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Arch Dis Child Fetal Neonatal Ed. 2009 Sep;94(5):F339-44. doi: 10.1136/adc.2008.146282. Epub 2009 Mar 22.

Very preterm children show impairments across multiple neurodevelopmental domains by age 4 years.

Author information

1
Canterbury Child Development Research Group, Department of Psychology, University of Canterbury, Christchurch, New Zealand. lianne.woodward@canterbury.ac.nz

Abstract

OBJECTIVES:

Neurodevelopmental outcomes associated with preterm birth are of major health and educational concern. This study examined the neuromotor, cognitive, language and emotional/behavioural outcomes of a regional cohort of 4-year-old children born extremely preterm (EPT: 23-27 weeks' gestation), very preterm (VPT: 28-33 weeks) and full term (FT: 38-41 weeks). Of particular interest were children's risks of impairment across multiple neurodevelopmental domains.

METHODS:

Data were gathered as part of a prospective longitudinal study of 105 very preterm (< or = 33 weeks gestation) and 107 FT children born during 1998-2000. At 4 years corrected age, children underwent a comprehensive multidisciplinary assessment that included a paediatric neurological examination, cognitive and language testing, and an assessment of child emotional and behavioural adjustment.

RESULTS:

At age 4 years, compared to FT children, EPT and VPT children had increased risks of cerebral palsy (EPT 18%, VPT 15%, FT 1%), cognitive delay (EPT 33%, VPT 36%, FT 13%), language delay (EPT 29%, VPT 29%, FT 10%) and emotional/behavioural adjustment problems (EPT 37%, VPT 13%, FT 11%). EPT and VPT children were three times more likely to have multiple domain impairments than FT children (EPT 30%, VPT 29%, FT 10%).

CONCLUSIONS:

A substantial proportion of preschool children born very preterm show clinically significant problems in at least one neurodevelopmental domain, with impairment in multiple domains being common. There is a need to monitor preschool development across a range of functional domains and to consider the likely cascading effects of multiple impairments on later development.

PMID:
19307223
DOI:
10.1136/adc.2008.146282
[Indexed for MEDLINE]
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