Five-year-follow-up of very low birthweight infants: neurological and psychological outcome.

All surviving infants with birthweight < or = 1500 g born in 1982 and 1983 at St. James's University Hospital, Leeds, were followed up for 5 years. There were 88 survivors (including 5 in utero transfers) from the original cohort of 126 infants. In their fifth year the following assessments were made: neurological, audiological, intellectual, behavioural, growth and general health. A comparison group of full-term male infants was also studied with respect to intellectual status, social and emotional behaviour and general health. Principal neurological impairments found were: cerebral palsy 9 (10.2%), hydrocephalus 1 (1.1%), epilepsy 2 (2.3%) and sensorineural deafness 2 (2.3%). One third of the VLBW children required the services of the child development centre. Seventy-nine of the 88 VLBW children were tested with the WPPSI. Seven (8.8%) scored below 70. The VLBW boys had mean IQ scores of 90.6 while the mean for the girls was 100.2. The very low birthweight boys were significantly intellectually impaired compared with their peers. Socially and emotionally they were largely comparable with their full-term peers. The findings suggest that there has been no increase in severe disability following a policy of active neonatal intensive care. However, the quality of survival of VLBW children born in the 1980s, despite improvements in perinatal care, remains a major concern.