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Updated: Dec 22, 2025
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
International comparisons of neurodevelopmental outcomes in infants born very preterm
Héloïse Torchin1, Andreï S Morgan2, Pierre-Yves Ancel3
1Université de Paris, Epidemiology and Statistics Research Center/CRESS, INSERM, INRA, F-75004, Paris, France; Department of Neonatal Medicine, Cochin-Port Royal Hospital, AP-HP, Paris, F-75014, France.
Insights
Survival and neurodevelopmental outcomes for very preterm infants (<32 weeks) and extremely preterm infants (<28 weeks) are summarized. Methodological challenges in comparing international data and improving outcome reporting are discussed.
Area of Science:
- Neonatalogy
- Developmental Pediatrics
- Perinatal Epidemiology
Background:
- Preterm birth remains a significant challenge in neonatal care, with survival and neurodevelopmental outcomes varying widely.
- Understanding these outcomes is crucial for improving clinical practice and long-term child health.
- Existing data often face methodological inconsistencies, hindering direct international comparisons.
Purpose of the Study:
- To summarize survival and neurodevelopmental impairment rates in very preterm (<32 weeks' gestation) and extremely preterm (<28 weeks' gestation) infants.
- To highlight methodological issues in comparing international data on preterm infant outcomes.
- To discuss factors influencing survival and neurodevelopmental outcomes and suggest future research directions.
Main Methods:
- Systematic review and meta-analysis of recent data on preterm infant survival and neurodevelopmental impairment.
- Analysis of population-based and multi-center cohorts of extremely preterm infants.
- Discussion of methodological factors including population characteristics, outcome definitions, gestational age and neurodevelopmental assessment timing, birth year, and follow-up rates.
Main Results:
- Survival rates and rates of neurodevelopmental impairment in very and extremely preterm infants were summarized based on recent meta-analyses.
- Key methodological challenges in comparing international data were identified and exemplified.
- The influence of perinatal care intensity and post-discharge management on outcomes was discussed.
Conclusions:
- There is a critical need for harmonized data collection and standardized reporting of neurodevelopmental outcomes in very preterm children.
- Addressing methodological inconsistencies is essential for accurate international comparisons and evidence-based practice.
- Further research is needed to optimize perinatal and post-discharge care for improved long-term outcomes in this vulnerable population.
Abstract:
We summarise rates of survival and neurodevelopmental impairment in very (<32 weeks' gestation) and extremely (<28 weeks' gestation) preterm infants using data from recent meta-analyses. Methodological issues that require consideration when comparing international data are highlighted using examples of population-based or multi-centre cohorts of children born extremely preterm. The impact of baseline population, outcome definition, gestational age assessment, age at neurodevelopmental assessment, year of birth and follow-up rates are discussed. The impact of the intensity of perinatal care and of post-discharge management on survival and neurodevelopmental outcomes is also discussed. There is a future need for harmonisation of data collection and for more accurate and standardised reporting of neurodevelopmental outcomes in very preterm children.
