Background Active perinatal care increases the survival of extremely preterm infants but there are concerns that improved survival might increase the rate of disabled survivors.
Objective To determine neurodevelopmental outcome at 6.5 years of age in extremely preterm children (EPT, <27 weeks) in a Swedish National cohort.
Design/methods Poulation-based prospective cohort of all EPT children born in Sweden from April 1, 2004, to March 31, 2007. Survivors were assessed and compared with a term-born control group. Of 707 live-born infants, 69% survived to 6.5 years. Intellectual ability was measured with WISC- lV and results were related to the mean and SD of the controls. Clinical examination and parental questionnaires were used for diagnosis of cerebral palsy, hearing and vision impairments.
Results At a median age of 78 months, 445 of 494 eligible EPT children (90%) were assed (59 by chart review). The rates of cerebral palsy, moderate visual impairment, blindness and deafness were 9.2%, 5.2%, 2.0% and 0.7%, respectively vs 0.0%, 0.5%, 0% and 0%, respectively among 370 controls. 364 EPT children and 369 controls were formally tested with WISC-lV. Intellectual impairment < -2SD but >-3SD, and < -3SD was 9% and 19%, respectively vs 1.9% and 0%, respectively among controls. In 445 EPT children either formally assessed or by chart review, the rates of moderate and severe neurodevelopmental disabilities were 19% and 11%, respectively compared with 2.4% and 0%, respectively among control children.
Conclusion Disability rates are comparable to similar studies that report lower survival rates.