Original Article

Changes in neurodevelopmental outcome at age eight in geographic cohorts of children born 22-27 weeks’ gestational age during the 1990s

Gehan Roberts^1,*, Peter J Anderson², Cinzia De Luca¹, Lex W Doyle, Professor¹

¹ The Royal Women’s Hospital, Melbourne, Australia;
² University of Melbourne, Australia

Correspondence to: Gehan Roberts, Department of Obstetrics and Gynaecology, The Royal Women’s Hospital, Level 7, Royal Women’s Hospital, 20 Flemington Rd, Parkville, 3052, Australia; gehan.roberts{at}rch.org.au

Accepted 5 September 2009

Background: The survival rate for children born with gestational ages 22-27 weeks is increasing, and this may be associated with higher rates of disability. The aims of this study were to determine the outcomes at age 8 for a regional cohort of children born at 22-27 weeks during 1997, and to compare their rates of disability with a cohort of the same gestational age born in 1991-92.

Methods: Consecutive children with gestational ages 22-27 weeks born in the state of Victoria, Australia, in 1997 and matched term controls were assessed at 8 years. Outcomes included blindness, deafness, cerebral palsy and intellectual impairment, and disabilities caused by these impairments. These outcomes were compared with a cohort of 22-27 week and term children born in 1991-92 in the same region.

Results: Follow-up rates for the 1997 cohort at 8 years of age were 95% (144/151) for 22-27 week survivors, and 89% (173/195) for controls. Rates of disability were substantially higher in the preterm cohort than the controls. The 1997 and 1991-92 preterm cohorts had similar rates of moderate or severe disability (19%), however the rate of mild impairment was greater in 1997 (40% vs 24%). Rates of disability were almost identical in control groups. Intellectual impairment and cerebral palsy were the major reasons for the higher rates of disability.

Conclusions: The high prevalence of adverse neurodevelopmental outcome in children born at 22-27 weeks compared with term controls at school age persists, and may even be increasing over time.

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