Disappointing follow-up findings for indigent high-risk newborns
R. E. Lasky, J. E. Tyson, C. R. Rosenfeld, D. Krasinski, S. Dowling and N. F. Gant
Indigent populations have received little attention in neonatal follow-up
studies. We conducted "blinded" evaluations one year past term for 204
indigent high-risk infants who were ventilator treated or had a very low
birth weight (VLBW) (less than or equal to 1500 g) and 85 healthy term
controls from families similar to those of the high-risk infants. Marked
developmental delay (Bayley Mental Developmental Index, less than 70) or
gross motor abnormality occurred in 2% of controls, 27% of VLBW infants,
33% of ventilator-treated infants, and 39% of ventilator-treated VLBW
infants. Despite considerable effort to prevent attrition, 43% of high-risk
survivors were unavailable for follow-up at the one-year visit. Even if all
of these infants were assumed to be normal, the incidence of developmental
delay exceeded that in 11 of 12 recent studies. Indigent high-risk infants
deserve considerable follow-up attention because of their high rate of
attrition and developmental delay.
