Neurological and developmental outcome in extremely preterm children born in England in 1995 and 2006: the EPICure studies
Objective To determine outcomes at age 3 years in babies born before 27 completed weeks’ gestation in 2006, and to evaluate changes in outcome since 1995 for babies born between 22 and 25 weeks’ gestation.Design Prospective national cohort studies, EPICure and EPICure 2.Setting Hospital and home bas...
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| Veröffentlicht in: | BMJ (Online) 2012-12, Vol.345 (dec04 3), p.e7961-e7961 |
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| creator | Moore, Tamanna Hennessy, Enid M Myles, Jonathan Johnson, Samantha J Draper, Elizabeth S Costeloe, Kate L Marlow, Neil |
| description | Objective To determine outcomes at age 3 years in babies born before 27 completed weeks’ gestation in 2006, and to evaluate changes in outcome since 1995 for babies born between 22 and 25 weeks’ gestation.Design Prospective national cohort studies, EPICure and EPICure 2.Setting Hospital and home based evaluations, England.Participants 1031 surviving babies born in 2006 before 27 completed weeks’ gestation. Outcomes for 584 babies born at 22-25 weeks’ gestation were compared with those of 260 surviving babies of the same gestational age born in 1995.Main outcome measures Survival to age 3 years, impairment (2008 consensus definitions), and developmental scores. Multiple imputation was used to account for the high proportion of missing data in the 2006 cohort.Results Of the 576 babies evaluated after birth in 2006, 13.4% (n=77) were categorised as having severe impairment and 11.8% (n=68) moderate impairment. The prevalence of neurodevelopmental impairment was significantly associated with length of gestation, with greater impairment as gestational age decreased: 45% at 22-23 weeks, 30% at 24 weeks, 25% at 25 weeks, and 20% at 26 weeks (P |
| doi_str_mv | 10.1136/bmj.e7961 |
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| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3514471</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1223430618</sourcerecordid><originalsourceid>FETCH-LOGICAL-b564t-88c8e0ac4070f45c824e03989028412064f0fa19bee691dd85c9329402c6a90e3</originalsourceid><addsrcrecordid>eNp9kU9vEzEQxS0EolXogS-AVoIDHLaM_9sckCAKtGooHICrtfFOkg2762DvVi2fHqcpESDByZbn5zfz5hHymMIppVy9XHSbU9RW0XvkmGqpSmo4v0-OwUpbGsrNETlJaQMAjGtjlXxIjhhnlBkDx-THJY4xtGHV-Kotqr4uarzCNmw77If8EsbBhw6Lpi_weojYYXtTbCMOGLvCr5u2jtgXixD7HTLrV-1OI1-ptfJWjwGoV8WwxmL26Xw6RizSMNYNpkfkwbJqE57cnRPy5d3s8_SsnH98fz59My8XUomhNMYbhMoL0LAU0hsmELg1FpgRlIESS1hW1C4QlaV1baS3nFkBzKvKAvIJeb3X3Y6LDmufjcWqddvYdFW8caFq3J-Vvlm7VbhyXFIhNM0Cz-8EYvg-Yhpc1ySPbbaKYUyOMsYFB5UXPyFP_0I3YYx9tueoFZIzqYX-L6W1Ac20FJl6sad8DClFXB5GpuB20bscvbuNPrNPfvd4IH8FnYFyDzRpwOtDvYrfnNJcS3f5depgfnFx9tZ8yN8m5Nme3_X4d9-fm2XCjw</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1778072754</pqid></control><display><type>article</type><title>Neurological and developmental outcome in extremely preterm children born in England in 1995 and 2006: the EPICure studies</title><source>Jstor Complete Legacy</source><source>MEDLINE</source><source>BMJ Journals - NESLi2</source><creator>Moore, Tamanna ; Hennessy, Enid M ; Myles, Jonathan ; Johnson, Samantha J ; Draper, Elizabeth S ; Costeloe, Kate L ; Marlow, Neil</creator><creatorcontrib>Moore, Tamanna ; Hennessy, Enid M ; Myles, Jonathan ; Johnson, Samantha J ; Draper, Elizabeth S ; Costeloe, Kate L ; Marlow, Neil</creatorcontrib><description>Objective To determine outcomes at age 3 years in babies born before 27 completed weeks’ gestation in 2006, and to evaluate changes in outcome since 1995 for babies born between 22 and 25 weeks’ gestation.Design Prospective national cohort studies, EPICure and EPICure 2.Setting Hospital and home based evaluations, England.Participants 1031 surviving babies born in 2006 before 27 completed weeks’ gestation. Outcomes for 584 babies born at 22-25 weeks’ gestation were compared with those of 260 surviving babies of the same gestational age born in 