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Cognitive trajectories from infancy to early adulthood following birth before 26 weeks of gestation: a prospective, population-based cohort study.

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journal contribution
posted on 20.04.2018, 13:59 by Louise Linsell, Samantha Johnson, Dieter Wolke, Helen O'Reilly, Joan K. Morris, Jennifer J. Kurinczuk, Neil Marlow
OBJECTIVE: To determine the trajectory of cognitive test scores from infancy to adulthood in individuals born extremely preterm compared with term-born individuals. DESIGN: A prospective, population-based cohort study. SETTING: 276 maternity units in the UK and Ireland. PATIENTS: 315 surviving infants born less than 26 completed weeks of gestation recruited at birth in 1995 and 160 term-born classroom controls recruited at age 6. MAIN OUTCOME MEASURES: Bayley Scales of Infant Development-Second Edition (age 2.5); Kaufman Assessment Battery for Children (ages 6/11); Wechsler Abbreviated Scale of Intelligence-Second Edition (age 19). RESULTS: The mean cognitive scores of extremely preterm individuals over the period were on average 25.2 points below their term-born peers (95% CI -27.8 to -22.6) and remained significantly lower at every assessment. Cognitive trajectories in term-born boys and girls did not differ significantly, but the scores of extremely preterm boys were on average 8.8 points below those of extremely preterm girls (95% CI -13.6 to -4.0). Higher maternal education elevated scores in both groups by 3.2 points (95% CI 0.8 to 5.7). Within the extremely preterm group, moderate/severe neonatal brain injury (mean difference: -10.9, 95% CI -15.5 to -6.3) and gestational age less than 25 weeks (mean difference: -4.4, 95% CI -8.4 to -0.4) also had an adverse impact on cognitive function. CONCLUSIONS: There is no evidence that impaired cognitive function in extremely preterm individuals materially recovers or deteriorates from infancy through to 19 years. Cognitive test scores in infancy and early childhood reflect early adult outcomes.

Funding

The EPICure Study was funded by a Medical Research Council Programme Grant to NM (ref No.: MR/J01107X/1). NM receives part funding from the Department of Health’s NIHR Biomedical Research Centre’s funding scheme at UCLH/UCL.

History

Citation

Archives of Disease in Childhood, 2018, 103, pp. 363-370

Author affiliation

/Organisation/COLLEGE OF LIFE SCIENCES/School of Medicine/Department of Health Sciences

Version

VoR (Version of Record)

Published in

Archives of Disease in Childhood

Publisher

BMJ Publishing Group for Royal College of Paediatrics and Child Health, European Academy of Paediatrics

issn

0003-9888

eissn

1468-2044

Acceptance date

18/09/2017

Copyright date

2018

Available date

20/04/2018

Publisher version

http://adc.bmj.com/content/103/4/363.info

Language

en

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