EPICure: facts and figures: why preterm labour should be treated

Area of Science:

• Neonatalogy
• Developmental Pediatrics
• Public Health

Background:

• Extremely preterm birth (before 26 weeks gestation) presents significant short- and long-term risks.
• The EPICure studies aimed to comprehensively assess outcomes for this high-risk population.

Purpose of the Study:

• To determine the short- and long-term outcomes of infants born extremely preterm.
• To identify perinatal factors influencing survival and neurodevelopmental outcomes.

Main Methods:

• Prospective data collection on all births before 26 weeks gestation in the UK and Republic of Ireland in 1995.
• Follow-up assessments at 2.5 and 6 years, including neurological examinations and cognitive testing (IQ, MDI).
• Statistical analysis, including logistic regression, to identify predictors of adverse outcomes.

Main Results:

• Survival rate was 39% (314/811) for infants admitted to neonatal units.
• At 6 years, 13% had disabling cerebral palsy and 13% had severe sensory impairment.
• Cognitive impairment was common, with a mean IQ of 82; 21% had IQs >3 SD below the comparator group.

Conclusions:

• Perinatal factors, including antenatal steroid use and mode of delivery, significantly impact outcomes.
• Abnormal head scan findings predict motor disability, while postnatal transfer is associated with motor disability.
• Improved survival since 1995 is noted, but the impact on severe adverse outcomes requires further investigation with new cohorts.