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Published on: November 20, 2015
Presence and pattern of scarring in children born very preterm
Anna C Tottman1, Jane M Alsweiler2,3, Frank H Bloomfield1,3
1Liggins Institute, University of Auckland, Auckland, New Zealand.
Insights
Most children born very preterm develop significant scarring by school age, even with modern neonatal intensive care. This long-term scarring affects 90% of assessed children, impacting their quality of life.
Area of Science:
- Neonatal Medicine
- Pediatric Surgery
- Dermatology
Background:
- Modern neonatal intensive care has improved survival rates for very preterm infants.
- The long-term consequences of neonatal intensive care, specifically scarring, are not well-documented.
Purpose of the Study:
- To assess the prevalence, pattern, and extent of scarring in children born very preterm.
- To investigate the relationship between scarring and factors like sex and ethnicity.
Main Methods:
- Observational cohort study of 129 children born <30 weeks' gestation or <1500 g.
- Children examined at 7 years' corrected age.
- Documentation of scar presence, size, number, and distribution.
Main Results:
- 90% of children exhibited scarring, with 81% having multiple scars.
- 60% had large scars, and 75% had scars in more than one body area.
- Scarring was more prevalent in boys and non-European children.
Conclusions:
- Very preterm children frequently experience extensive scarring into school age.
- Neonatal intensive care, despite advancements, is associated with significant long-term scarring.
- Further research is needed to understand and mitigate this scarring burden.
Abstract:
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.
