[Neurologic follow-up of the premature infant with very low birth weight].

The most recent studies on premature infants with low birth weights (less than 1500 grams) and extremely low birth weights (less than 1000 grams), other than confirming the spectacular drop in mortality in these subjects, have evaluated their neuropsychic development and the extent of the handicaps over the long term. The major handicaps (cerebral paralysis, mental retardation) have considerably decreased in the survivors, if one makes exception for cases with birth weights less than 750 grams (which present sequelae in high percentages, even if reported differently in the few works published). Minor handicaps (neuropsychological and behavioral defects) are maintained on relatively high levels (20-30% of subjects that survive). There is no doubt that the handicaps of these children may in large part be lead back to ischemic cerebral injuries and/or hemorrhages, well documented today in their evolution from neuroradiological technologies. The mechanism of neurological damage is, however, complex, both in its origin and in its development. Other factors contribute to this as well, among which environmental conditions seem to have an importance that can't be ignored. This applies especially for minor handicaps, which clearly predominate in premature infants of less advantaged social classes. At any rate, the neuropsychic development of premature infants with low birth weights is very individualized and difficult to predict, also because there is still much uncertainty about the value of neonatal prognostic indexes. In the course of the first year of life, neuromotor anomalies can be detected that then spontaneously disappear. In other cases, a more delayed recuperation, even if partial, can be obtained with delays in neuromotor development.(ABSTRACT TRUNCATED AT 250 WORDS)