Survival after being born too soon, but at what cost?
1999; Elsevier BV; Volume: 354; Issue: 9176 Linguagem: Inglês
10.1016/s0140-6736(99)00150-6
ISSN1474-547X
Autores Tópico(s)Infant Nutrition and Health
ResumoThe survival rate of very preterm infants has been increasing steadily in recent decades. 1 Blackman JA Neonatal intensive care: is it worth it? Developmental sequelae of very low birthweight. Pediatr Clin North Am. 1991; 38: 1497-1511 PubMed Google Scholar , 2 Perlman M Claris O Hao Y et al. Secular changes in the outcomes to eighteen to twenty-four months of age of extremely low birth weight infants, with adjustment for changes in risk factors and severity of illness. J Pediatr. 1995; 126: 75-87 Summary Full Text Full Text PDF PubMed Scopus (21) Google Scholar Although the remarkable advances in medical care and technology that have permitted this secular trend are commendable, there are undercurrents of concern about the quality of life for such children in later life. 3 Hack M Fanaroff AA Outcomes of children of extremely low birthweight and gestational age in the 1990s. Early Hum Dev. 1999; 53: 193-218 Summary Full Text Full Text PDF PubMed Scopus (465) Google Scholar Many have learning difficulties or behavioural problems when they get to school, and up to half require additional help or facilities. 4 Hille ET den Ouden AL Bauer L van den Oudenrijn C Brand R Verloove-Vanhorick SP School performance at nine years of age in very premature and very low birth weight infants:perinatal risk factors and predictors at five years of age. Collaborative Project on Preterm and Small for Gestational Age (POPS) Infants in The Netherlands. J Pediatr. 1994; 125: 426-434 Summary Full Text PDF PubMed Scopus (187) Google Scholar , 5 Horwood LJ Mogridge N Darlow BA Cognitive, educational, and behavioural outcomes at 7 to 8 years in a national very low birthweight cohort. Arch Dis Child Fetal Neonatal Ed. 1998; 79: F12-F20 Crossref PubMed Scopus (196) Google Scholar Yet there has been no consensus among published studies, even those of high-risk groups of extremely low birthweight infants (<1000 g) (eg, 6 Finnstrom O Otterblad Olausson P et al. Neurosensory outcome and growth at three years in extremely low birthweight infants:follow-up results from the Swedish national prospective study. Acta Paediatr. 1998; 87: 1055-1060 Crossref PubMed Google Scholar ). This situation may reflect variation in study design rather than real differences in reproductive casualty. Nevertheless, it is important to establish benchmarks for the success of neonatal intensive care in representative samples.
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