Frühgeborene unter 1500 g Geburtsgewicht

 

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Zusammenfassung

In Deutschland kommen rund 1,4 % aller Neugeborenen mit einem Gewicht unter 1500 g zur Welt. Im Jahr 2015 waren das 9484 Kinder, von denen 87 % lebend nach Hause entlassen werden konnten. Seit 2006 schreibt der Gemeinsame Bundesausschuss eine Nachuntersuchung dieser Kinder im Alter von 2 Jahren vor, etwa mit den Bayley Scales of Infant Development. In diesem Alter lassen sich Zerebralparesen relativ sicher diagnostizieren, Aussagen zur kognitiven Entwicklung sind aber erst mit etwa 4–5 Jahren einigermaßen verlässlich. Längsschnittdaten aus Niedersachsen der Jahrgänge 2004–2008 weisen nur in 73 % eine übereinstimmende Klassifizierung der gleichen Frühgeborenen (FG) im Alter von 2 und 5 Jahren auf. Die landesweiten Berliner Einschulungsuntersuchungen im Alter von 5–6 Jahren weisen bei 36 % der Kinder unter 750 g Geburtsgewicht und bei 22 % der Kinder zwischen 750 und 1500 g Geburtsgewicht auf einen sonderpädagogischen Förderbedarf hin (gegenüber 5 % bei normalgewichtigen Neugeborenen). Im Alter von 26 Jahren hatten ehemalige Frühgeborene der Bayerischen Entwicklungsstudie (Jahrgänge 1985/86) einen um 7–15 Punkte verringerten Intelligenzquotienten gegenüber Reifgeborenen (RG), sie neigten mehr zu sozialen Ängsten, hatten Schwierigkeiten, einen Partner bzw. eine Part-nerin zu finden und waren häufiger von ihren Eltern abhängig als Kontrollpersonen.

Summary

Preterm infants with a birth weight below 1,500 g comprise approximately 1.4 % of all live-born infants in Germany, amounting to 9484 infants in 2015. Their calculated survival-to-discharge estimate was of 87 %. Follow-up examinations at 2 years of age using the Bayley Scales of Infant Development or similar standardized tests are mandatory since 2006. This time point allows for a robust diagnosis of cerebral palsy but not of cognitive impairment. When preterm infants born 2004–2008 in Lower Saxony were examined both at 2 and 5 years of age, only 73 % were in the same diagnostic categories at both occasions. State-wide school readiness examinations at 5–6 years of age, conducted 2007–2011 in Berlin, diagnosed special educational needs in 36 % of children with a birth weight <750 g, and in 22 % of children with a birth weight of 750–1,500 g, as compared to 5 % of normal birth weight children. Adults born preterm with a birth weight <1,500 g in Bavaria 1985/86 had 7–15 points lower IQ score, displayed more anxiety, complained more about difficulties finding an intimate partner, and had less self-sustained living than controls.

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