INTRODUCTION Improved survival rates of neonates with very low birth weight (<1500 g) have led to a higher incidence of neurodevelopmental sequelae. OBJECTIVE Examine neurodevelopment outcomes over the first two years of life of infants who weighed <1500 g at birth, in relation to birth weight, gestational age and 1-minute and 5-minute Apgar scores, in a Havana tertiary care hospital. METHODS A case-series study was conducted to assess neurodevelopment outcomes of very low birth weight infants over their first two years of life. The study population comprised 116 surviving neonates with very low birth weight (<1500 g), born in the Dr Ramón González Coro University Maternity Hospital in Havana, Cuba, 2006–2010. A longitudinal, multidisciplinary and interdisciplinary follow up of all infants’ neurodevelopment was performed, from hospital discharge to age two years, corrected for gestational age at birth. Data on each infant’s perinatal variables were collected: birth weight in grams, gestational age at birth, and 1-minute and 5-minute Apgar scores. Patients were classified as having normal neurodevelopment, mild abnormalities and moderate-to-severe abnormalities. Pearson’s chi-square test was used to determine possible relationships between perinatal variables studied and neurodevelopment, with exact sampling distribution and 95% confidence level. RESULTS Normal neurodevelopment was observed in 69% of very low birth weight infants, 25.9% had mild abnormalities, and 5.2% displayed moderate-to-severe abnormalities. The results demonstrate a statistically significant relationship between gestational age and neurodevelopmental outcomes; more neurodevelopmental abnormalities were found in infants born at earlier gestational age (<30 weeks). CONCLUSIONS Surviving very low birth weight neonates with lower gestational age at birth face a higher risk of neurodevelopmental abnormalities.

INTRODUCTION: The objective of present study was to describe the neurodevelopment during the first 2 years of life of the first Cuban newborns underwent high frequency ventilation (HFV) in oscillatory modality. METHODS: A longitudinal and descriptive study was conducted in 19 newborns treated with HFV and the final assessment of neurodevelopment was related to some perinatal variables and to the ventilation type. RESULTS: There were neonates (21%) presenting with neurodevelopment alterations. Course was normal in all those weighing less than 2000 g at birth, and in the 40% of the series weighing 2500 or more. There were alterations in the 13% of pre-term neonates and in the 50% of at-term births, as well as a slight predominance of normality in male sex (82% versus 75%). There was only one patient with a low and a sustained Apgar score from the 4 with sequelae. Neurodevelopment course was normal in 89% of those underwent to high frequency ventilation during 8 hours or more; in 30% we found alterations from those underwent to ventilation during less than 48 hours. Almost all the neonates underwent to ventilation during more than 96 hours, including those presenting sequelae. CONCLUSIONS: The fifth part of newborns underwent high frequency ventilation had neurodevelopment sequelae during the first 2 years of life with a predominance of the moderate ones. This ventilation modality by itself was not associated with a higher sequelae incidence, which were more frequent in neonates with higher weight and gestational age. With less time in high frequency and a total higher time in ventilation therapy, greater was the incidence of neurodevelopment alterations.

INTRODUCCIÓN. El objetivo de este estudio fue describir el neurodesarrollo en los primeros 2 años de vida de los primeros recién nacidos (RN) cubanos que recibieron ventilación de alta frecuencia (VAF) en la modalidad oscilatoria. MÉTODOS. Se realizó un estudio descriptivo y longitudinal de 19 RN tratados con VAF y se relacionó la evaluación final del neurodesarrollo con algunas variables perinatales y del modo de ventilación. Se utilizaron medidas descriptivas, tales como valores absolutos y porcentajes. RESULTADOS. Hubo un 21 % de neonatos con alteraciones del neurodesarrollo. La evolución fue normal en todos los menores de 2000 g de peso al nacer y en el 40 % del grupo de 2500 g y más. Hubo alteraciones en el 13 % de los neonatos pretérmino y en el 50 % de los nacidos a término. Existió un ligero predominio de normalidad en el sexo masculino (82 % frente al 75 %). Hubo un solo paciente con Apgar bajo sostenido, de los 4 que presentaron secuelas. La evolución del neurodesarrollo fue normal en el 89 % de los ventilados con alta frecuencia por 48 h o más; se detectaron alteraciones en el 30 % de los que la recibieron por menos de 48 h. Casi todos los neonatos fueron ventilados por más de 96 h, incluidos los que presentaron secuelas. CONCLUSIONES. La quinta parte de los RN sometidos a VAF presentaron secuelas del neurodesarrollo en los primeros 2 años de vida, con predominio de las moderadas. Esta modalidad de ventilación en sí misma no estuvo asociada a una mayor incidencia de secuelas, las que fueron más frecuentes en los neonatos de mayor peso y mayor edad gestacional. A menor tiempo en alta frecuencia y mayor tiempo total en ventiloterapia, mayor fue la incidencia de las alteraciones del neurodesarrollo.