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A better understanding of the developmental problems in extremely low birth weight (ELBW) preterm infants may enhance their chances of proper adaptation to their environment and make it possible to retrospectively assess perinatal and neonatal methods of treatment. The aim of the study was to evaluate the cognitive and motor development of ELBW children born from 2002 to 2004 in the 7th year of life. Based on these results and perinatal mortality data, it was established what chance the children have to live free of severe complications.Two hundred and four alive newborns with birth weight .1000 g were born in the Malopolska voivodship between 1.09.2002 and 31.08.2004. One hundred and fifteen children (56%) died in early infancy. The study included 81 (91%) children out of the 89 surviving ones. Their mean gestational age at birth was 27.3 weeks. (SD: 2.1 weeks) and their mean birth weight was 840g (SD: 130g). Neurosensory disturbances were assessed in all the children and their cognitive development was evaluated with the use of the WISC-R (Wechsler Intelligence Scale for Children . Revised) scale. The children were divided into 3 groups: group I . normal development (full motor capacity and IQ84 points and no vision or hearing impairment), group II . mild or moderate impairment (cerebral palsy level I, II or III according to the Gross Motor Function Classification System [GMCS], or IQ 40-84 points, or abnormal vision or hearing, or signs of the hyperactivity syndrome), group III . severe impairment (cerebral palsy level IV, and/or IQ40 points, or deafness/blindness).Forty-five (56%) children were included in group I, 25 (30%) in group II and 11 (14%) in group III. Moreover, other neurologic abnormalities, such as uneven development, problems with concentration, or abnormal grapho-motor ability were highly prevalent in the group of ELBW children. The incidence of cerebral palsy in the population studied was 16%, the incidence of deafness and severe hearing impairment was 11%, and blindness and severe vision impairment . 12%. In general, the chance of survival free of severe complications was merely 15% in children with birthweight .700 g, 28% in children with birth weight 701- 800 g, 45% in children with birth weight 801-900 g, and 62% in children with birth weight 901-1000 g.1. The data gathered in a regional study may yield valuable information useful in assessing the prognosis of the general health status of ELBW newborns. 2. Most of the children present uneven development, problems with concentration, or abnormal grapho-motor ability, which may be a cause of learning problems and abnormal relationships with peers. 3. A follow-up study up to adulthood is required for this group of ELBW newborns.

Children born with extremely low birth weight often present delayed growth in the first years of their lives: they remain shorter and weigh less than their peers. Current reports published worldwide state that later in life these children are at an increased risk of cardiac and vascular diseases, diabetes and obesity. Abnormal distribution and the excess of fat tissue predispose them to develop the metabolic syndrome. THE AIM of the study was to evaluate the somatic development of seven-year-old children born with birth-weight ≤1000 g (ELBW) in the Malopolska voivodship and to estimate the content and distribution of fat tissue. Moreover, the risk factors of disturbed somatic development were evaluated.Two hundred and four live newborns with birth weight ≤1000 g were born in the Malopolska voivodship between 1.09.2002 and 31.08.2004. One hundred and fifteen of these children (56%) died in early infancy. The study included 81 children in the 7th year of life out of the 89 surviving ones. Their mean gestational age at birth was 27.3 weeks. (SD: 2.1 weeks) and their mean birth-weight was 840 g (SD: 130 g). All the children underwent anthropometric measurements and the thickness of the skin fold over the triceps was measured. Body mass index (BMI) was calculated and the body composition was assessed by multifrequency bioimpedance. The control group consisted of 39 children born at term chosen randomly from the general population and matched with regard to age and sex.The ELBW children in the 7th year of life were shorter (z-score: -1.06±1.4 p0.001), had lower body mass (z-score: -0.57±0.9; p=0.01), smaller head circumference (z-score: -1.2±1.3; p0.001), lower BMI (z-score: -0.99±1.6; p0.001) as compared to their peers. Fat tissue mass was lower in the ELBW group than in the control group (11% vs 16%; p0.01). The most retarded somatic development was observed in the group of children suffering from cerebral palsy.1. Children born with ELBW, at 7 years of life, present significantly retarded somatic development as compared with their full-term peers. 2. The most important risk factor of somatic development disturbances is cerebral palsy. 3. Children born with low birth weight and ELBW, need long term follow up.

The assessment of psychomotor and somatic development at the age of 2 years of preterm infants with and without bronchopulmonary dysplasia (BPD).Case -- control study.Neonatal Intensive Care Unit, University Hospital.62 preterm infants born before 32 weeks of gestation, with mean birth weight equaled to 1112 g were included into 2 groups: group A -- with BPD (n=31), group B (control) -- matched by sex, birth weight, gestational age (n=31).Evaluation of reaching milestones, neurological examination at 3, 9, 12, 18-24 months, Psyche-Cattel tests at 12 and 24 months, hearing and visions examinations, head, chest circumference, length and weight at 3, 6, 9, 12 and 24 months.Age of unsupported sitting and walking, intelligence quotient (IQ), cerebral palsy, hearing and sight impairment.Reaching motor milestones were similar in the both groups (unsupported sitting (mean) 10.4 vs. 8.7 months, unsupported walking: 15.1 vs. 13.9 months). Cerebral palsy occurred more (non-significantly) frequently in group A than in group B (7/31 vs. 2/31, p=0.15). Significantly lower IQ was found in group A at the age of 1 year in comparison with group B (x +/- SEM: 79.9 +/- 2.1 vs. 86.1 +/- 1.5, p=0.03) and at the age of 2 years (x +/- SEM: 89.2 +/- 2.7 vs. 96.0 +/- 2.1, p=0.06). Weight, length, head and chest circumferences at the term of delivery were similar in the both groups, but at the age of 9 and 24 months the group A children weighted less than group B (respectively: 7432 vs. 8128 g, 10010 vs. 11116; p0.05) and at the age of 24 months were significantly shorter (816 vs. 848 mm, p=0.04).Bronchopulmonary dysplasia significantly influences intellectual and somatic development of preterm newborns.

The diagnosis and prophylaxis of developmental dysplasia of the hip (DDH) is still controversial. In particular the role of the clinical examination and US scan of the hip is discussed in the medical literature.The aim of the study is to present our experience with diagnostic problems in DDH, and especially to present the value of the clinical examination in diagnosing patients with DDH requiring orthopedic treatment.During 36 months clinical and ultrasonographic examination with Graf's method was performed in 972 infants (1944 hips, 511 girls, 461 boys) at the mean age of 9 weeks. The sensitivity, specificity, positive and negative predictive values (PPV, NPV) of clinical examination of the hip in the diagnosis of DDH requiring orthopedic treatment were assessed.The diagnosis of pathologic dysplasia according to Graf's criteria was made in 5.7% of patients. More than half of them (3.5% of all investigated group) had no obvious clinical signs of dysplasia, even among children with most advanced dysplasia (0.25% of the cohort). Sensitivity of the clinical examination in detecting patients with DDH requiring treatment was 46%, specificity -- 92%, PPV -- 28%, NPV -- 96%.Clinical examination alone has little value in DDH diagnosis and screening. Large percentage of treated DDH had no obvious pathologic signs in clinical examination -- were clinically 'silent'. We postulate performing US scan screening in all infants with positive risk factors and positive for DDH clinical examination up to the 6th week of life. In all other children US scan of the hips should be advised up to the end of 12th week of life.