Date of Award:
Doctor of Philosophy (PhD)
Technological advances in neonatal care have dramatically improved the survival and disability rates among low birthweight infants (LBW). One common factor associated with later problems among these babies is intraventricular hemorrhage (IVH). A meta-analysis was conducted among LBW infants with and without IVH to determine developmental outcome. More than 450 studies were located. Only 125 studies met inclusion criteria.
Mean effect sizes were computed by comparing the LBW group to either a fullterm children, LBW children scored worse in all areas except gross motor skills.
Cognitive assessment was done commonly up to 6 years of age. LBW infants scored about 1/2 standard deviation below their comparison group. A positive linear trend was found for severity of IVH: those children without an IVH scored comparably to fullterm children, while those with severe bleeds were about one standard deviation behind.
Assessment of academic skills was done with the 8- to 11-year olds. There was no information given on presence/severity of IVH. Very few assessments were done. On general academic measures, the LBW children scored about 1/2 standard deviation behind the comparison group.
Over 80% of the language assessments were done at 15- to 38-months of age. LBW children tended to score 1/2 to 3/4 of a standard deviation below the comparison group. The severity of hemorrhage did not mediate these results.
Fine motor assessments were performed on children 9 months to 11 years old. LBW children were about 2/3 of a standard deviation behind the comparison group. These skills were not affected by severity of IVH.
Gross motor abilities were typically measured before the children were 24 months old. LBW children showed more deficits in this area than in any other: almost 90% of a standard deviation behind. Gross motor skills appear to be strongly impacted both by being low birthweight and by the severity of IVH.
Results indicate that IVH is a mediating factor in outcome among LBW infants. More research needs to be conducted on these children when they are school age, so long-term effects of low birthweight can be determined.
Thompson, Shannon G., "Intraventricular Hemorrhage Sequelae in Low Birthweight Infants: A Meta-analysis" (1993). All Graduate Theses and Dissertations. 6066.