Neurodevelopmental outcome at 5.5 years in Dutch preterm infants born at 24-26 weeks' gestational age: The EPI-DAF study

Pauline E. Van Beek*, Monique Rijken, Lisa Broeders, Hendrik J. Ter Horst, Corine Koopman-Esseboom, Ellen De Kort, A. R.C. Laarman, S. M. Mulder - De Tollenaer, Katerina Steiner, Renate M.C. Swarte, Elke Van Westering-Kroon, Guid Oei, Aleid G. Leemhuis, Peter Andriessen

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

1 Citation (Scopus)

Abstract

Objective: 

After lowering the Dutch threshold for active treatment from 25 to 24 completed weeks' gestation, survival to discharge increased by 10% in extremely preterm live born infants. Now that this guideline has been implemented, an accurate description of neurodevelopmental outcome at school age is needed. 

Design: 

Population-based cohort study. 

Setting: 

All neonatal intensive care units in the Netherlands. 

Patients: 

All infants born between 240/7 and 266/7 weeks' gestation who were 5.5 years' corrected age (CA) in 2018-2020 were included. 

Main outcome measures: 

Main outcome measure was neurodevelopmental outcome at 5.5 years. Neurodevelopmental outcome was a composite outcome defined as none, mild or moderate-to-severe impairment (further defined as neurodevelopmental impairment (NDI)), using corrected cognitive score (Wechsler Preschool and Primary Scale of Intelligence Scale-III-NL), neurological examination and neurosensory function. Additionally, motor score (Movement Assessment Battery for Children-2-NL) was assessed. All assessments were done as part of the nationwide, standardised follow-up programme. 

Results: 

In the 3-year period, a total of 632 infants survived to 5.5 years' CA. Data were available for 484 infants (77%). At 5.5 years' CA, most cognitive and motor (sub)scales were significantly lower compared with the normative mean. Overall, 46% had no impairment, 36% had mild impairment and 18% had NDI. NDI-free survival was 30%, 49% and 67% in live born children at 24, 25 and 26 weeks' gestation, respectively (p<0.001). 

Conclusions: 

After lowering the threshold for supporting active treatment from 25 to 24 completed weeks' gestation, a considerable proportion of the surviving extremely preterm children did not have any impairment at 5.5 years' CA.

Original languageEnglish
Article numberarchdischild-2023-325732
Pages (from-to)272-278
Number of pages7
JournalArchives of Disease in Childhood: Fetal and Neonatal Edition
Volume109
Issue number3
DOIs
Publication statusPublished - 1 May 2024

Bibliographical note

Publisher Copyright:
© Author(s) (or their employer(s)) 2024.

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