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Neurodevelopmental outcomes following late and moderate prematurity: a population-based cohort study
  1. Samantha Johnson1,
  2. T Alun Evans1,
  3. Elizabeth S Draper1,
  4. David J Field1,
  5. Bradley N Manktelow1,
  6. Neil Marlow2,
  7. Ruth Matthews1,
  8. Stavros Petrou3,
  9. Sarah E Seaton1,
  10. Lucy K Smith1,
  11. Elaine M Boyle1
  1. 1Department of Health Sciences, University of Leicester, Leicester, UK
  2. 2Department of Academic Neonatology, Institute for Women's Health, University College London, London, UK
  3. 3Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
  1. Correspondence to Dr Samantha Johnson, Department of Health Sciences, University of Leicester, 22–28 Princess Road West, Leicester LE1 6TP, UK; sjj19{at}le.ac.uk.

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.

  • Neurodevelopment
  • Neonatology

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

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