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Changes in neurodevelopmental outcome at age eight in geographic cohorts of children born at 22–27 weeks' gestational age during the 1990s
  1. G Roberts1,3,5,
  2. P J Anderson1,2,4,5,
  3. C De Luca1,2,
  4. L W Doyle1,2,3,5
  1. 1The Premature Infant Follow-up Program at the Royal Women's Hospital, Melbourne, Australia
  2. 2Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Australia
  3. 3Department of Paediatrics, The University of Melbourne, Melbourne, Australia
  4. 4Department of Psychology, The University of Melbourne, Melbourne, Australia
  5. 5Murdoch Children's Research Institute, Victoria, Australia
  6. 6Mercy Hospital for Women, Melbourne, Australia
  7. 7Monash Medical Centre, Melbourne, Australia
  1. Correspondence to Dr Gehan Roberts, Department of Obstetrics and Gynaecology, The Royal Women's Hospital, 20 Flemington Road, Parkville 3052, Australia; gehan.roberts{at}rch.org.au

Abstract

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 eight 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 1991–1992.

Methods Consecutive children with gestational ages in the range 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 (CP) 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 1991–1992 in the same region.

Results Follow-up rates for the 1997 cohort at 8 years of age were 95% (144/151) for 22–27 weeks survivors and 89% (173/195) for controls. Rates of disability were substantially higher in the preterm cohort than the controls. The 1997 and 1991–1992 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 CP 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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Footnotes

  • Participants Convenor: Lex W Doyle (The Premature Infant Follow-up Program at the Royal Women's Hospital, Melbourne, Australia; Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Australia; Murdoch Children's Research Institute, Victoria, Australia). Collaborators (in alphabetical order): Peter Anderson (Department of Psychology, The University of Melbourne, Melbourne, Australia; Murdoch Children's Research Institute, Victoria, Australia); Catherine Callanan (The Premature Infant Follow-up Program at the Royal Women's Hospital, Melbourne, Australia); Elizabeth Carse (Monash Medical Centre, Melbourne, Australia); Margaret P Charlton, (Monash Medical Centre, Melbourne, Australia); Noni Davis (The Premature Infant Follow-up Program at the Royal Women's Hospital, Melbourne, Australia); Cinzia R De Luca (The Premature Infant Follow-up Program at the Royal Women's Hospital, Melbourne, Australia; Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Australia); Julianne Duff, (The Premature Infant Follow-up Program at the Royal Women's Hospital, Melbourne, Australia); Marie Hayes (Monash Medical Centre, Melbourne, Australia); Esther Hutchinson (The Premature Infant Follow-up Program at the Royal Women's Hospital, Melbourne, Australia; Elaine Kelly (The Premature Infant Follow-up Program at the Royal Women's Hospital, Melbourne, Australia; Mercy Hospital for Women, Melbourne, Australia); Marion McDonald (The Premature Infant Follow-up Program at the Royal Women's Hospital, Melbourne, Australia); Gillian Opie (Mercy Hospital for Women, Melbourne, Australia); Gehan Roberts (The Premature Infant Follow-up Program at the Royal Women's Hospital, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Australia; Murdoch Children's Research Institute, Victoria, Australia); Linh Ung (The Premature Infant Follow-up Program at the Royal Women's Hospital, Melbourne, Australia); Andrew Watkins (Mercy Hospital for Women, Melbourne, Australia); Amanda Williamson (Mercy Hospital for Women, Melbourne, Australia); Heather Woods (Mercy Hospital for Women, Melbourne, Australia).

  • Funding This study was funded by the Victorian Government, who had no involvement in design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication.

  • Competing Interests None.

  • Ethics approval This study was conducted with the approval of the Research and Ethics Committees of the Royal Women's Hospital, Mercy Hospital for Women and Monash Medical Centre, Melbourne.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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