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. 2018 Apr;103(4):363-370.
doi: 10.1136/archdischild-2017-313414. Epub 2017 Nov 16.

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

Louise Linsell  1 , Samantha Johnson  2 , Dieter Wolke  3 , Helen O'Reilly  4 , Joan K Morris  5 , Jennifer J Kurinczuk  1 , Neil Marlow  4
Affiliations

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

Louise Linsell et al. Arch Dis Child. 2018 Apr.

Abstract

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.

Keywords: epidemiology; neonatology; neurodevelopment.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Flow of study participants in the EPICure cohort study.
Figure 2
Figure 2
Longitudinal trajectories of observed cognitive test scores in extremely preterm participants and term-born controls from age 2.5 to 19 years.
Figure 3
Figure 3
Observed and predicted mean cognitive test scores plus 95% CIs in extremely preterm (EP) participants and term-born controls at ages 2.5, 6, 11 and 19.
See this image and copyright information in PMC

References

    1. Farooqi A, Hägglöf B, Sedin G, et al. Chronic conditions, functional limitations, and special health care needs in 10- to 12-year-old children born at 23 to 25 weeks’ gestation in the 1990s: a Swedish national prospective follow-up study. Pediatrics 2006;118:e1466–77. 10.1542/peds.2006-1070 - DOI - PubMed
    1. Marlow N, Wolke D, Bracewell MA, et al. Neurologic and developmental disability at six years of age after extremely preterm birth. N Engl J Med 2005;352:9–19. 10.1056/NEJMoa041367 - DOI - PubMed
    1. Anderson P, Doyle LW, Victorian Infant Collaborative Study Group. Neurobehavioral outcomes of school-age children born extremely low birth weight or very preterm in the 1990s. JAMA 2003;289:3264–72. 10.1001/jama.289.24.3264 - DOI - PubMed
    1. McGurn B, Deary IJ, Starr JM. Childhood cognitive ability and risk of late-onset Alzheimer and vascular dementia. Neurology 2008;71:1051–56. 10.1212/01.wnl.0000319692.20283.10 - DOI - PubMed
    1. Deary IJ, Whiteman MC, Starr JM, et al. The impact of childhood intelligence on later life: following up the Scottish mental surveys of 1932 and 1947. J Pers Soc Psychol 2004;86:130–47. 10.1037/0022-3514.86.1.130 - DOI - PubMed

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