Neurosensory, cognitive and academic outcomes at 8 years in children born 22-23 weeks' gestation compared with more mature births.
Arch Dis Child Fetal Neonatal Ed
; 109(5): 511-518, 2024 Aug 16.
Article
in En
| MEDLINE
| ID: mdl-38395594
ABSTRACT
Despite providing intensive care to more infants born <24 weeks' gestation, data on school-age outcomes, critical for counselling and decision-making, are sparse. OBJECTIVE:
To compare major neurosensory, cognitive and academic impairment among school-aged children born extremely preterm at 22-23 weeks' gestation (EP22-23) with those born 24-25 weeks (EP24-25), 26-27 weeks (EP26-27) and term (≥37 weeks).DESIGN:
Three prospective longitudinal cohorts.SETTING:
Victoria, Australia.PARTICIPANTS:
All EP live births (22-27 weeks) and term-born controls born in 1991-1992, 1997 and 2005. MAIN OUTCOMEMEASURES:
At 8 years, major neurosensory disability (any of moderate/severe cerebral palsy, IQ <-2 SD relative to controls, blindness or deafness), motor, cognitive and academic impairment, executive dysfunction and poor health utility. Risk ratios (RRs) and risk differences between EP22-23 (reference) and other gestational age groups were estimated using generalised linear models, adjusted for era of birth, social risk and multiple birth.RESULTS:
The risk of major neurosensory disability was higher for EP22-23 (n=21) than more mature groups (168 EP24-25; 312 EP26-27; 576 term), with increasing magnitude of difference as the gestation increased (adjusted RR (95% CI) compared with EP24-25 1.39 (0.70 to 2.76), p=0.35; EP26-27 1.85 (0.95 to 3.61), p=0.07; term 13.9 (5.75 to 33.7), p<0.001). Similar trends were seen with other outcomes. Two-thirds of EP22-23 survivors were free of major neurosensory disability.CONCLUSIONS:
Although children born EP22-23 experienced higher rates of disability and impairment at 8 years than children born more maturely, many were free of major neurosensory disability. These data support providing active care to infants born EP22-23.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Cerebral Palsy
/
Gestational Age
/
Infant, Extremely Premature
Limits:
Child
/
Female
/
Humans
/
Male
/
Newborn
Country/Region as subject:
Oceania
Language:
En
Journal:
Arch Dis Child Fetal Neonatal Ed
Journal subject:
PEDIATRIA
/
PERINATOLOGIA
Year:
2024
Document type:
Article
Affiliation country:
Australia
Country of publication:
United kingdom