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Extreme prematurity, growth and neurodevelopment at 8 years: a cohort study
  1. Leah Hickey1,2,3,
  2. Alice Burnett1,3,4,5,
  3. Alicia J Spittle3,6,7,
  4. Gehan Roberts2,3,8,
  5. Peter Anderson4,9,
  6. Katherine Lee4,10,
  7. Lex W Doyle3,4,7,11,
  8. Jeanie Ling Yoong Cheong4,5,7,11
  9. Victorian Infant Collaborative Study Group
    1. 1Department of Neonatal Medicine, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
    2. 2Clinical Sciences, Murdoch Children’s Research Institute, Parkville, Victoria, Australia
    3. 3Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
    4. 4Victorian Infant Brain Studies, Murdoch Children’s Research Institute, Parkville, Victoria, Australia
    5. 5Premature Infant Follow-up Program, Royal Women'd Hospital, Melbourne, Victoria, Australia
    6. 6Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia
    7. 7Neonatal Services, Royal Women's Hospital, Parkville, Victoria, Australia
    8. 8Centre for Community Child Health, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
    9. 9Turner Institute for Brain & Mental Health, Monash University, Melbourne, Victoria, Australia
    10. 10Clinical Epidemiology and Biostatistics Unit, Murdoch Children’s Research Institute, Parkville, Victoria, Australia
    11. 11Department of Obstetrics, University of Melbourne, Melbourne, Victoria, Australia
    1. Correspondence to Dr Leah Hickey, Department of Neonatal Medicine, The Royal Children's Hospital Melbourne, Parkville, VIC 3052, Australia; leah.hickey{at}rch.org.au

    Abstract

    Objective Infants born extremely preterm (EP, <28 weeks’ gestation) exhibit poorer growth and neurodevelopmental impairment in early childhood compared with their term-born peers. Whether poor growth persists and whether associations of growth with neurodevelopmental functioning have changed in the decades since the introduction of surfactant are not well described. This study aims to (1) compare growth from birth to 2 years then 8 years in children born EP between three different eras, and (2) investigate the associations of growth from birth to 2 years then 8 years with cognitive, academic, executive and motor function at 8 years, and if associations have changed over time.

    Design Prospective observational cohort studies in the State of Victoria, Australia in three discrete eras: 1991–1992, 1997 and 2005. EP children had weight and head circumference measured at birth, and weight, head circumference and height at 2 and 8 years. Cognitive ability, academic performance, executive function and motor skills were assessed at 8 years, corrected for prematurity.

    Results 499/546 (91%) of surviving EP children were fully assessed at 8 years. Growth in children born EP did not differ substantially between eras and associations between growth and neurodevelopment did not change over time. Overall, better weight and head growth from birth to 2 years were associated with improved neurodevelopment at 8 years.

    Conclusions Growth of children born EP has not improved in more recent eras. Better early head and weight growth are associated with improved neurodevelopment in mid-childhood.

    • extremely preterm
    • growth
    • long-term outcomes
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    Footnotes

    • Twitter @lmhickey

    • Collaborators Members of the Victorian Infant Collaborative Study Group—Convenor: Jeanie Cheong (Neonatal Services, Royal Women’s Hospital, Melbourne, Australia; Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Australia; Department of Obstetrics & Gynaecology, University of Melbourne, Melbourne, Australia; Premature Infant Follow-up Program, Royal Women’s Hospital, Melbourne, Australia). Collaborators (in alphabetical order): Peter Anderson (Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Australia; Premature Infant Follow-up Program, Royal Women’s Hospital, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia), Alice Burnett (Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Australia; Premature Infant Follow-up Program, Royal Women’s Hospital, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia; Neonatal Medicine, The Royal Children’s Hospital, Melbourne, Australia), Catherine Callanan (Premature Infant Follow-up Program, Royal Women’s Hospital, Melbourne, Australia), Elizabeth Carse (Newborn Services, Monash Medical Centre, Melbourne, Australia), Margaret P Charlton (Newborn Services, Monash Medical Centre, Melbourne, Australia), Noni Davis (Premature Infant Follow-up Program, Royal Women’s Hospital, Melbourne, Australia), Lex W Doyle (Neonatal Services, Royal Women’s Hospital, Melbourne, Australia; Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Australia; Department of Obstetrics & Gynaecology, University of Melbourne, Melbourne, Australia; Premature Infant Follow-up Program, Royal Women’s Hospital, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia), Julianne Duff (Premature Infant Follow-up Program, Royal Women’s Hospital, Melbourne, Australia), Leah Hickey (Department of Paediatrics, University of Melbourne, Melbourne, Australia; Neonatal Medicine, The Royal Children’s Hospital, Melbourne, Australia), Esther Hutchinson (Premature Infant Follow-up Program, Royal Women’s Hospital, Melbourne, Australia; Neonatal Medicine, The Royal Children’s Hospital, Melbourne, Australia), Marie Hayes (Newborn Services, Monash Medical Centre, Melbourne, Australia), Elaine Kelly (Premature Infant Follow-up Program, Royal Women’s Hospital, Melbourne, Australia; Neonatal Services, Mercy Hospital for Women, Melbourne, Australia), Katherine J Lee (Clinical Epidemiology and Biostatistics, Murdoch Children's Research Institute, Melbourne, Australia), Marion McDonald (Premature Infant Follow-up Program, Royal Women’s Hospital, Melbourne, Australia), Gillian Opie (Neonatal Services, Mercy Hospital for Women, Melbourne, Australia), Gehan Roberts (Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Australia; Premature Infant Follow-up Program, Royal Women’s Hospital, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia; Centre for Community and Child Health, The Royal Children’s Hospital, Melbourne, Australia), Amanda Williamson (Neonatal Services, Mercy Hospital for Women, Melbourne, Australia).

    • Contributors LH, JLYC and LWX conceived and designed the study, performed data analysis and interpretation, and drafted and revised the article. KL provided statistical advice and performed data analysis. AB, AJS, GR and PA assisted in drafting and revising the article. All authors approved the final version as submitted and agree to be accountable for all aspects of the work.

    • Funding Supported by grants from the National Health and Medical Research Council of Australia (Centre of Clinical Research Excellence #546519; Centre of Research Excellence #1060733; Project Grant #108702; Career Development Fellowship #1141354 to JLYC, #1127984 to KL, #1108714 to AJS) and the Victorian Government’s Operational Infrastructure Support Program.

    • Disclaimer The funding sources had no role in the study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available on reasonable request. Authors can be contacted at the corresponding author contact details to access additional data on reasonable request.

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