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Neurodevelopmental outcomes following late and moderate prematurity : a population-based cohort study
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Johnson, S., Evans, T. A., Draper, E. S., Field, D. J., Manktelow, B. N., Marlow, N., Matthews, R., Petrou, Stavros, Seaton, S. E., Smith, L. K. and Boyle, E. M. (2015) Neurodevelopmental outcomes following late and moderate prematurity : a population-based cohort study. Archives of Disease in Childhood - Fetal and Neonatal Edition, 100 (4). F301-F308. doi:10.1136/archdischild-2014-307684 ISSN 1359-2998.
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Official URL: http://dx.doi.org/10.1136/archdischild-2014-307684
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.
Item Type: | Journal Article | ||||||||||
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Journal or Publication Title: | Archives of Disease in Childhood - Fetal and Neonatal Edition | ||||||||||
Publisher: | B M J Group | ||||||||||
ISSN: | 1359-2998 | ||||||||||
Official Date: | 1 April 2015 | ||||||||||
Dates: |
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Volume: | 100 | ||||||||||
Number: | 4 | ||||||||||
Page Range: | F301-F308 | ||||||||||
DOI: | 10.1136/archdischild-2014-307684 | ||||||||||
Status: | Peer Reviewed | ||||||||||
Publication Status: | Published | ||||||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||||||
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