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Cognitive trajectories from infancy to early adulthood following birth before 26 weeks of gestation : a prospective, population-based cohort study

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Linsell, Louise, Johnson, Samantha Ann, Wolke, Dieter, O'Reilly, Helen, Morris, Joan K., Kurinczuk, Jennifer J. and Marlow, Neil (2018) Cognitive trajectories from infancy to early adulthood following birth before 26 weeks of gestation : a prospective, population-based cohort study. Archives of Disease in Childhood, 103 . pp. 363-370. doi:10.1136/archdischild-2017-313414

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Official URL: http://dx.doi.org/10.1136/archdischild-2017-313414

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Abstract

Objective. To determine the trajectory of cognitive test scores from infancy to adulthood in individuals born extremely preterm compared with term-born individuals.

Design. A prospective, population-based cohort study.

Setting. 276 maternity units in the UK and Ireland.

Patients. 315 surviving infants born less than 26 completed weeks of gestation recruited at birth in 1995 and 160 term-born classroom controls recruited at age 6.

Main outcome measures. Bayley Scales of Infant Development-Second Edition (age 2.5); Kaufman Assessment Battery for Children (ages 6/11); Wechsler Abbreviated Scale of Intelligence-Second Edition (age 19).

Results. The mean cognitive scores of extremely preterm individuals over the period were on average 25.2 points below their term-born peers (95% CI -27.8 to -22.6) and remained significantly lower at every assessment. Cognitive trajectories in term-born boys and girls did not differ significantly, but the scores of extremely preterm boys were on average 8.8 points below those of extremely preterm girls (95% CI -13.6 to -4.0). Higher maternal education elevated scores in both groups by 3.2 points (95% CI 0.8 to 5.7). Within the extremely preterm group, moderate/severe neonatal brain injury (mean difference: -10.9, 95% CI -15.5 to -6.3) and gestational age less than 25 weeks (mean difference: -4.4, 95% CI -8.4 to -0.4) also had an adverse impact on cognitive function.

Conclusions. There is no evidence that impaired cognitive function in extremely preterm individuals materially recovers or deteriorates from infancy through to 19 years. Cognitive test scores in infancy and early childhood reflect early adult outcomes.

Item Type: Journal Article
Subjects: R Medicine > RJ Pediatrics
Divisions: Faculty of Science > Psychology
SWORD Depositor: Library Publications Router
Library of Congress Subject Headings (LCSH): Premature infants, Cognition disorders in children, Cognition -- Testing
Journal or Publication Title: Archives of Disease in Childhood
Publisher: BMJ
ISSN: 0003-9888
Official Date: April 2018
Dates:
DateEvent
April 2018Published
16 November 2017Available
18 September 2017Accepted
Volume: 103
Page Range: pp. 363-370
DOI: 10.1136/archdischild-2017-313414
Status: Peer Reviewed
Publication Status: Published
Publisher Statement: ** From PubMed via Jisc Publications Router. ** History: received 19-05-2017; revised 16-08-2017; accepted 18-09-2017.
Access rights to Published version: Open Access
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
MR/J01107X/1[MRC] Medical Research Councilhttp://dx.doi.org/10.13039/501100000265
UNSPECIFIED[NIHR] National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272

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