Kresnawati Windhi, Pandie Peter John, Rohsiswatmo Rinawati
Department of Child Health, Gatot Soebroto Military Hospital, Jakarta, Indonesia.
Department of Child Health, Biak General Hospital, Papua, Indonesia.
Front Pediatr. 2025 May 1;13:1581033. doi: 10.3389/fped.2025.1581033. eCollection 2025.
Preterm birth and very low birth weight (VLBW) remain major contributors to neonatal morbidity and mortality, particularly in low-income settings such as Indonesia, where healthcare resources are limited. In response, the Ministry of Health introduced mentoring programs in 2014, followed by intensive neonatal training initiatives in 2015. These interventions substantially improved survival rates for LBW infants however, they face significant growth and developmental challenges. This study aims to investigate the growth and development of VLBW infants in remote area at five years of age.
Data were collected retrospectively between September 2021 and May 2022 from children born between 2016 and 2017 with VLBW (<1,500 grams) at Biak Regional Hospital, Indonesia. Growth parameters, including stunting and wasting and developmental outcomes such as cerebral palsy, blindness, and developmental impairment or delays were assessed after 5 years of age for follow up assessment.
Among 78 identified infants with VLBW, 54 infants (69.2%) with a gestational age of <34 weeks were discharged alive between 2016 and 2017. Their gestational ages ranged from 27 to 33 weeks, with birth weights between 625 and 1,400 grams. Overall, 12 infants died before reaching one year of age while five died after one year. The 1-year survival rate was 77.8%, while 5-year survival rate was 68.5%. The incidences of stunting, wasting, cerebral palsy, and blindness were 32.1%, 46.4%, 21.4%, and 10.7%, respectively.
The high prevalence of growth and developmental impairments highlights the need for sustained multidisciplinary efforts to improve long-term outcomes for VLBW infants. In resource-limited settings, the focus should extend beyond survival to ensure optimal growth and development of the children.
早产和极低出生体重（VLBW）仍然是新生儿发病和死亡的主要原因，尤其是在印度尼西亚等医疗资源有限的低收入地区。作为回应，卫生部于2014年推出了指导计划，随后在2015年开展了强化新生儿培训举措。这些干预措施大幅提高了低出生体重婴儿的存活率，然而，他们面临着重大的生长和发育挑战。本研究旨在调查偏远地区极低出生体重婴儿5岁时的生长和发育情况。
2021年9月至2022年5月期间，对印度尼西亚比亚克地区医院2016年至2017年出生的极低出生体重（<1500克）儿童进行回顾性数据收集。在5岁时进行随访评估，评估生长参数，包括发育迟缓、消瘦以及脑瘫、失明、发育障碍或发育迟缓等发育结局。
在78名确定的极低出生体重婴儿中，54名（69.2%）孕周<34周的婴儿于2016年至2017年期间存活出院。他们的孕周在27至33周之间，出生体重在625至1400克之间。总体而言，12名婴儿在1岁前死亡，5名在1岁后死亡。1年生存率为77.8%，5年生存率为68.5%。发育迟缓、消瘦、脑瘫和失明的发生率分别为32.1%、46.4%、21.4%和10.7%。
生长和发育障碍的高患病率凸显了持续开展多学科努力以改善极低出生体重婴儿长期结局的必要性。在资源有限的环境中，重点应从生存扩展到确保儿童的最佳生长和发育。
