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Presence and pattern of scarring in children born very preterm
  1. Anna C Tottman1,
  2. Jane M Alsweiler2,3,
  3. Frank H Bloomfield1,3,
  4. Jane E Harding1
  5. on behalf of the PIANO study team
  1. 1 Liggins Institute, University of Auckland, Auckland, New Zealand
  2. 2 Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
  3. 3 Newborn Services, National Women’s Health, Auckland City Hospital, Auckland, New Zealand
  1. Correspondence to Professor Jane E Harding, Liggins Institute, Private Bag 92019, Grafton, Auckland 1142, New Zealand; j.harding{at}


The long-term scarring burden of preterm infants undergoing modern neonatal intensive care is not known. This observational cohort study aimed to document the presence and pattern of scarring in children born <30 weeks’ gestation or <1500 g birth weight and cared for at the National Women’s Health neonatal intensive care unit, Auckland, New Zealand. Children were examined at 7 years’ corrected age and the presence, size, number and distribution of scars documented. Scarring was seen in 90% of 129 children assessed, with 81% having multiple scars, 60% having large scars (85% of whom had no history of major neonatal surgery) and 75% having more than one body area scarred. Scarring was more common in boys and in children of non-European ethnicity. Despite modern neonatal intensive care practices, children born very preterm are frequently and extensively scarred at school age.

  • neonatology
  • dermatology

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  • Contributors All the authors conceived and designed the study. ACT collected the data and wrote the initial draft of the manuscript. ACT and JEH analysed the data. JMA, FHB and JEH critically revised the paper and contributed to discussion.

  • Funding This study was funded in part by grants from the Health Research Council of New Zealand and the A+ Trust.

  • Competing interests None declared.

  • Ethics approval Northern B ethics committee (NTY/ 12/ 05/ 035).

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

  • Collaborators PIANO study team: Jane Alsweiler, Coila Bevan, Frank Bloomfield, Greg Gamble, Jane Harding, Sabine Hüth, Yannan Jiang, Myra Leung, Jenny Rogers, Ben Thompson, Anna Tottman, Tanya Poppe, Heather Stewart, Kathryn Williamson and Trecia Wouldes.