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Antenatal steroids and neurodevelopment in 12-year-old children born extremely preterm
Olga Kochukhova1,2, Ylva Fredriksson Kaul1, Martin Johansson1
1Departments of Women's and Children's Health, Uppsala University, Sweden.
Insights
Children born very preterm at 12 years old still show neurodevelopmental deficits. Antenatal steroids may offer long-term cognitive and motor benefits, especially for extremely preterm infants.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Public Health
Background:
- Preterm birth is a major risk factor for adverse neurodevelopmental outcomes.
- Long-term effects of prematurity on cognitive and motor skills require continued investigation.
- The impact of interventions like antenatal steroids on neurodevelopmental trajectories needs further evaluation.
Purpose of the Study:
- To assess neurodevelopmental outcomes at 12 years in children born very preterm.
- To identify perinatal, neonatal, and socioeconomic factors influencing these outcomes.
- To determine if antenatal steroid benefits on cognition persist into childhood.
Main Methods:
- Prospective cohort study of 78 very preterm children (22.7-31.9 weeks gestation) followed to 12 years.
- Neurodevelopmental assessment included cognitive, motor, and visual-motor integration tasks.
- Comparison with an age-matched control group (n=50) and analysis of preterm subgroups.
Main Results:
- Preterm children exhibited significantly lower scores in cognitive, motor, and visual-motor integration compared to controls.
- Gestational age and maternal education showed differential associations in very vs. extremely preterm subgroups.
- Severe retinopathy of prematurity was strongly linked to poorer outcomes; antenatal steroids associated with better cognition and motor skills in the extremely preterm group.
Conclusions:
- Very preterm children born in the 2000s continue to display neurodevelopmental deficits at age 12.
- Antenatal steroid administration demonstrates lasting positive associations with cognitive and motor skills in extremely preterm infants.
Aim:
To investigate neurodevelopmental outcome in 12-year-old children born very preterm in relation to perinatal, neonatal and socioeconomic variables. To examine whether previously described positive effects of antenatal steroids on cognition persist at 12 years.
Methods:
Prospective cohort, 78 children with gestational ages 22.7-31.9 weeks, born in 2004-2007 and examined at 12 years of age with cognitive, motor and visual motor integration tasks and compared to an age-matched control group (n = 50). Two preterm subgroups were studied: very preterm children (28-31 gestational weeks, n = 53) and extremely preterm children (22-27 gestational weeks, n = 25).
Results:
The preterm children had significantly lower scores on all cognitive, motor and visual motor integration tasks than the controls. Gestational age and maternal education influenced associations differently in the two preterm subgroups. Also, severe retinopathy of prematurity demonstrated strong associations to outcome. In the extremely preterm group, administration of antenatal steroids was associated with better cognition, basic attention, word generation and motor skills.
Conclusion:
At 12 years of age, very preterm children born in the 2000s still have deficits across several neurodevelopmental domains compared to term-born peers. Administration of antenatal steroids has long-lasting associations to cognition and motor skills in extremely preterm-born children.
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