PT  - JOURNAL ARTICLE
AU  - van Beek, Pauline E
AU  - Rijken, Monique
AU  - Broeders, Lisa
AU  - ter Horst, Hendrik J
AU  - Koopman-Esseboom, Corine
AU  - de Kort, Ellen
AU  - Laarman, Céleste
AU  - Mulder-de Tollenaer, Susanne M
AU  - Steiner, Katerina
AU  - Swarte, Renate MC
AU  - van Westering-Kroon, Elke
AU  - Oei, S Guid
AU  - Leemhuis, Aleid G
AU  - Andriessen, Peter
ED  - ,
TI  - Two-year neurodevelopmental outcome in children born extremely preterm: the EPI-DAF study
AID  - 10.1136/archdischild-2021-323124
DP  - 2022 Sep 01
TA  - Archives of Disease in Childhood - Fetal and Neonatal Edition
PG  - 467--474
VI  - 107
IP  - 5
4099  - http://fn.bmj.com/content/107/5/467.short
4100  - http://fn.bmj.com/content/107/5/467.full
SO  - Arch Dis Child Fetal Neonatal Ed2022 Sep 01; 107
AB  - Objective In 2010, the Dutch practice regarding initiation of active treatment in extremely preterm infants was lowered from 25 completed weeks’ to 24 completed weeks’ gestation. The nationwide Extremely Preterm Infants – Dutch Analysis on Follow-up Study was set up to provide up-to-date data on neurodevelopmental outcome at 2 years’ corrected age (CA) after this guideline change. Design: National cohort study.Patients All live born infants between 240/7 weeks’ and 266/7 weeks’ gestational age who were 2 years’ CA in 2018–2020.Main outcome measure Impairment at 2 years’ CA, based on cognitive score (Bayley-III-NL), neurological examination and neurosensory function.Results 651 of 991 live born infants (66%) survived to 2 years’ CA, with data available for 554 (85%). Overall, 62% had no impairment, 29% mild impairment and 9% moderate-to-severe impairment (further defined as neurodevelopmental impairment, NDI). The percentage of survivors with NDI was comparable for infants born at 24 weeks’, 25 weeks’ and 26 weeks’ gestation. After multivariable analysis, severe brain injury and low maternal education were associated with higher odds on NDI. NDI-free survival was 48%, 67% and 75% in neonatal intensive care unit (NICU)-admitted infants at 24, 25 and 26 weeks’ gestation, respectively.Conclusions Lowering the threshold has not been accompanied by a large increase in moderate-to-severely impaired infants. Among live-born and NICU-admitted infants, an increase in NDI-free survival was observed from 24 weeks’ to 26 weeks’ gestation. This description of a national cohort with high follow-up rates gives an accurate description of the range of outcomes that may occur after extremely preterm birth.All data relevant to the study are included in the article or uploaded as supplementary information. Other data may be obtained from a third party and are not publicly available.