Two-thirds of adolescents who received active perinatal care after extremely preterm birth had mild or no disabilities

Acta Paediatr. 2016 Nov;105(11):1288-1297. doi: 10.1111/apa.13499. Epub 2016 Jul 7.

Abstract

Aim: Active perinatal care (APC) increases the survival of extremely preterm (EPT) infants, but may increase the rate of disabilities. We examined neurodevelopmental outcomes in adolescents aged 10-15 years who were born EPT and received APC in two Swedish tertiary care centres.

Methods: Cognitive function was assessed using the Wechsler Intelligence Scale for Children, and neurosensory impairments were assessed by reviewing the case records and a standard parent health questionnaire. The outcomes were compared to term-born controls.

Results: We assessed 132 EPT adolescents and 103 controls. The rates of cerebral palsy, moderate to severe visual impairment and moderate to severe hearing impairment were 9%, 4% and 6%, respectively, for the EPT children and zero for the controls. Serious cognitive impairment was present in 31% of the EPT adolescents and 5% of the controls. Combining impairments across domains showed that 34% of EPT adolescents had moderate and severe disabilities compared with 5% of the controls. Impairments were more common at 23-24 weeks of gestational age (43%) than at 25 weeks (28.4%).

Conclusion: Two-thirds (66%) of adolescents born EPT who received APC had mild or no disabilities. Our results are relevant for healthcare providers and clinicians counselling families.

Keywords: Active perinatal care; Cognitive function; Extremely preterm children; Long-term outcome; Neurodevelopmental outcome.

MeSH terms

  • Adolescent
  • Case-Control Studies
  • Child
  • Child Development*
  • Cognition Disorders / diagnosis
  • Cognition Disorders / epidemiology*
  • Developmental Disabilities / epidemiology*
  • Female
  • Gestational Age
  • Humans
  • Infant, Extremely Premature*
  • Infant, Newborn
  • Logistic Models
  • Male
  • Perinatal Care / methods
  • Perinatal Care / standards*
  • Severity of Illness Index
  • Social Class
  • Survival Analysis
  • Sweden / epidemiology
  • Time
  • Wechsler Scales