1995.Main outcome measures Survival to age 3 years, impairment (2008 consensus definitions), and developmental scores. Multiple imputation was used to account for the high proportion of missing data in the 2006 cohort.Results Of the 576 babies evaluated after birth in 2006, 13.4% (n=77) were categorised as having severe impairment and 11.8% (n=68) moderate impairment. The prevalence of neurodevelopmental impairment was significantly associated with length of gestation, with greater impairment as gestational age decreased: 45% at 22-23 weeks, 30% at 24 weeks, 25% at 25 weeks, and 20% at 26 weeks (P<0.001). Cerebral palsy was present in 83 (14%) survivors. Mean developmental quotients were lower than those of the general population (normal values 100 (SD 15)) and showed a direct relation with gestational age: 80 (SD 21) at 22-23 weeks, 87 (19) at 24 weeks, 88 (19) at 25 weeks, and 91 (18) at 26 weeks. These results did not differ significantly after imputation. Comparing imputed outcomes between the 2006 and 1995 cohorts, the proportion of survivors born between 22 and 25 weeks’ gestation with severe disability, using 1995 definitions, was 18% (95% confidence interval 14% to 24%) in 1995 and 19% (14% to 23%) in 2006. Fewer survivors had shunted hydrocephalus or seizures. Survival of babies admitted for neonatal care increased from 39% (35% to 43%) in 1995 to 52% (49% to 55%) in 2006, an increase of 13% (8% to 18%), and survival without disability increased from 23% (20% to 26%) in 1995 to 34% (31% to 37%) in 2006, an increase of 11% (6% to 16%). Conclusion Survival and impairment in early childhood are both closely related to gestational age for babies born at less than 27 weeks’ gestation. Using multiple imputation to account for the high proportion of missing values, a higher proportion of babies admitted for neonatal care now survive without disability, particularly those born at gestational ages 24 and 25 weeks.</description><identifier>ISSN: 0959-8138</identifier><identifier>ISSN: 1756-1833</identifier><identifier>EISSN: 1756-1833</identifier><identifier>DOI: 10.1136/bmj.e7961</identifier><identifier>PMID: 23212880</identifier><language>eng</language><publisher>England: British Medical Journal Publishing Group</publisher><subject>Age ; Babies ; Births ; Blindness - diagnosis ; Blindness - epidemiology ; Blindness - etiology ; Cerebral palsy ; Cerebral Palsy - diagnosis ; Cerebral Palsy - epidemiology ; Cerebral Palsy - etiology ; Child, Preschool ; Children ; Developmental Disabilities - diagnosis ; Developmental Disabilities - epidemiology ; Developmental Disabilities - etiology ; England - epidemiology ; Families & family life ; Female ; Follow-Up Studies ; Gestational Age ; Hearing loss ; Hearing Loss - diagnosis ; Hearing Loss - epidemiology ; Hearing Loss - etiology ; Humans ; Hydrocephalus ; Infant ; Infant Mortality - trends ; Infant, Extremely Premature ; Infant, Newborn ; Infant, Premature, Diseases - diagnosis ; Infant, Premature, Diseases - epidemiology ; Infant, Premature, Diseases - etiology ; Intensive Care, Neonatal - statistics & numerical data ; Intensive Care, Neonatal - trends ; Intervention ; Logistic Models ; Lost to Follow-Up ; Male ; Maternal & child health ; Morbidity ; Neonates ; Neurodevelopmental disorders ; Newborn babies ; Outcome Assessment, Health Care ; Paralysis ; Pediatrics ; Premature babies ; Preschool education ; Prevalence ; Prospective Studies ; Psychological Tests ; Risk Factors ; Seizures ; Standard deviation ; Survival</subject><ispartof>BMJ (Online), 2012-12, Vol.345 (dec04 3), p.e7961-e7961</ispartof><rights>Moore et al 2012</rights><rights>Copyright BMJ Publishing Group LTD Dec 4, 2012</rights><rights>Copyright: 2012 © Moore et al 2012</rights><rights>Moore et al 2012 2012 Moore