A Longitudinal Study of Very Low‐birthweight Infants. II: Results of Controlled Trial of Intensive Care and Incidence of Handicaps

Abstract

Between 1966 and 1970, infants with birthweights between 1000 and 1500g entered a randomized controlled trial to determine the short-term and long-term results of neonatal intensive care. Of 158 long-term survivors, 5 were lost to follow-up, but the multidisciplinary research team prospectively followed 143 children up to the age of 8 yr. Useful data were available for the other 10 children. Of the long-term survivors 74 had received routine and 84 had received intensive nursery care. At 8 yr of age there were no statistically significant differences in the frequencies of a variety of individual abnormalities; fewer of the intensively managed children had cerebral palsy, but sensorineural deafness and ocular abnormalities occurred more frequently. Individual chidren were graded into 4 carefully defined groups: profound handicap (4.4% of entire study group); severe handicap (10.1%); significant handicap (37.3%); and trivial or no handicap (41.8%). Inadequate data were available for 6.3% of the children. The improved survival attributed to intensive neonatal care was achieved at the expense of additional severely handicapped children and this feature is discussed.