developmental outcomes for premature babies

[Stephanie__0]

  What are the typical developmental delays that might occur for preemies born about 9 weeks premature, weighing
  1700g, who experienced episodes of apnea, respiratory distress and grade II intraventricular hemorrhage?
  Also, what roles might professionals like Social Workers, physical therapists, speech pathologists and psychologists
  play during his first three years of life.  

[HFHS.RN-AM]

Dear Stephanie,
There are no "typical" developmental delays for each of these conditions in any child. There are however risks for complications, and the risk varies with the severity of each condition and the child's overall health.
Premature infants often experience periods of apnea, which is cessation of breathing for greater than 20 seconds duration (this time may vary from institution to institution). Apnea resolves by itself over time as the child's systems mature, but are vey frightening for the caregivers as the potential outcome is death. Prior to discharge from the NICU, the parents must receive CPR training and monitors set up in the home for detection of apneic events. Often the infant is put on medications that help reduce the risk, these include caffeine and theophylline. Other measures to prevent SIDS include putting the baby to sleep on his back, not using pillows and use of a firm mattress. Brain injury occurs when there is lack of oxygen to supply the brain cells. This generallly takes 5 minutes or more.
Respiratory distress is not unusual in a 31 week infant because the lungs have yet to reach maturity. The risk decreases each year however due to administering steroids to the mother as well as giving the newborn Survanta to mature the lungs. Chronic Lung Disease (otherwise known as Bronco Pulmonary Dysplasia) results from prolonged mechanical ventilation of the immature lung, usually resolves by the time the child is two, but puts the child at increased risk of infection ans respiratory problems during that time. There are not cognitive, motor of neurological delays merely due to respiratory problems. There would occur if the brain experienced hypoxia due to respiratory distess.
A Gr. II intraventricular bleed is a moderate bleed into the venticles of the brain. There is no dilatation of the ventricle, and therefore no brain compression. There is a 10% risk of a major disability, but this is the same as if there was no bleed at all. There is however a slightly higher risk for learning difficulties which become apparent arounf schoolage.
In most NICUs, followup is done by a multidisciplinary team until the child is 2 or 3. These teams include all those people yoiu mentioned, and are only involved if evaluation warrents following.  Thorough developmental assesments are done every few months to be sure that the child is reaching predicted milestones.
HFHS.RN-AM
*KEYWORD:    Cerebral Palsy, Apnea of Prematurity, Intraventicular Hemmorage, Chronic Lung Disease, Broncho Pulmonary Dysplasia