Neurodevelopmental Disability Through 11 Years of Age in Children Born Before 26 Weeks of Gestation
- 1 August 2009
- journal article
- research article
- Published by American Academy of Pediatrics (AAP) in PEDIATRICS
- Vol. 124 (2), e249-e257
- https://doi.org/10.1542/peds.2008-3743
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.This publication has 29 references indexed in Scilit:
- Academic attainment and special educational needs in extremely preterm children at 11 years of age: the EPICure studyArchives of Disease in Childhood: Fetal & Neonatal, 2009
- The Manual Ability Classification System (MACS) for children with cerebral palsy: scale development and evidence of validity and reliabilityDevelopmental Medicine and Child Neurology, 2007
- Gender differences in neurodevelopmental outcomes among extremely preterm, extremely‐low‐birthweight infantsActa Paediatrica, 2006
- Common Visual Defects and Peer Victimization in ChildrenInvestigative Ophthalmology & Visual Science, 2005
- Outcome at 14 years of extremely low birthweight infants: a regional studyArchives of Disease in Childhood: Fetal & Neonatal, 2001
- The fragile maleBMJ, 2000
- Searching for justice: The discovery of IQ gains over time.American Psychologist, 1999
- The cognitive outcome of very preterm infants may be poorer than often reported: An empirical investigation of how methodological issues make a big differenceEuropean Journal of Pediatrics, 1994
- Rising IQ Scores in British Children: Recent EvidenceJournal of Child Psychology and Psychiatry, 1992
- Predicting Developmental Outcome At School Age From Infant Tests of Normal, At‐Risk and Retarded InfantsDevelopmental Medicine and Child Neurology, 1990