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1249 Development Outcome of Extreme Preterm Infants at 2 Years; has the Outcome Changed Over Last Few Years?
  1. O Narayan
  1. Paediatrics, Princess Royal University Hospital, Orpington, UK

Abstract

Background and Aims Extremely low and very low gestational age (ELGA and VLGA) constitutes a risk factor for development even in absence of cerebral damage, as an immature central nervous system is exposed to invasive and inadequate stimulation. Different developmental trajectories emerged in relation to GA, with poorer developmental outcomes and higher rates of impairment in ELGAs and few mild impairments in VLGAs.

Method A retrospective Audit was done. All new-borns at Princess Royal University Hospital, Orpington, UK (< 30+0) between Jan 2008–Dec 2009 were included.

The parameters were as follows:

  • Gender

  • Gestation

  • Significant Neonatal intervention

  • Referred by hospital for dev asses or not

  • Assessed by community Paediatrcians or not

  • Assessed at 2 years or not (H/C)

  • Referred to portage services or not if delay

  • Development delay if any

  • Outcome documented or not

Results Total no of cases:

  • 2008: 26

  • 2009: 23

  • Total: 49

  • 47 eligible (as 2 had died)

  • 10 (from out of borough or moved out so not followed up) so 37 eligible

  • 29/37 (78%) followed up

Delay

  • Severe 6 (21%)

  • Mild 9 (31%)

  • No delay 14(48%)

These results are very similar to EPICure studies done in 2006.

Conclusions Children born prematurely still have a higher chance of physical impairment, 3–5 times higher rate of cognitive deficits at 6 years, 2–3 times higher risk of psychiatric diagnosis at 11–12 years. (EPICure).

To have the best possible outcome of these children one should follow them in a multidisciplinary team possibly in an integrated care pathway.

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