Background and purpose: Despite general recognition that surviving very-low-birth-weight (VLBW) infants are at risk for neurodevelopmental impairments and educational achievement difficulties, there has been relatively little study on their functional status in areas such as locomotion, communication, cognition, self-care, and interpersonal relationships. This study assessed the functional status of VLBW infants and full-term infants in early childhood, and sought to identify risk factors for functional morbidity.
Methods: A total of 238 VLBW infants and 91 full-term infants were included in this prospective follow-up study. The functional status of the infants was assessed using the Chinese Child Development Inventory (CCDI) and neurodevelopment was evaluated using the Bayley Scales of Infant Development, second version (BSID-II) at 3 years of corrected age. Perinatal and sociodemographic data were collected through review of medical records.
Results: The VLBW infants had lower scores on all the CCDI measures compared with the full-term infants. Functional limitation (defined as more than 2 standard deviations below the means of the full-term infants) occurred more frequently in the VLBW infants than in the full-term infants: gross motor, 23% vs 3%; fine motor, 12% vs 1%; expressive language, 21% vs 2%; comprehension-conceptual, 23% vs 4%; situation comprehension, 17% vs 4%; self-help, 17% vs 1%; and personal-social, 19% vs 3% (all p < 0.01). Significant risk factors associated with functional morbidity included gestational age < 30 weeks, grade III-IV intraventricular hemorrhage, chronic lung disease, stage III-IV retinopathy of prematurity, male gender, and maternal education below high school.
Conclusion: VLBW infants have a higher risk of functional morbidity than their full-term counterparts in early childhood. Infants with functional limitations on CCDI screening might require comprehensive developmental assessment and continued follow-up.