Physical growth and neurodevelopmental outcome of nonhandicapped low-risk children born preterm.

BACKGROUND: Outcome studies on the effects of prematurity are increasingly restricted to extremely immature infants with birth weight below 1000 g or gestational age below 26 weeks. In contrast, studies comprising low-risk preterm infants are rare. AIM: To examine growth and neurodevelopmental outcome, 70 low-risk low birth weight (LBW) children without neurological impairment were followed from birth to 7 years of age. At 7 years of age, LBW children were compared to a matched control group born at term. METHODS: Postnatal growth was measured at 20 months in the LBW group and at 7 years in LBW and control children. At 20 months, the LBW group was assessed with the Griffiths Scales. At 7 years, LBW and control children were assessed with a neuropsychological test battery comprising tests for language, visual-perceptual, visual-motor, fine and gross motor abilities. RESULTS: At 7 years of age, the frequency of children with low (3rd-9th percentile) or subnormal (<3rd percentile) growth parameters was increased in the LBW group. The Mean Griffiths Developmental Quotient (DQ) of the preterm group was normal (102.3+/-8.4), and there were only two results below DQ 85. There was no difference between 49 children appropriate for gestational age and 21 small for gestational age (SGA) children. At 7 years of age, reduced mean test results in the range of -0.5 SDS were observed for language and visual-motor abilities in the preterm group. This was due to an increased frequency of LBW children with moderately (SDS -1.0 to -2.0 SDS) subnormal test results. Even for the slightly LBW group (2000 to 2499 g), poorer language abilities were confirmed. CONCLUSION: All LBW infants, including low-risk populations, should be included in a follow-up program in order to detect deficits early in life and begin treatment before school entry.

Kangaroo transport instead of incubator transport.

OBJECTIVE: Compared with in utero transport, incubator transport for preterm infants has several disadvantages including instability during transport with increased mortality and morbidity, lack of adequate systems for securing the infant in the event of an accident, and separation of mother and infant. As a new kind of postnatal transportation that bears some analogy to in utero transport and may be safer than incubator transport, we investigated kangaroo transport, transporting the infant on the mother's or other caregiver's chest. This article presents a description and preliminary data for kangaroo transport. DESIGN: We conducted kangaroo transports of 31 stable preterm and term infants in different settings and recorded data regarding transport conditions and cardiorespiratory stability. Eighteen transports were back transfers, and 13 were transfers in. Twenty-seven transports were conducted by the mother, 1 by the father, 2 by nurses, and 1 by a doctor. Transport distance was 2 to 400 km. RESULTS: Heart rate, respiratory rate, oxygen saturation, and rectal temperature remained stable during all kangaroo transports lasting 10 to 300 minutes. Weight at transport was 1220 to 3720 g. Parents felt very comfortable and safe and appreciated this method of transport. CONCLUSIONS: Kangaroo transport promotes mother-infant closeness and might ameliorate several of the risks associated with incubator transport.