presence of any of the following: (1) cerebral palsy; (2) severe visual impairment; (3) hearing impairment; or (4) cognitive impairment. Cognitive impairment was defined as (1) a Bayley Scales of Infant Development-II Mental Development Index score <70; and (2) Bayley Scales of Infant and Toddler Development-III Cognitive and Language Composite scores <85. Cognitive testing was performed for infants with suspected problems upon clinician's referral to developmental specialists.
At a median corrected age of 20 months, 26/52 (50%) of included infants had neurodevelopmental impairment. Cerebral palsy, severe visual impairment, wearing of glasses, hearing impairment, and cognitive impairment occurred in 22%, 0%, 8%, 5%, and 57% of the included infants, respectively. The proportions of infants with <2 standard deviations of weight, length, and head circumference were 54%, 52%, and 56%, respectively. The majority (70%) of infants were rehospitalized, and the most common cause was respiratory problems.
Half of infants with a birth weight <500 g in Korea may exhibit neurodevelopmental impairment and growth retardation at a corrected age of 18-24 months. Multidisciplinary follow-up along with continuous rehabilitation will be needed to improve neurological and physical development in this special population.
本研究旨在调查在韩国新生儿网络中出生体重＜500g 的婴儿在 18-24 个月时的结局。
回顾了在韩国新生儿网络 2013-2017 年注册、胎龄≥22 周且出生体重＜500g、在纠正年龄 18-24 个月时随访的婴儿的人体测量学和神经发育数据。神经发育障碍定义为存在以下任何一种情况：（1）脑瘫；（2）严重视力障碍；（3）听力障碍；或（4）认知障碍。认知障碍定义为：（1）贝利婴幼儿发育量表-II 精神发育指数得分＜70；（2）贝利婴幼儿发育量表-III 认知和语言综合得分＜85。有认知问题的婴儿由临床医生转介给发育专家进行认知测试。
在中位纠正年龄为 20 个月时，纳入的 52 名婴儿中有 26 名（50%）存在神经发育障碍。脑瘫、严重视力障碍、戴眼镜、听力障碍和认知障碍分别发生在纳入婴儿中的 22%、0%、8%、5%和 57%。体重、身长和头围＜2 个标准差的婴儿比例分别为 54%、52%和 56%。大多数（70%）婴儿需要再次住院，最常见的原因是呼吸系统问题。
在韩国，出生体重＜500g 的婴儿在纠正年龄 18-24 个月时，约有一半可能存在神经发育障碍和生长迟缓。为改善该特殊人群的神经和身体发育，需要多学科随访和持续康复。
