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Arch Dis Child. 2010 Oct;95(10):786-90. doi: 10.1136/adc.2009.160283. Epub 2009 Oct 14.

The stability of the diagnosis of developmental disability between ages 2 and 8 in a geographic cohort of very preterm children born in 1997.

Author information

  • 1Department of Obstetrics and Gynaecology, The Royal Women's Hospital, 20 Flemington Road, Parkville, VIC 3052, Australia. gehan.roberts@rch.org.au

Abstract

OBJECTIVE:

Studies reporting the developmental outcomes for very preterm (VPT) children often focus on development at age 2 years. The aim of this study was to assess the stability of the rates of diagnosis of developmental disability from age 2 to 8 years in a regional cohort of VPT and extremely low-birth weight (ELBW) children and compare these with term controls.

METHODS:

VPT (22-27 completed weeks of gestation) and ELBW (birth weight 500-999 g) children and matched term controls born in Victoria, Australia, in 1997 were enrolled at birth in a regional prospective longitudinal study. Outcomes were assessed at ages 2 and 8 years.

RESULTS:

Of the 283 VPT/ELBW live births, 71% survived to age 8 years and 94% were assessed. Of the 199 controls, 100% survived to age 8 years and 86.9% were assessed. At age 2 years, the rates of nil, mild, moderate and severe disabilities in the VPT/ELBW children were respectively 51.9%, 20.9%, 13.4% and 13.9%; and at age 8 years, 43.9%, 36.9%, 10.7% and 8.6%. The Cohen κ statistic revealed poor agreement between disability status at ages 2 and 8 years for VPT/ELBW children (0.20, p<0.001) but a higher level of agreement (0.37, p<0.001) for the control children. This was primarily driven by differences in classification of cognitive disability between ages 2 and 8 years.

CONCLUSIONS:

Developmental outcomes at age 2 years are only a moderate predictor of long-term outcome and are not a reliable end point for follow-up studies of VPT and ELBW children.

PMID:
19828882
[PubMed - indexed for MEDLINE]
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