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Published on: August 25, 2014
Two-thirds of adolescents who received active perinatal care after extremely preterm birth had mild or no
A Holsti1, M Adamsson1, F Serenius2
1Institute of Clinical Sciences, Department of Pediatrics, University of Umeå, Umeå, Sweden.
Insights
Active perinatal care (APC) for extremely preterm (EPT) infants resulted in mild or no disabilities for two-thirds of adolescents. However, significant rates of neurodevelopmental impairments were observed compared to term-born controls.
Area of Science:
- Neonatal care and developmental pediatrics.
- Long-term neurodevelopmental outcomes in preterm infants.
Background:
- Active perinatal care (APC) improves survival for extremely preterm (EPT) infants.
- Potential increase in long-term disabilities associated with APC.
Purpose of the Study:
- To evaluate neurodevelopmental outcomes in adolescents (10-15 years) born EPT who received APC.
- Compare outcomes of EPT adolescents to term-born controls.
Main Methods:
- Cognitive function assessed using Wechsler Intelligence Scale for Children.
- Neurosensory impairments identified via case records and parent questionnaires.
- Comparison group: term-born controls.
Main Results:
- 9% cerebral palsy, 4% visual impairment, 6% hearing impairment in EPT adolescents.
- 31% of EPT adolescents had serious cognitive impairment versus 5% of controls.
- 34% of EPT adolescents experienced moderate to severe disabilities, compared to 5% of controls.
Conclusions:
- 66% of EPT adolescents receiving APC had mild or no disabilities.
- Results are crucial for healthcare providers counseling families on EPT infant outcomes.
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.
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