Related Experiment Video
Updated: Jul 24, 2025
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Comparing behavioural outcomes in children born extremely preterm between 2006 and 1995: the EPICure studies
Jennifer Larsen1, Puja Kochhar2,3, Dieter Wolke4
1Department of Population Health Sciences, George Davies Centre, University of Leicester, University Road, Leicester, LE1 7RH, UK.
Insights
Behavioral outcomes for extremely preterm (EP) children have not improved over time. Children born EP in 2006 showed worse behavioral difficulties compared to those born in 1995 and term-born peers.
Area of Science:
- Pediatric Medicine
- Neurodevelopmental Disorders
- Longitudinal Cohort Studies
Background:
- Children born extremely preterm (EP) face heightened risks for neurocognitive and behavioral issues.
- This study examines if behavioral outcomes have changed over time with improved survival rates for EP infants.
Purpose of the Study:
- To compare behavioral outcomes at 11 years of age in two cohorts of EP children born in 1995 and 2006.
- To assess changes in neurocognitive and behavioral morbidity in EP children over time.
Main Methods:
- Prospective comparison of two national cohorts: EPICure (1995) and EPICure2 (2006).
- Behavioral assessments at 11 years using Strengths and Difficulties Questionnaire (SDQ), ADHD Rating Scale (ADHD-RS), and Social Communication Questionnaire (SCQ).
- Outcomes compared between EP and term-born children within each cohort and between the two EP cohorts.
Main Results:
- EP children in both cohorts exhibited more behavioral difficulties than term-born children.
- No significant improvement in mean scores or clinical difficulties for EP children between 1995 and 2006 cohorts.
- EP children born in 2006 had significantly higher SDQ and ADHD-RS scores compared to EP children born in 1995.
Conclusions:
- Behavioral outcomes for extremely preterm children have not improved between 1995 and 2006.
- EP children born in 2006 demonstrated worse outcomes relative to term-born peers compared to the 1995 cohort.
- Continued long-term clinical follow-up and psychological support are essential for EP children.
Background:
Children born extremely preterm (EP) are at increased risk of neurocognitive and behavioural morbidity. Here, we investigate whether behavioural outcomes have changed over time concomitant with increasing survival following EP birth.
Methods:
Comparison of outcomes at 11 years of age for two prospective national cohorts of children born EP in 1995 (EPICure) and 2006 (EPICure2), assessed alongside term-born children. Behavioural outcomes were assessed using the parent-completed Strengths and Difficulties Questionnaire (SDQ), DuPaul Attention-Deficit/Hyperactivity Disorder Rating Scale (ADHD-RS), and Social Communication Questionnaire (SCQ).
Results:
In EPICure, 176 EP and 153 term-born children were assessed (mean age: 10.9 years); in EPICure2, 112 EP and 143 term-born children were assessed (mean age: 11.8 years). In both cohorts, EP children had higher mean scores and more clinically significant difficulties than term-born children on almost all measures. Comparing outcomes for EP children in the two cohorts, there were no significant differences in mean scores or in the proportion of children with clinically significant difficulties after adjustment for confounders. Using term-born children as reference, EP children in EPICure2 had significantly higher SDQ total difficulties and ADHD-RS hyperactivity impulsivity z-scores than EP children in EPICure.
Conclusions:
Behavioural outcomes have not improved for EP children born in 2006 compared with those born in 1995. Relative to term-born peers, EP children born in 2006 had worse outcomes than those born in 1995. There is an ongoing need for long-term clinical follow-up and psychological support for children born EP.