et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b564t-88c8e0ac4070f45c824e03989028412064f0fa19bee691dd85c9329402c6a90e3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://bmj.com/content/345/bmj.e7961.full.pdf$$EPDF$$P50$$Gbmj$$Hfree_for_read</linktopdf><linktohtml>$$Uhttp://bmj.com/content/345/bmj.e7961.full$$EHTML$$P50$$Gbmj$$Hfree_for_read</linktohtml><link.rule.ids>114,115,230,314,776,780,881,3183,23550,27901,27902,77569,77600</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23212880$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Moore, Tamanna</creatorcontrib><creatorcontrib>Hennessy, Enid M</creatorcontrib><creatorcontrib>Myles, Jonathan</creatorcontrib><creatorcontrib>Johnson, Samantha J</creatorcontrib><creatorcontrib>Draper, Elizabeth S</creatorcontrib><creatorcontrib>Costeloe, Kate L</creatorcontrib><creatorcontrib>Marlow, Neil</creatorcontrib><title>Neurological and developmental outcome in extremely preterm children born in England in 1995 and 2006: the EPICure studies</title><title>BMJ (Online)</title><addtitle>BMJ</addtitle><description>Objective To determine outcomes at age 3 years in babies born before 27 completed weeks’ gestation in 2006, and to evaluate changes in outcome since 1995 for babies born between 22 and 25 weeks’ gestation.Design Prospective national cohort studies, EPICure and EPICure 2.Setting Hospital and home based evaluations, England.Participants 1031 surviving babies born in 2006 before 27 completed weeks’ gestation. Outcomes for 584 babies born at 22-25 weeks’ gestation were compared with those of 260 surviving babies of the same gestational age born in 1995.Main outcome measures Survival to age 3 years, impairment (2008 consensus definitions), and developmental scores. Multiple imputation was used to account for the high proportion of missing data in the 2006 cohort.Results Of the 576 babies evaluated after birth in 2006, 13.4% (n=77) were categorised as having severe impairment and 11.8% (n=68) moderate impairment. The prevalence of neurodevelopmental impairment was significantly associated with length of gestation, with greater impairment as gestational age decreased: 45% at 22-23 weeks, 30% at 24 weeks, 25% at 25 weeks, and 20% at 26 weeks (P<0.001). Cerebral palsy was present in 83 (14%) survivors. Mean developmental quotients were lower than those of the general population (normal values 100 (SD 15)) and showed a direct relation with gestational age: 80 (SD 21) at 22-23 weeks, 87 (19) at 24 weeks, 88 (19) at 25 weeks, and 91 (18) at 26 weeks. These results did not differ significantly after imputation. Comparing imputed outcomes between the 2006 and 1995 cohorts, the proportion of survivors born between 22 and 25 weeks’ gestation with severe disability, using 1995 definitions, was 18% (95% confidence interval 14% to 24%) in 1995 and 19% (14% to 23%) in 2006. Fewer survivors had shunted hydrocephalus or seizures. Survival of babies admitted for neonatal care increased from 39% (35% to 43%) in 1995 to 52% (49% to 55%) in 2006, an increase of 13% (8% to 18%), and survival without disability increased from 23% (20% to 26%) in 1995 to 34% (31% to 37%) in 2006, an increase of 11% (6% to 16%). Conclusion Survival and impairment in early childhood are both closely related to gestational age for babies born at less than 27 weeks’ gestation. Using multiple imputation to account for the high proportion of missing values, a higher proportion of babies admitted for neonatal care now survive without disability, particularly those born at gestational ages 24 and 25 weeks.</description><subject>Age</subject><subject>Babies</subject><subject>Births</subject><subject>Blindness - diagnosis</subject><subject>Blindness - epidemiology</subject><subject>Blindness - etiology</subject><subject>Cerebral palsy</subject><subject>Cerebral Palsy - diagnosis</subject><subject>Cerebral Palsy - epidemiology</subject><subject>Cerebral Palsy - etiology</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Developmental Disabilities - diagnosis</subject><subject>Developmental Disabilities - epidemiology</subject><subject>Developmental Disabilities - etiology</subject><subject>England - epidemiology</subject><subject>Families & family life</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Gestational Age</subject><subject>Hearing