Abstract 1520 Neonatal Epidemiology and Follow-up Poster Symposium, Monday, 5/3

Single site ELBW studies report diverse neonatal and follow-up data. The purpose of this ELBW study is to evaluate site factors which may affect neonatal morbidity and 18 month neurodevelopmental outcomes. The sample consists of 1151 VLBW infants born between 1/93 and 12/94 and evaluated at 18+6m between 11/94 and 2/97. Neonatal registry data and family SES data were collected. It was hypothesized that sites with a larger percentage of economically disadvantaged mothers would have poorer neonatal outcomes and increased neurodevelopmental morbidity at 18 months. Neonatal data and family SES were collected. The children were evaluated at 18 + 4 mo corrected age by certified examiners with the Bayley II Scales of Infant Development and a neurologic examination. Summary data for the 12 sites are shown as the median, minimum and maximum values. Analyses were by chi square. (Table) Significant site differences were identified for all SES variables, neonatal therapies, and outcomes. Logistic regression analyses controlling for birth weight and gestation confirmed independent site effects on Bayley MDI, Bayley PDI and neurologic exam (p<.0001) outcome at 18 months. These inter site variations may obliterate or accentuate established relationships between specific morbidities and outcome. Site differences should be taken into consideration when interpreting multi center outcome studies, particularly in comparisons with a single site.

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