Predicting Long-Term Survival Without Major Disability for Infants Born Preterm.

Area of Science:

• Neuroscience
• Developmental Pediatrics
• Public Health

Background:

• Preterm birth is a major global health concern.
• Long-term neurodevelopmental and cognitive outcomes for preterm infants remain a critical area of research.
• Understanding factors influencing disability-free survival is essential for early intervention and support.

Purpose of the Study:

• To investigate the long-term neurodevelopmental and cognitive outcomes for children born preterm.
• To determine the probability of disability-free survival up to age 25 years based on gestational age.
• To identify covariates affecting disability-free survival in preterm infants.

Main Methods:

• Retrospective cohort study using Western Australian population databases (1983-2010).
• Disability defined as intellectual disability, autism, or cerebral palsy.
• Kaplan-Meier method and parametric survival models used to analyze disability-free survival.

Main Results:

• Disability-free survival to 25 years varied significantly by gestational age, from 4.1% at 22 weeks to 97.2% at full term.
• Children born at 22-25 weeks had substantially lower survival probabilities compared to full-term infants.
• Birth profile factors (Apgar score, sex, socioeconomic status, ethnicity, residence) showed marked disparities in disability-free survival.

Conclusions:

• Gestational age is a primary determinant of disability-free survival in preterm infants.
• Apgar score, birth weight, sex, socioeconomic status, and maternal ethnicity significantly impact long-term outcomes.
• Targeted interventions considering these factors are crucial for improving neurodevelopmental trajectories.