lONG TERM neurodevelopmental prognosis very low birth weight infants

Purpose: We aimed at researching the problems of ?32 weeks of gestation or long term neurodevelopmental problems of ?1500 g babies and the factors affecting neurological disease in our study, in addition this study we aimed at enabling new diagnosed cases to have the required supportive treatment. Material and Method: At January 2000-December 2010 In Adnan Menderes University Faculty of Medicine, Child Health and Diseases Department, Neonatal Intensive Care Unit (NBIC), total 66 case neurological examination, development test, cranial MRI of which is made were taken into study from 169 cases, the birth weight which is ? 1500 g, which has ?32 week of gestation. The features that can affect neurodevelopmental prognosis belonging to prenatal and neonatal period of the cases were recorded. The neurological examination of the cases included in the study, gross motor functions, gross motor classifying system (GMCS), fine motor functions were evaluated by Two Hands Fine Motor Function (THFMF) Scoring. Each case under 6 years old was administered DENVER II developmental screening test; to the ones who are 6 years old and older were applied Wechsler Intelligence Scale of chidren - Revised developed for children (WISC-R) and each cases were administered cranial MRI (Magnetics Resonance Imaging). Results: The cases who are from 20 to 123 months (average age 46,14± 19,31 months), 66 cases were taken into study, 34 of whom are girls (51,5%). The average gestation age of the cases were 29,5 ± 1,77 (25-31,6) gestational weeks, birth weights were 1255±254,2 g (700-2100g). Neurological examination of 17 cases (25,8 %) were abnormal. 9 cases (13,5%) were taken cerebral palsy diagnosis, three of them were taken diagnosis by this study. 7 of them (77,7%) had spastic diplegia, 2 of them had spastic tetraparesis all of cerebral palsy cases. 42 (63,6%) of 57 cases who were administered Denver II developmental screening test were impairment to their ages. Intelligence functionality level and general functionality of all administered WISC-R were normal. In cranial MRI, (PVL) white matter lesion was found in 18,2% of the cases, cortical/subcortical lesion in 1,5% and basal ganglia/thalamus lesion in 1,5% and in 4,6% of them the other anomalies were obtained. Of the prenatal period features which had negative effect on neurodevelopment; a meaningful relation between polyhydramniosis and abnormal neurological examination (p=0.015) and development tests (p=0,046) was found. A meaningful relation between placentae previa and abnormal neurological examination (p=0,063?0,05) and abnormal cranial MRI (p=0,006) findings was found. A meaningful relation between IVF (p=0,021), passive smoking (p=0,047), chorioamnionitis (p=0,042), having urinary tract infection during gestation (p=0,043), ablatio placentae (p=0,023) and abnormal development tests was found. The relation between male from the neonatal features and cranial MRI (p=0,001) abnormality, advanced stage (Stage 3-4) ROP and neurological examination abnormality (p=0,008) and cranial MRI abnormality (p=0,020); between advanced stage IVK and PVL and neurological examination (respectively p=0,003; p=0,001) abnormalities was statistically meaningful. Conclusion: In this study which long term neurodevelopmental disorders in babies with VLBW were dealt with, the most important risk factors for neurological prognosis were that placentae previa, advanced stage IVK, PVL and ROP. Understanding these and predictive value of similar prenatal and neonatal morbidities well, and also, increasing the parents information on this subject is important in terms of predicting the special needs in neonatal period, early infantility, childhood, adolescence and adult years. Minimizing morbidity which will be carried to adolescence and adulthood can be enabled by providing the essential background for early diagnosis and rehabilitation service in respect of the problems which can be experienced in follow-up and by making the children?s potential lead to the highest.