Variables which influence the neurodevelopment at 2 years of newborns born less than 32 weeks of gestational age or less than 1,500 g

Abstract

Introduction: Children with very low birth weight have a high risk of complications in the neonatal period and neurodevelopment impairment is a major sequel. Objective: To analyze how perinatal variables influence neuro­develop­ment at 2 years of age in newborns with less than 32 weeks of gestational age (GA) or less than 1,500 g at birth. Methods: Retrospective descriptive study of all records of the National Registry of Very Low Weight (VLBWNT) and clinical information from 2009 to 2012. We considered a major sequel: the need for auditory prosthesis, blindness, cerebral palsy or developmental quotient below 80. Statistical analysis performed with STATA® v13, considering a level of statistical significance of 0.1. Results: Registration of 348 newborns. Exclusion of 88: 26 transferred and 62 deaths. Of the 260 included, 152 (58.5%) had a regular follow-up. There were no significant differences between groups with or without follow-up, except for SNAPPE 2 index and patent ductus arteriosus persistence. The p50 of the GA was 30 w, the p50 of the birth weight was 1,200 g and 62% did not have major sequels. The female gender has a lower risk of sequels, compared to male (OR 0.5493; p: 0.0990). The presence of grade 3 intraperiventricular hemorrhage (IPVH) represents an 11-fold higher risk of sequels, compared to grade 0 (OR 11.78; p: 0.002) Conclusion: An assessment at 2 years of age showed a high percentage of children with sequels, being at greater risk the male gender and severe IPVH. This study is important because it brings information important to organize the health system in order to meet the special needs of this population.

Keywords

• very low birth weight
• neurodevelopment
• prematurity
• sequel