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

Autor:	van Beek PE; Department of Neonatology, Máxima Medical Center, Veldhoven, The Netherlands pauline.van.beek@mmc.nl., Rijken M; Department of Neonatology, Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, The Netherlands., Broeders L; The Netherlands Perinatal Registry, Utrecht, The Netherlands., Ter Horst HJ; Department of Neonatology, Beatrix Children's Hospital, University Medical Center Groningen, Groningen, The Netherlands., Koopman-Esseboom C; Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands., de Kort E; Department of Neonatology, Máxima Medical Center, Veldhoven, The Netherlands., Laarman ARC; Department of Neonatology, Amsterdam University Medical Center location VUMC, Amsterdam, The Netherlands., Mulder-de Tollenaer SM; Department of Neonatology, Isala Clinics, Zwolle, The Netherlands., Steiner K; Department of Neonatology, Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, The Netherlands., Swarte RMC; Department of Neonatology, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, The Netherlands., van Westering-Kroon E; Department of Neonatology, Maastricht University Medical Center, Maastricht, The Netherlands., Oei G; Department of Obstetrics and Gynaecology, Máxima Medical Center, Veldhoven, The Netherlands.; Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands., Leemhuis AG; Department of Neonatology, Emma Childrens' Hospital, Amsterdam University Medical Center location AMC, Amsterdam, The Netherlands., Andriessen P; Department of Neonatology, Máxima Medical Center, Veldhoven, The Netherlands.; Department of Applied Physics, School of Medical Physics and Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.
Jazyk:	angličtina
Zdroj:	Archives of disease in childhood. Fetal and neonatal edition [Arch Dis Child Fetal Neonatal Ed] 2024 Apr 18; Vol. 109 (3), pp. 272-278. Date of Electronic Publication: 2024 Apr 18.
DOI:	10.1136/archdischild-2023-325732
Abstrakt:	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 24 0/7 and 26 6/7 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. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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