95 Family Functioning and Long-Term Outcome of Infants ≥1500 Birth Weight and/or 31 Weeks Gestation Admitted to the Tertiary Care NICU for the Maritime Provinces

The Neonatal Intensive Care Unit (NICU) has a diverse population of infants with varying gestations and diagnoses. While outcomes in extremely premature neonates have been extensively studied, there is a lack of information regarding long-term outcome and family functioning in more mature infants.

To determine the developmental and behavioral outcomes in infants admitted to a NICU and to assess the global functioning of their families 5-7 years later.

A descriptive cohort study of infants ≥1500 gms birth weight and/or ≥31 weeks gestation admitted from January 1996 to December 31, 1997 to the tertiary care NICU servicing the Canadian Maritime provinces. Patients admitted for <6 hours were excluded. Acuity at admission was measured by SNAP (Score of Neonatal Acute Physiology) and was linked to outcomes, as defined by the CBCL (Child Behavior Checklist), the PSI (Parenting Stress Index) and the CDI (Child Development Inventory), done at 5–7 years of age. Further information regarding parental demographics and information on childhood illness was obtained by questionnaire at the same time. A chart review done at 5–7 years obtained information regarding: APGAR score, admitting diagnosis, birth weight, gestation, need for ventilation and cord Ph at birth.

1359 infants' charts were reviewed. 8 infants died since discharge, 60.9% of infants were term, and 17.9% were growth restricted. The admission SNAP was significantly higher in preterm infants (p=0.0217) and in growth restricted infants (p=0.002). 415 (31%) families responded to the mailed questionnaires. The mean age of the children at the time of questionnaire completion was 5.9 years (std 0.47). There were no differences between responders and nonresponders for: sex, gestation, birth-weight, and growth restriction. There were significantly more single mothers (p<0.0001) and younger mothers (p<0.0001) among the nonre-sponders. The mean general Development Index on the CDI was 65 (std 10.01), indicating age appropriate functioning. 15% of the respondents had a clinically significant Total Stress score as measured by the PSI.

Based on the CDI, children who were admitted to the NICU show age appropriate functioning overall, yet their families report clinically significant stress levels. Other indices of child development will be reported. Post-discharge is warranted in this population and their families to provide appropriate support.