The very low birth weight infant: the broader spectrum of morbidity during infancy and early childhood.

Neonatal intensive care has improved very low birth weight (less than 1.5 kg) outcome. To evaluate the spectrum of morbidity related to this care, 505 survivors born between 1975 and 1979 were followed during the first three years of life. Transient neurological abnormalities of muscle tone which resolved by two years of age were seen in 40% of children. The incidence of chronic physical disease (lung disease, sequelae of necrotizing enterocolitis, and cholestatic jaundice) was 23% at term, 12% by 8 months, and 3.3% by 20 months. Subnormal weight for age at three years was found in 17% of infants born appropriate for gestational age and 46% of those born small for gestational age. Thirty-three percent of children were rehospitalized during infancy, 10% during their second year, and 10% during their third year of life. Mean IQ was 92.0. In the total population 80.6% were considered normal, 1.7% had major congenital malformations, 10.1% had neurosensory abnormalities, and 7.6% had developmental delay (DQ or IQ less than 80). Close followup care is essential to ensure the eventual adaptation and functional normalization which occurs in the majority of these high-risk infants.