696 24 months Kyo Yeon Koo, et al. • Long term outcome in ELBW infants 2) Examination of poor prognosis between 18 months and infants was analyzed by Chi-square test (or Fisher’s exact test) and multiple logistic regression analysis was performed. For statistical The poor outcome of ELBW infants was divided broadly analysis, the SAS v9.1 (SAS Institute Inc, Cary, NC) was used. A P into two categories and examined. The two categories were (1) value of less than 0.05 was considered to be statistically significant. whether the infant died after a postmenstrual age of 36 weeks and (2) whether the findings of impairment such as CP, delayed development, hearing loss, blindness, etc. were found between the corrected ages of 18 months and 24 months. CP and delayed development were determined based on the evaluation of specialists Results 1. General characteristic of the subject patients and their mother of the rehabilitation department at our hospital. CP was defined The average gestational age of the subject infants was 27.6±2.1 as non-progressive motor disorder resulting in physical disability, (24.5-33.5) weeks, and the mean birth weight was 816±126 g (520 chiefly in the area of body movement. In addition to such CP, -990). 51 (64%) infants were male, 29 (36%) were female and the cases with developmental delay of more than 2 standard 14% were born by the IVF-ET procedure (Table 1). The mean age deviations (95%) on neurologic examination and which underwent of mothers was 31±4 years with premature rupture of membrane rehabilitation as well as physical therapy were included in the in 13 patients (16 %); 27 mothers (33%) were administered ‘delayed development’ category. Hearing loss was defined as more steroids prior to birth, and 28 had chorioamnionitis confirmed than 55dB by brainstem evoked response audiometry (BERA) pathologically or by bacteria culture (Table 2). 22). Blindness was defined as corrected vision of 20/200 or lower with almost absent peripheral vision based on the judgment of ophthalmologists of our hospital. 3) Statistical analysis The association of the 4 neonatal severe morbidities with ELBW occurred after the postmenstrual age of 36 weeks and CP, delayed Table 1. Baseline Characteristics of Infants Characteristics Birth weight* (g) Gestational age* (wk) Sex Male Female Delivery mode C-sec NSVD Multiple gestation IVF-ET IUGR 1 minute APGAR* 5 minute APGAR* Hospital day* Ventilator duration* (d) Oxygen duration* (d) HMD Air leak syndrome PDA NEC No. (%) 816±126 27.6±2.1 51 (64) 29 (36) 67 (84) 13 (16) 65 (81) 11 (14) 40 (50) 2.4±0.3 4.3±1.8 105±39 42±42 64±46 72 (90) 4 ( 5) 36 (45) 3 ( 4) Range 520-990 24.5-33.5 0-5 0-7 47-309 2-308 4-308 *Values are mean±SD Abbreviations: SD, standard deviation; C-sec, cesarean delivery; NSVD, normal spontaneous vaginal delivery; IVF-ET, in vitro fertilization and embryo transfer; IUGR, intrauterine growth restriction; APGAR, Apgar score; HMD, hyaline membrane disease; PDA, patent ductus arteriosus; NEC, necrotizing enterocolitis *Values are mean±SD †Increased or decreased fetal heart rate during a contraction or late deceleration on non-stress test (NST) Abbreviations: SD, standard deviation; PROM, premature rupture of membranes; PIH, pregnancy induced hypertension 2. The relationship of neonatal morbidities and poor prognosis The association of the 4 neonatal morbidities (severe BPD, severe brain injury, severe ROP, and severe PNAC) with death development, blindness, and hearing loss developing between 18 months and 24 months were analyzed, and the odds ratio (OR) obtained. In univariate analysis, the OR of severe BPD was 3.2 (95 % Confidence interval [CI], 1.0-9.8, P =0.037), the OR of severe brain injury was 5.1 (95 % CI, 1.6-16.2, P =0.004), the OR of severe ROP was 3.0 (95 % CI, 1.2-7.6, P =0.017), and the OR of severe PNAC was 5.7 (95 % CI, 1.1-29.5,P =0.038), and these were significantly associated with poor long term outcomes. The number of patients of each category of poor outcome and their percentage were distinguished and presented. Of the Table 2. Baseline Characteristics of Mothers Characteristics Age* (y) PROM PROM* (hr) Antenatal steroid Chorioamnionitis PIH Placenta abruption Fetal distress† No. (%) 31±4 13 (16) 138±75 27 (33) 28 (35) 33 (41) 5 ( 6) 29 (37)