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No change in neurodevelopment at 11 years after extremely preterm birth

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Marlow, Neil, Ni, Yanyan, Lancaster, Rebecca, Suonpera, Emmi, Bernardi, Marialivia, Fahy, Amanda, Larsen, Jennifer, Trickett, Jayne, Hurst, John R., Morris, Joan, Wolke, Dieter and Johnson, Samantha (2021) No change in neurodevelopment at 11 years after extremely preterm birth. Archives of Disease in Childhood - Fetal and Neonatal Edition, 106 (4). pp. 418-424. doi:10.1136/archdischild-2020-320650

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Official URL: http://dx.doi.org/10.1136/archdischild-2020-320650

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Abstract

Objective To determine whether improvements in school age outcomes had occurred between two cohorts of births at 22–25 weeks of gestation to women residents in England in 1995 and 2006.

Design Longitudinal national cohort studies.

Setting School-based or home-based assessments at 11 years of age.

Participants EPICure2 cohort of births at 22–26 weeks of gestation in England during 2006: a sample of 200 of 1031 survivors were evaluated; outcomes for 112 children born at 22–25 weeks of gestation were compared with those of 176 born in England during 1995 from the EPICure cohort. Classroom controls for each group acted as a reference population.

Main outcome measures Standardised measures of cognition and academic attainment were combined with parent report of other impairments to estimate overall neurodevelopmental status.

Results At 11 years in EPICure2, 18% had severe and 20% moderate impairments. Comparing births at 22–25 weeks in EPICure2 (n=112), 26% had severe and 21% moderate impairment compared with 18% and 32%, respectively, in EPICure. After adjustment, the OR of moderate or severe neurodevelopmental impairment in 2006 compared with 1995 was 0.76 (95% CI 0.45 to 1.31, p=0.32). IQ scores were similar in 1995 (mean 82.7, SD 18.4) and 2006 (81.4, SD 19.2), adjusted difference in mean z-scores 0.2 SD (95% CI −0.2 to 0.6), as were attainment test scores. The use of multiple imputation did not alter these findings.

Conclusion Improvements in care and survival between 1995 and 2006 are not paralleled by improved cognitive or educational outcomes or a reduced rate of neurodevelopmental impairment.

Item Type: Journal Article
Subjects: R Medicine > RG Gynecology and obstetrics
R Medicine > RJ Pediatrics
Divisions: Faculty of Medicine > Warwick Medical School > Health Sciences
Faculty of Medicine > Warwick Medical School > Health Sciences > Mental Health and Wellbeing
Faculty of Science > Psychology
Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): Neurodevelopmental treatment for infants , Developmental disabilities , Developmentally disabled children -- Education , Premature labor , Prematurely born children , Prematurely born children -- Education
Journal or Publication Title: Archives of Disease in Childhood - Fetal and Neonatal Edition
Publisher: B M J Group
ISSN: 1359-2998
Official Date: 18 June 2021
Dates:
DateEvent
18 June 2021Published
27 January 2021Available
15 December 2020Accepted
Volume: 106
Number: 4
Page Range: pp. 418-424
DOI: 10.1136/archdischild-2020-320650
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Restricted or Subscription Access
Copyright Holders: © Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
UNSPECIFIED[NIHR] National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
MR/N024869/1Medical Research Councilhttp://dx.doi.org/10.13039/501100000265

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