Two-year neurodevelopmental outcome in children born extremely preterm: the EPI-DAF study

Pauline E van Beek*, Monique Rijken, Lisa Broeders, Hendrik J Ter Horst, Corine Koopman-Esseboom, Ellen de Kort, Céleste Laarman, Susanne M Mulder-de Tollenaer, Katerina Steiner, Renate Mc Swarte, Elke van Westering-Kroon, S Guid Oei, Aleid G Leemhuis, Peter Andriessen, EPI-DAF study group

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

OBJECTIVE: In 2010, the Dutch practice regarding initiation of active treatment in extremely preterm infants was lowered from 25 completed weeks' to 24 completed weeks' gestation. The nationwide Extremely Preterm Infants - Dutch Analysis on Follow-up Study was set up to provide up-to-date data on neurodevelopmental outcome at 2 years' corrected age (CA) after this guideline change. Design: National cohort study.

PATIENTS: All live born infants between 240/7 weeks' and 266/7 weeks' gestational age who were 2 years' CA in 2018-2020.

MAIN OUTCOME MEASURE: Impairment at 2 years' CA, based on cognitive score (Bayley-III-NL), neurological examination and neurosensory function.

RESULTS: 651 of 991 live born infants (66%) survived to 2 years' CA, with data available for 554 (85%). Overall, 62% had no impairment, 29% mild impairment and 9% moderate-to-severe impairment (further defined as neurodevelopmental impairment, NDI). The percentage of survivors with NDI was comparable for infants born at 24 weeks', 25 weeks' and 26 weeks' gestation. After multivariable analysis, severe brain injury and low maternal education were associated with higher odds on NDI. NDI-free survival was 48%, 67% and 75% in neonatal intensive care unit (NICU)-admitted infants at 24, 25 and 26 weeks' gestation, respectively.

CONCLUSIONS: Lowering the threshold has not been accompanied by a large increase in moderate-to-severely impaired infants. Among live-born and NICU-admitted infants, an increase in NDI-free survival was observed from 24 weeks' to 26 weeks' gestation. This description of a national cohort with high follow-up rates gives an accurate description of the range of outcomes that may occur after extremely preterm birth.

Original languageEnglish
Pages (from-to)467-474
Number of pages8
JournalArchives of Disease in Childhood-fetal and Neonatal Edition
Volume107
Issue number5
Early online date2 Mar 2022
DOIs
Publication statusPublished - Sept 2022

Keywords

  • AGE
  • CARE
  • EXTREMELY PREMATURE-INFANTS
  • child health
  • epidemiology
  • infant development
  • intensive care units
  • neonatal
  • neonatology

Fingerprint

Dive into the research topics of 'Two-year neurodevelopmental outcome in children born extremely preterm: the EPI-DAF study'. Together they form a unique fingerprint.

Cite this