Major Morbidity
General
The definition of major handicap in most follow-up studies includes the following conditions:
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While blindness and deafness are usually permanent conditions, the other two problems often change over time. This emphasizes the importance of longterm follow-up and reassessment. However, in 2005, it was reported that only 23% of pediatricians used a standardized screening tool, such as the Denver, for their ex-premature patients. Reported barriers to more widespread use included time limitations, lack of trained staff and inadequate reimbursement.The increased survival of ELBW babies in the 1990s, compared to earlier years, has already been mentioned. A recent review has also documented increased morbidity rates. This study compared two periods, 1982-89 and 1990-98, for babies 500-1000 grams Bwt. While survival rates increased from 49% to 67%, major handicap rate also increased from 26% to 36%. Longterm follow-up studies are difficult to coordinate, expensive and both time- and labor-intensive. Therefore, they usually categorize babies into larger GA/Bwt groups than those tracking survival only. The accompanying page represents a sample of the latest outcome data.Return to top of page