1541 RELATIONSHIP BETWEEN PERINATAL FACTORS AND NEUROLOGIC OUTCOME OF VERY LOW BIRTH WEIGHT INFANTS

Abstract

Relationship between maternal, perinatal and nursery factors to neurologic outcome of infants with birthweight (BW) ≤1500g were evaluated. Two hundred-eleven infants born from Jan. 1979 - Dec. 1981 were discharged from the nursery and 159 (75.4%) were followed to a minimum of 40 weeks chronologic age corrected for prematurity. Multiple maternal demographic, medical, socioeconomic, perinatal and obstetrical factors were evaluated. The incidence of these factors in BW categories of ≤1000g and 1001-1500g and their significance related to abnormal neurologic outcome was evaluated. There were no differences in incidence of maternal or obstetrical factors in the two BW categories. Infants with BW ≤1000g had a greater incidence of seizures, respiratory distress syndrome, necrotizing enterocolitis and multiple infections in the nursery than the larger infants (p<0.025).

Nineteen infants (12%) of the entire group were neurologically abnormal on follow-up, including 5 of the 15 infants with BW ≤ 1000g (33%) and 15 of the 144 infants with BW 1001-1500g (10%). (p<0.05) There were no differences in incidence of maternal or obstetrical factors between neurologically normal or abnormal infants. A greater incidence of 1 min Apgar score ≤4, need for ventilatory assistance, apnea and seizures in the nursery (p<0.05) was found in the abnormal group. In summary, neither maternal or obstetrical factors related to BW or to neurologic outcome. Postnatal complications were found more often in very tiny infants and in those neurologically abnormal on follow-up.

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