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Developmental Trajectories in Very Preterm Born Children Up to 8 Years: A Longitudinal Cohort Study

Aim: Long-term outcome data in preterm children is often limited to cross-sectional measurement of neurodevelopmental impairment (NDI) at the corrected age of 24-36 months. However, impairments may only become overt during childhood or resolve with time, and individual trajectories in outcome over t...

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Autores principales: van Beek, Pauline E., van der Horst, Iris E., Wetzer, Josse, van Baar, Anneloes L., Vugs, Brigitte, Andriessen, Peter
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8143520/
https://www.ncbi.nlm.nih.gov/pubmed/34041210
http://dx.doi.org/10.3389/fped.2021.672214
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author van Beek, Pauline E.
van der Horst, Iris E.
Wetzer, Josse
van Baar, Anneloes L.
Vugs, Brigitte
Andriessen, Peter
author_facet van Beek, Pauline E.
van der Horst, Iris E.
Wetzer, Josse
van Baar, Anneloes L.
Vugs, Brigitte
Andriessen, Peter
author_sort van Beek, Pauline E.
collection PubMed
description Aim: Long-term outcome data in preterm children is often limited to cross-sectional measurement of neurodevelopmental impairment (NDI) at the corrected age of 24-36 months. However, impairments may only become overt during childhood or resolve with time, and individual trajectories in outcome over time may vary. The primary aim of this study was to describe NDI in very preterm born children at three subsequent ages of 2, 5, and 8 years of age. As a secondary aim, a longitudinal analysis was performed on the individual longitudinal trajectories in NDI from 2 to 8 years of age. Methods: Single-center prospective cohort study including children born between 1990 and 2011 below 30 weeks' gestation and followed into 2019. The outcome measurement was NDI assessed at 2, 5, and 8 years of age. NDI is a composite score that includes cognitive, neurological, visual, and auditory functions, in which problems were categorized as none, mild, moderate, or severe. Cognitive function measured as total DQ/IQ score was assessed by standardized psychometric tests. Neurological, visual, and auditory functions were assessed by the neonatologist. Results: In total, 921 children were eligible for follow-up, of whom 726 (79%) children were assessed. No NDI was seen in 54, 54, and 62%, mild NDI was seen in 31, 36, and 30%, and moderate-to-severe NDI was seen in 15, 9.2, and 8.6% of the children at 2, 5, and 8 years, respectively. From 2 to 8 years, 63% of the children remained in the same NDI category, 20% of the children improved to a better NDI category, and 17% deteriorated toward a worse NDI category. No differences were found in baseline characteristics of infants that improved or deteriorated. Extreme prematurity, male gender and low parental education were associated with worse NDI status at all time points. Although we observed considerable individual variation over time in NDI status, the course of the trajectories in NDI were not associated with gestation, gender, and parental education. Conclusions: Continued follow-up until school life is essential in order to provide optimal and individually focused referrals and care when needed.
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spelling pubmed-81435202021-05-25 Developmental Trajectories in Very Preterm Born Children Up to 8 Years: A Longitudinal Cohort Study van Beek, Pauline E. van der Horst, Iris E. Wetzer, Josse van Baar, Anneloes L. Vugs, Brigitte Andriessen, Peter Front Pediatr Pediatrics Aim: Long-term outcome data in preterm children is often limited to cross-sectional measurement of neurodevelopmental impairment (NDI) at the corrected age of 24-36 months. However, impairments may only become overt during childhood or resolve with time, and individual trajectories in outcome over time may vary. The primary aim of this study was to describe NDI in very preterm born children at three subsequent ages of 2, 5, and 8 years of age. As a secondary aim, a longitudinal analysis was performed on the individual longitudinal trajectories in NDI from 2 to 8 years of age. Methods: Single-center prospective cohort study including children born between 1990 and 2011 below 30 weeks' gestation and followed into 2019. The outcome measurement was NDI assessed at 2, 5, and 8 years of age. NDI is a composite score that includes cognitive, neurological, visual, and auditory functions, in which problems were categorized as none, mild, moderate, or severe. Cognitive function measured as total DQ/IQ score was assessed by standardized psychometric tests. Neurological, visual, and auditory functions were assessed by the neonatologist. Results: In total, 921 children were eligible for follow-up, of whom 726 (79%) children were assessed. No NDI was seen in 54, 54, and 62%, mild NDI was seen in 31, 36, and 30%, and moderate-to-severe NDI was seen in 15, 9.2, and 8.6% of the children at 2, 5, and 8 years, respectively. From 2 to 8 years, 63% of the children remained in the same NDI category, 20% of the children improved to a better NDI category, and 17% deteriorated toward a worse NDI category. No differences were found in baseline characteristics of infants that improved or deteriorated. Extreme prematurity, male gender and low parental education were associated with worse NDI status at all time points. Although we observed considerable individual variation over time in NDI status, the course of the trajectories in NDI were not associated with gestation, gender, and parental education. Conclusions: Continued follow-up until school life is essential in order to provide optimal and individually focused referrals and care when needed. Frontiers Media S.A. 2021-05-10 /pmc/articles/PMC8143520/ /pubmed/34041210 http://dx.doi.org/10.3389/fped.2021.672214 Text en Copyright © 2021 van Beek, van der Horst, Wetzer, van Baar, Vugs and Andriessen. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
van Beek, Pauline E.
van der Horst, Iris E.
Wetzer, Josse
van Baar, Anneloes L.
Vugs, Brigitte
Andriessen, Peter
Developmental Trajectories in Very Preterm Born Children Up to 8 Years: A Longitudinal Cohort Study
title Developmental Trajectories in Very Preterm Born Children Up to 8 Years: A Longitudinal Cohort Study
title_full Developmental Trajectories in Very Preterm Born Children Up to 8 Years: A Longitudinal Cohort Study
title_fullStr Developmental Trajectories in Very Preterm Born Children Up to 8 Years: A Longitudinal Cohort Study
title_full_unstemmed Developmental Trajectories in Very Preterm Born Children Up to 8 Years: A Longitudinal Cohort Study
title_short Developmental Trajectories in Very Preterm Born Children Up to 8 Years: A Longitudinal Cohort Study
title_sort developmental trajectories in very preterm born children up to 8 years: a longitudinal cohort study
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8143520/
https://www.ncbi.nlm.nih.gov/pubmed/34041210
http://dx.doi.org/10.3389/fped.2021.672214
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