loss</subject><subject>Hearing Loss - diagnosis</subject><subject>Hearing Loss - epidemiology</subject><subject>Hearing Loss - etiology</subject><subject>Humans</subject><subject>Hydrocephalus</subject><subject>Infant</subject><subject>Infant Mortality - trends</subject><subject>Infant, Extremely Premature</subject><subject>Infant, Newborn</subject><subject>Infant, Premature, Diseases - diagnosis</subject><subject>Infant, Premature, Diseases - epidemiology</subject><subject>Infant, Premature, Diseases - etiology</subject><subject>Intensive Care, Neonatal - statistics & numerical data</subject><subject>Intensive Care, Neonatal - trends</subject><subject>Intervention</subject><subject>Logistic Models</subject><subject>Lost to Follow-Up</subject><subject>Male</subject><subject>Maternal & child health</subject><subject>Morbidity</subject><subject>Neonates</subject><subject>Neurodevelopmental disorders</subject><subject>Newborn babies</subject><subject>Outcome Assessment, Health Care</subject><subject>Paralysis</subject><subject>Pediatrics</subject><subject>Premature babies</subject><subject>Preschool education</subject><subject>Prevalence</subject><subject>Prospective Studies</subject><subject>Psychological Tests</subject><subject>Risk Factors</subject><subject>Seizures</subject><subject>Standard deviation</subject><subject>Survival</subject><issn>0959-8138</issn><issn>1756-1833</issn><issn>1756-1833</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>9YT</sourceid><sourceid>ACMMV</sourceid><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kU9vEzEQxS0EolXogS-AVoIDHLaM_9sckCAKtGooHICrtfFOkg2762DvVi2fHqcpESDByZbn5zfz5hHymMIppVy9XHSbU9RW0XvkmGqpSmo4v0-OwUpbGsrNETlJaQMAjGtjlXxIjhhnlBkDx-THJY4xtGHV-Kotqr4uarzCNmw77If8EsbBhw6Lpi_weojYYXtTbCMOGLvCr5u2jtgXixD7HTLrV-1OI1-ptfJWjwGoV8WwxmL26Xw6RizSMNYNpkfkwbJqE57cnRPy5d3s8_SsnH98fz59My8XUomhNMYbhMoL0LAU0hsmELg1FpgRlIESS1hW1C4QlaV1baS3nFkBzKvKAvIJeb3X3Y6LDmufjcWqddvYdFW8caFq3J-Vvlm7VbhyXFIhNM0Cz-8EYvg-Yhpc1ySPbbaKYUyOMsYFB5UXPyFP_0I3YYx9tueoFZIzqYX-L6W1Ac20FJl6sad8DClFXB5GpuB20bscvbuNPrNPfvd4IH8FnYFyDzRpwOtDvYrfnNJcS3f5depgfnFx9tZ8yN8m5Nme3_X4d9-fm2XCjw</recordid><startdate>20121204</startdate><enddate>20121204</enddate><creator>Moore, Tamanna</creator><creator>Hennessy, Enid M</creator><creator>Myles, Jonathan</creator><creator>Johnson, Samantha J</creator><creator>Draper, Elizabeth S</creator><creator>Costeloe, Kate L</creator><creator>Marlow, Neil</creator><general>British Medical Journal Publishing Group</general><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group Ltd</general><scope>9YT</scope><scope>ACMMV</scope><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88I</scope><scope>8AF</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ASE</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FPQ</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K6X</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M2O</scope><scope>M2P</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PHGZM</scope><scope>PHGZT</scope><scope>PJZUB</scope><scope>PKEHL</scope><scope>PPXIY</scope><scope>PQEST</scope><scope>PQGLB</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20121204</creationdate><title>Neurological and developmental outcome in extremely preterm children born in England in 1995 and 2006: the EPICure studies</title><author>Moore, Tamanna ; Hennessy, Enid M ; Myles, Jonathan ; Johnson, Samantha J ; Draper, Elizabeth S ; Costeloe, Kate L ; Marlow, Neil</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b564t-88c8e0ac4070f45c824e03989028412064f0fa19bee691dd85c9329402c6a90e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Age</topic><topic>Babies</topic><topic>Births</topic><topic>Blindness - diagnosis</topic><topic>Blindness - epidemiology</topic><topic>Blindness - etiology</topic><topic>Cerebral palsy</topic><topic>Cerebral Palsy - diagnosis</topic><topic>Cerebral Palsy - epidemiology</topic><topic>Cerebral Palsy - etiology</topic><topic>Child, Preschool</topic><topic>Children</topic><topic>Developmental Disabilities - diagnosis</topic><topic>Developmental