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Neurodevelopmental Outcomes 12 Years After Extremely Preterm Birth in Sweden

Fredrik Serenius1, Thomas Abrahamsson2,3, Ulrika Ådén3,4,2

  • 1Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.

Pediatrics
|February 4, 2026
PubMed

Insights

Children born extremely preterm (EPT) face significant challenges, including higher rates of neurodevelopmental disabilities (NDDs), autism spectrum disorder (ASD), and attention deficit hyperactivity disorder (ADHD) by age 12. Multimorbidity and behavioral issues are also common, requiring ongoing multidisciplinary care.

Area of Science:

  • Pediatrics
  • Neuroscience
  • Developmental Psychology

Background:

  • Extremely preterm (EPT) birth (<27 weeks gestation) is associated with increased risks for adverse neurodevelopmental outcomes.
  • Early identification and intervention are crucial for improving long-term outcomes in EPT survivors.

Purpose of the Study:

  • To assess the prevalence of neurodevelopmental disabilities (NDDs), attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), developmental coordination disorder (DCD), and behavioral problems in a national cohort of EPT children at early adolescence.
  • To understand the extent of multimorbidity among these children.

Main Methods:

  • A national cohort of infants born EPT in Sweden (2004-2007) was followed up to age 12 years.
  • Assessments included standardized instruments for cognition, motor function, behavior, and parent-completed questionnaires.
  • National health registers provided diagnostic data.

Main Results:

  • EPT children showed significantly higher rates of moderate/severe NDD (37.4%), ASD (14.9%), ADHD (21.2%), DCD (29.4%), and behavioral problems (35.3%) compared to controls.
  • Comorbidity was high, with 59% of EPT children with moderate/severe NDD having at least two co-occurring conditions.
  • Only 42.0% of EPT children were free from ASD, ADHD, and DCD.

Conclusions:

  • A substantial proportion of EPT children experience NDDs, ASD, ADHD, DCD, and behavioral problems by age 12.
  • The high prevalence of multimorbidity underscores the complexity of care required for this population.
  • Multidisciplinary follow-up is essential for addressing the multifaceted challenges faced by EPT survivors.
Abstract

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