Neurodevelopmental Outcomes Following Late and Moderate Prematurity: a Population-based Cohort Study

Overview

Journal Arch Dis Child Fetal Neonatal Ed

Specialties Gynecology & Obstetrics
Pediatrics

Date 2015 Apr 3

PMID 25834170

Citations 101

Authors

Samantha Johnson

T Alun Evans

Elizabeth S Draper

David J Field

Bradley N Manktelow

Neil Marlow

Ruth Matthews

Stavros Petrou

Sarah E Seaton

Lucy K Smith

Elaine M Boyle

Affiliations

Soon will be listed here.

Abstract

Objective: There is a paucity of data relating to neurodevelopmental outcomes in infants born late and moderately preterm (LMPT; 32(+0)-36(+6) weeks). This paper present the results of a prospective, population-based study of 2-year outcomes following LMPT birth.

Design: 1130 LMPT and 1255 term-born children were recruited at birth. At 2 years corrected age, parents completed a questionnaire to assess neurosensory (vision, hearing, motor) impairments and the Parent Report of Children's Abilities-Revised to identify cognitive impairment. Relative risks for adverse outcomes were adjusted for sex, socio-economic status and small for gestational age, and weighted to account for over-sampling of term-born multiples. Risk factors for cognitive impairment were explored using multivariable analyses.

Results: Parents of 638 (57%) LMPT infants and 765 (62%) controls completed questionnaires. Among LMPT infants, 1.6% had neurosensory impairment compared with 0.3% of controls (RR 4.89, 95% CI 1.07 to 22.25). Cognitive impairments were the most common adverse outcome: LMPT 6.3%; controls 2.4% (RR 2.09, 95% CI 1.19 to 3.64). LMPT infants were at twice the risk for neurodevelopmental disability (RR 2.19, 95% CI 1.27 to 3.75). Independent risk factors for cognitive impairment in LMPT infants were male sex, socio-economic disadvantage, non-white ethnicity, preeclampsia and not receiving breast milk at discharge.

Conclusions: Compared with term-born peers, LMPT infants are at double the risk for neurodevelopmental disability at 2 years of age, with the majority of impairments observed in the cognitive domain. Male sex, socio-economic disadvantage and preeclampsia are independent predictors of low cognitive scores following LMPT birth.

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References

Johnson S, Wolke D, Marlow N . Developmental assessment of preterm infants at 2 years: validity of parent reports. Dev Med Child Neurol. 2008; 50(1):58-62. DOI: 10.1111/j.1469-8749.2007.02010.x. View

Fuchs K, Gyamfi C . The influence of obstetric practices on late prematurity. Clin Perinatol. 2008; 35(2):343-60, vi. DOI: 10.1016/j.clp.2008.03.004. View

Chyi L, Lee H, Hintz S, Gould J, Sutcliffe T . School outcomes of late preterm infants: special needs and challenges for infants born at 32 to 36 weeks gestation. J Pediatr. 2008; 153(1):25-31. DOI: 10.1016/j.jpeds.2008.01.027. View

Moster D, Lie R, Markestad T . Long-term medical and social consequences of preterm birth. N Engl J Med. 2008; 359(3):262-73. DOI: 10.1056/NEJMoa0706475. View

Volpe J . Brain injury in premature infants: a complex amalgam of destructive and developmental disturbances. Lancet Neurol. 2008; 8(1):110-24. PMC: 2707149. DOI: 10.1016/S1474-4422(08)70294-1. View

Robinson M, Mattes E, Oddy W, de Klerk N, Li J, McLean N . Hypertensive diseases of pregnancy and the development of behavioral problems in childhood and adolescence: the Western Australian Pregnancy Cohort Study. J Pediatr. 2008; 154(2):218-24. DOI: 10.1016/j.jpeds.2008.07.061. View

Petrini J, Dias T, McCormick M, Massolo M, Green N, Escobar G . Increased risk of adverse neurological development for late preterm infants. J Pediatr. 2008; 154(2):169-76. DOI: 10.1016/j.jpeds.2008.08.020. View

Morse S, Zheng H, Tang Y, Roth J . Early school-age outcomes of late preterm infants. Pediatrics. 2009; 123(4):e622-9. DOI: 10.1542/peds.2008-1405. View

Darlow B, Horwood L, Wynn-Williams M, Mogridge N, Austin N . Admissions of all gestations to a regional neonatal unit versus controls: 2-year outcome. J Paediatr Child Health. 2009; 45(4):187-93. DOI: 10.1111/j.1440-1754.2008.01457.x. View

10.

Hillemeier M, Farkas G, Morgan P, Martin M, Maczuga S . Disparities in the prevalence of cognitive delay: how early do they appear?. Paediatr Perinat Epidemiol. 2009; 23(3):186-98. PMC: 3439196. DOI: 10.1111/j.1365-3016.2008.01006.x. View

11.

Johnson S, Hollis C, Kochhar P, Hennessy E, Wolke D, Marlow N . Autism spectrum disorders in extremely preterm children. J Pediatr. 2010; 156(4):525-31.e2. DOI: 10.1016/j.jpeds.2009.10.041. View

12.

Johnson S, Hollis C, Kochhar P, Hennessy E, Wolke D, Marlow N . Psychiatric disorders in extremely preterm children: longitudinal finding at age 11 years in the EPICure study. J Am Acad Child Adolesc Psychiatry. 2010; 49(5):453-63.e1. View

13.

Gurka M, LoCasale-Crouch J, Blackman J . Long-term cognition, achievement, socioemotional, and behavioral development of healthy late-preterm infants. Arch Pediatr Adolesc Med. 2010; 164(6):525-32. PMC: 3287072. DOI: 10.1001/archpediatrics.2010.83. View

14.

Mackay D, Smith G, Dobbie R, Pell J . Gestational age at delivery and special educational need: retrospective cohort study of 407,503 schoolchildren. PLoS Med. 2010; 7(6):e1000289. PMC: 2882432. DOI: 10.1371/journal.pmed.1000289. View

15.

Johnson S, Seaton S, Manktelow B, Smith L, Field D, Draper E . Telephone interviews and online questionnaires can be used to improve neurodevelopmental follow-up rates. BMC Res Notes. 2014; 7:219. PMC: 3983863. DOI: 10.1186/1756-0500-7-219. View

16.

Mathiasen R, Hansen B, Andersen A, Forman J, Greisen G . Gestational age and basic school achievements: a national follow-up study in Denmark. Pediatrics. 2010; 126(6):e1553-61. DOI: 10.1542/peds.2009-0829. View

17.

Talge N, Holzman C, Wang J, Lucia V, Gardiner J, Breslau N . Late-preterm birth and its association with cognitive and socioemotional outcomes at 6 years of age. Pediatrics. 2010; 126(6):1124-31. DOI: 10.1542/peds.2010-1536. View

18.

Baron I, Erickson K, Ahronovich M, Baker R, Litman F . Cognitive deficit in preschoolers born late-preterm. Early Hum Dev. 2010; 87(2):115-9. DOI: 10.1016/j.earlhumdev.2010.11.010. View

19.

Woythaler M, McCormick M, Smith V . Late preterm infants have worse 24-month neurodevelopmental outcomes than term infants. Pediatrics. 2011; 127(3):e622-9. DOI: 10.1542/peds.2009-3598. View

20.

McGowan J, Alderdice F, Holmes V, Johnston L . Early childhood development of late-preterm infants: a systematic review. Pediatrics. 2011; 127(6):1111-24. DOI: 10.1542/peds.2010-2257. View