Improved survival rates have heightened emphasis on the long-term outcome
of infants born at very low-birth-weight (VLBW) and extremely low-birth-weight
(ELBW). Medical or physical, neurological, cognitive, academic, neuropsychological,
motor, social, emotional or behavioral, functional, and health-related quality
of life are all outcomes of interest.1- 2 Previously,
the incidence of major disabilities, such as moderate or severe mental retardation,
cerebral palsy, epilepsy, blindness, and sensorineural hearing loss, was the
greatest concern because of the severity of developmental morbidity. Over
the last decade, the incidence of these disabilities has remained constant,
ranging from 15% to 20%, with higher incidence corresponding to lower birth
weight and gestational age.3 In addition, more
subtle cognitive impairments have been detected in survivors without major
disabilities. These high-prevalence/low-severity dysfunctions include learning
disabilities, borderline intellectual functioning, attention-deficit/hyperactivity
disorders, specific neuropsychological deficits, and behavioral problems,4 and reportedly occur in 50% to 70% of VLBW infants.5- 6