Published online July 27, 2009
PEDIATRICS Vol. 124 No. 2 August 2009, pp. e249-e257 (doi:10.1542/peds.2008-3743)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via CrossRef
Google Scholar
Right arrow Articles by Johnson, S.
Right arrow Articles by Marlow, N.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Johnson, S.
Right arrow Articles by Marlow, N.
Related Collections
Right arrow Premature & Newborn
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

ARTICLE

Neurodevelopmental Disability Through 11 Years of Age in Children Born Before 26 Weeks of Gestation

Samantha Johnson, PhD, CPsychola,b, Joe Fawke, MBChB, MRCPCHb, Enid Hennessy, MScc, Vicky Rowell, MBBS, MRCPCHb, Sue Thomas, MRCP(Paed), FRCPCHd, Dieter Wolke, PhD, DiplPsych, CPsychole and Neil Marlow, DM, FMedScia

a Neonatology, Institute for Women's Health, University College London, London, United Kingdom
b Division of Human Development and School of Clinical Sciences, University of Nottingham, Nottingham, United Kingdom
c Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
d Department of Paediatrics, Leeds Teaching Hospitals, University of Leeds, Leeds, United Kingdom
e Department of Psychology and Health Sciences Research Institute, Warwick Medical School, University of Warwick, Coventry, United Kingdom

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.

Key Words: extremely preterm • outcome • neurodevelopment • cognitive • disability

Abbreviations: K-ABC—Kaufman-Assessment Battery for Children • MPC—mental processing composite (from K-ABC) • GMFCS—Gross Motor Function Classification System • MACS—Manual Abilities Classification System • CP—cerebral palsy • OR—odds ratio • CI—confidence interval

Accepted Mar 25, 2009.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?