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

Linsell, L; Johnson, S; Wolke, D; O'Reilly, H; Morris, JK; Kurinczuk, JJ; Marlow, N; (2017) Cognitive trajectories from infancy to early adulthood following birth before 26 weeks of gestation: a prospective, population-based cohort study. Archives in Disease in Childhood 10.1136/archdischild-2017-313414. (In press). Green open access

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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.

Type: Article
Title: Cognitive trajectories from infancy to early adulthood following birth before 26 weeks of gestation: a prospective, population-based cohort study
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/archdischild-2017-313414
Publisher version: http://doi.org/10.1136/archdischild-2017-313414
Language: English
Additional information: Copyright information © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/
Keywords: epidemiology, neonatology, neurodevelopment
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health > Neonatology
URI: https://discovery.ucl.ac.uk/id/eprint/10041583
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