Objective To evaluate the influence of antenatal and neonatal factors on the neurocognitive outcome in children at school age.
Design Longitudinal prospective trial in a French tertiary perinatal care centre.
Population 350 preterm singletons born at less than 32 weeks of amenorrhea, inborn, born between 1997 and 2001.
Methods Participants were invited for an examination to screen for neurocognitive disorders between 4 and 8 years of age and then re-contacted between 6 and 10 years of age in order to evaluate their results at school.
Main outcome measure Three profiles of neurocognitive outcome were defined (normal, minor or major disorders) and correlated with maternal, antenatal and neonatal factors.
Results The survival rate of our cohort was 80.8% (283/350) and follow-up of the survivors was 71.4% (202/283). There were 137 children (68%) with a profile for normal outcome, 29 children (14%) with minor disorders and 36 children (18%) with major disorders. The three principal risk factors for major or minor disorders were gestational age (GA) inferior to 28 weeks of amenorrhea (WA) (adjusted odds ratio (OR): 1.28 (95% CI 1.06 to 1.56)), chronic lung disease (CLD) (adjusted OR: 2.92 (95% CI 1.15 to 7.42)) and the latest abnormal EEG (adjusted OR: 2.61 (95% CI 1.10 to 6.18)). Moreover, abnormal cranial ultrasound was identified as an independent risk factor in the occurrence of major disorders (adjusted OR: 2.98 (95% CI 1.31 to 6.71)).
Conclusion Research for measures to prevent the occurrence of CLD must become a priority in the domain of neonatal intensive care.
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