Johnson, Samantha J., Fawke, Joe, Hennessy, Enid M., Rowell, Vicky, Thomas, S. (Sue), Wolke, Dieter and Marlow, Neil. (2009) Neurodevelopmental disability through 11 years of age in children born before 26 weeks of gestation. Pediatrics, Vol.124 (No.2). E249-E257. ISSN 0031-4005

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Abstract

BACKGROUND: To assess functional disability in children born before 26 weeks of gestation at 11 years of age and the stability of findings in individuals between 6 and 11 years of age. METHODS: Of 307 surviving children born in 1995, 219 (71%) were assessed at 11 years of age alongside 153 classmates. Children were evaluated by using standardized tests of cognitive ability and clinical condition at both ages. RESULTS: Using classmate data to determine reference ranges, serious cognitive impairment (score of less than -2 SD) was present in 40% of extremely preterm children and 1.3% of classmates (odds ratio [OR]: 50 [95% confidence interval (CI): 12-206]) at 11 years of age. Overall, 38 (17%) extremely preterm children had cerebral palsy; moderate or severe impairment of neuromotor function, vision, and hearing was present in 10%, 9%, and 2% of these children, respectively. Combining impairment across domains, 98 (45%) extremely preterm children had serious functional disability compared with 1% of the classmates (OR: 61 [95% CI: 15-253]); this was more common in boys than girls (OR: 1.8 [95% CI: 1.0-3.1]) and in those born at 23 or 24 weeks' gestation compared with those born at 25 weeks' gestation (OR: 1.8 [95% CI: 1.0-3.1]). The prevalence of serious functional disability was 46% at 6 years of age and 45% at 11 years of age. Using multiple imputation to correct for selective dropout, it is estimated that 50% (95% CI: 44%-57%) of extremely preterm children are free of serious disability at 11 years of age. CONCLUSIONS: Extremely preterm children remain at high risk for neurodevelopmental disability at 11 years of age compared with term peers. The prevalence of disability remained stable between 6 and 11 years of age, and large individual shifts in classification of disability were unusual. Pediatrics 2009; 124: e249-e257

Item Type:	Journal Article
Subjects:	R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry R Medicine > RJ Pediatrics
Divisions:	Faculty of Medicine > Warwick Medical School > Mental Health and Wellbeing Faculty of Science > Psychology
Library of Congress Subject Headings (LCSH):	Premature infants -- Development, Developmental neurobiology, Cognitive neuroscience, Developmental disabilities
Journal or Publication Title:	Pediatrics
Publisher:	American Academy of Pediatrics
ISSN:	0031-4005
Date:	August 2009
Volume:	Vol.124
Number:	No.2
Number of Pages:	9
Page Range:	E249-E257
Identification Number:	10.1542/peds.2008-3743
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access
Funder:	Medical Research Council (Great Britain) (MRC)
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URI:	http://wrap.warwick.ac.uk/id/eprint/27554

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