OBJECTIVE: To evaluate the incidence of neonatal morbidity (NM), and developmental impairments (DIs) of very low (VLBW) and extremely low birth weight (ELBW) infants born in 2000-2009. DESIGN: Epidemiological study. SETTING: Outpatient clinics for children with perinatal risk at the regional neonatal centers. METHODS: Data on live born, specific neonatal mortality (SNM) and NM data were taken from the database the database of Institute of Health Information and Statistics of Czech Republic (IHIS CR). The incidence of DIs (cerebral palsy - CP, developmental delay - DD, growth retardation and sensory impairment) was evaluated at 24 months corrected age. Each cohort included newborn infants born always in the two-year periods.. Comparison of the incidence of DIs according to the birth-weight or to gestational age was performed in children born in 2009. RESULTS: 1. NM - in VLBW newborns, CNS morbidity and early indecisions decreased slightly (i.e. by 7 and 5%), other forms remained unchanged. In ELBW infants, CNS morbidity declined by 13.9% (p<0.05), early infections only by 5% (NS). - 2. DIs: - in VLBW infants, cerebral morbidity and early infections were reduced slightly (i.e. by 7 and 5% resp.). In ELBW category, CP decreased by 12%, and visual impairment by 9% (p<0.05). - 3. The occurrence of DIs by birth weight or gestational age did not differ, only in children <1000 g, in comparison with the group of <28 wks, was delayed growth increased by 6% (NS). - 4. In 2000-2007, SNM rate and also number of disabled children declined continuously. During period 2008-2009, in contrast to the previous 8 years, incidence of impaired children in both categories increased slightly (by 3%, and 1%, resp., NS). CONCLUSION: During the study period, SNM declined continuously, especially in the ELBW category. We managed to partially reduce NM (CNS and early infection), the problem remained late infection. In the period 2000-2007, incidence of DIs decreased, significantly in case of CP and visual impairment in ELBW children. Surprisingly in the last two years 2008-2009, there appeared in both categories an increase in the proportion of children with disabilities. It is a worrying finding, which should be re-evaluated.

• MeSH
• kojenecká mortalita MeSH
• lidé MeSH
• novorozenec s extrémně nízkou porodní hmotností * MeSH
• novorozenec s velmi nízkou porodní hmotností * MeSH
• novorozenec MeSH
• předškolní dítě MeSH
• vývojové poruchy u dětí etiologie   MeSH
• Check Tag
• lidé MeSH
• novorozenec MeSH
• předškolní dítě MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

OBJECTIVE: To describe the incidence of developmental impairments (DI) among very low birth weight (VLBW) infants at 24 months' corrected age, born in perinatal centers in 1997-2007, and evaluate their changing prognosis of intact development. DESIGN: Prospective epidemiological study. SETTING: Follow-up clinics of neonatal centers level III. METHODS: Live birth rate, in-hospital mortality, neonatal morbidity, DI and quality of survival were assessed. Neonatal morbidity was analyzed in periods 2000/2, 2003/5, and 2006/7 by the data of Institute of Health Informatics and Statistics. DI and quality of survival were evaluated in cohorts of VLBW infants born in 1997/9 (period I), 2000/2 (period II), 2003/5 (period III) and 2006/7 (period IV). RESULTS: Live birth rate of VLBW newborns in 1997-2007 increased in total of 39.5%, in-hospital mortality decreased, significantly in 1997-9 (fall of 10%). Neonatal morbidity, except infections, also declined. Significant decrease in DI-CP and visual impairment, was observed after period II, in category 1000-1499 g of 7/1.5%, in infants <1000 g of 8/7% resp. After period II, the prevalence of impaired children 1000-1499 g decreased of 5%, whereas in category < 1000 g only small decrease of 2% occurred in period III. Number of children without impairment increased gradually in both categories. CONCLUSIONS: The study showed significant increase in surviving VLBW infants, especially in category <1000 g. Increased survival rate at concurrent fall in severe neonatal morbidity (except infections) was not accompanied with worsened prognosis of an intact development.

• MeSH
• kojenecká mortalita MeSH
• lidé MeSH
• mozková obrna diagnóza   etiologie   MeSH
• nemoci novorozenců diagnóza   mortalita   MeSH
• novorozenec s extrémně nízkou porodní hmotností * MeSH
• novorozenec s velmi nízkou porodní hmotností * MeSH
• novorozenec MeSH
• poruchy sluchu diagnóza   etiologie   MeSH
• poruchy zraku diagnóza   etiologie   MeSH
• předškolní dítě MeSH
• prognóza MeSH
• vývoj dítěte * MeSH
• Check Tag
• lidé MeSH
• novorozenec MeSH
• předškolní dítě MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH