Increased morbidity in low-birth-weight survivors with severe retrolental fibroplasia

Abstract

Fourteen (2.2%) of 645 survivors with birth weight less than or equal to 1500 gm cared for in the Special Care Nursery between 1975 and 1981 were identified as having stage III-IV retrolental fibroplasia (RLF) in one or both eyes. These 14 survivors and 14 controls matched for birth weight have been observed for 2 to 7 years. There were no differences between survivors with RLF and controls in birth weight, gestation, multiple neonatal risk factors, or Hollingshead socioeconomic status. The only significant difference was in prolonged O2 requirements (greater than 2 weeks) (13 of 14 patients vs 7 of 14 control infants (P less than 0.025) and prolonged assisted ventilation requirements (21 +/- 15 for RLF vs 6 +/- 10 days for control infants, P less than 0.05). Follow-up assessments showed that the RLF survivors had a significantly higher incidence of neurologic abnormality, lower developmental quotients, increased requirements for special education, increased number of hospitalizations for illness, and more maternal stress as observed in the mother's adapted Life Experience Survey. We conclude that low-birth-weight infants with stage III-IV RLF are at a higher risk for neurodevelopmental problems and that their families are in need of comprehensive support services.