Neurodevelopmental outcomes following late and moderate prematurity: a population-based cohort study

Arch Dis Child Fetal Neonatal Ed. 2015 Jul;100(4):F301-8. doi: 10.1136/archdischild-2014-307684. Epub 2015 Apr 1.

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.

Keywords: Neonatology; Neurodevelopment.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Breast Feeding
  • Child Development*
  • Cognition Disorders / diagnosis
  • Cognition Disorders / epidemiology
  • Cognition Disorders / etiology
  • Cohort Studies
  • Developmental Disabilities* / diagnosis
  • Developmental Disabilities* / epidemiology
  • Developmental Disabilities* / etiology
  • Ethnic Groups
  • Female
  • Gestational Age
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Premature*
  • Male
  • Motor Skills
  • Parents
  • Prevalence
  • Prospective Studies
  • Risk Factors
  • Sensation Disorders* / diagnosis
  • Sensation Disorders* / epidemiology
  • Sensation Disorders* / etiology
  • Sex Factors
  • Socioeconomic Factors
  • Surveys and Questionnaires
  • United Kingdom / epidemiology