Disabilities - epidemiology</topic><topic>Developmental Disabilities - etiology</topic><topic>England - epidemiology</topic><topic>Families & family life</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Gestational Age</topic><topic>Hearing loss</topic><topic>Hearing Loss - diagnosis</topic><topic>Hearing Loss - epidemiology</topic><topic>Hearing Loss - etiology</topic><topic>Humans</topic><topic>Hydrocephalus</topic><topic>Infant</topic><topic>Infant Mortality - trends</topic><topic>Infant, Extremely Premature</topic><topic>Infant, Newborn</topic><topic>Infant, Premature, Diseases - diagnosis</topic><topic>Infant, Premature, Diseases - epidemiology</topic><topic>Infant, Premature, Diseases - etiology</topic><topic>Intensive Care, Neonatal - statistics & numerical data</topic><topic>Intensive Care, Neonatal - trends</topic><topic>Intervention</topic><topic>Logistic Models</topic><topic>Lost to Follow-Up</topic><topic>Male</topic><topic>Maternal & child health</topic><topic>Morbidity</topic><topic>Neonates</topic><topic>Neurodevelopmental disorders</topic><topic>Newborn babies</topic><topic>Outcome Assessment, Health Care</topic><topic>Paralysis</topic><topic>Pediatrics</topic><topic>Premature babies</topic><topic>Preschool education</topic><topic>Prevalence</topic><topic>Prospective Studies</topic><topic>Psychological Tests</topic><topic>Risk Factors</topic><topic>Seizures</topic><topic>Standard deviation</topic><topic>Survival</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Moore, Tamanna</creatorcontrib><creatorcontrib>Hennessy, Enid M</creatorcontrib><creatorcontrib>Myles, Jonathan</creatorcontrib><creatorcontrib>Johnson, Samantha J</creatorcontrib><creatorcontrib>Draper, Elizabeth S</creatorcontrib><creatorcontrib>Costeloe, Kate L</creatorcontrib><creatorcontrib>Marlow, Neil</creatorcontrib><collection>BMJ Open Access Journals</collection><collection>BMJ Journals:Open Access</collection><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Index</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection (ProQuest)</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Research Library</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest Central (New)</collection><collection>ProQuest One Academic (New)</collection><collection>ProQuest Health & Medical Research Collection</collection><collection>ProQuest One Academic Middle East (New)</collection><collection>ProQuest One Health & Nursing</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Applied & Life Sciences</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMJ (Online)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Moore, Tamanna</au><au>Hennessy, Enid M</au><au>Myles, Jonathan</au><au>Johnson, Samantha J</au><au>Draper, Elizabeth S</au><au>Costeloe, Kate L</au><au>Marlow, Neil</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Neurological and developmental outcome in extremely preterm children born in England in 1995 and 2006: the EPICure studies</atitle><jtitle>BMJ (Online)</jtitle><addtitle>BMJ</addtitle><date>2012-12-04</date><risdate>2012</risdate><volume>345</volume><issue>dec04 3</issue><spage>e7961</spage><epage>e7961</epage><pages>e7961-e7961</pages><issn>0959-8138</issn><issn>1756-1833</issn><eissn>1756-1833</eissn><abstract>Objective To determine outcomes at age 3 years in babies born before 27 completed weeks’ gestation in 2006, and to evaluate changes in outcome since 1995 for babies born between 22 and 25 weeks’ gestation.Design Prospective national cohort studies, EPICure and EPICure 2.Setting Hospital and home based evaluations, England.Participants 1031 surviving babies born in 2006 before 27 completed weeks’ gestation. Outcomes for 584 babies born at 22-25 weeks’ gestation were compared with those of 260 surviving babies of the same gestational age born in 1995.Main outcome measures Survival to age 3 years, impairment (2008 consensus definitions), and developmental scores. Multiple imputation was used to account for the high proportion of missing data in the 2006 cohort.Results Of the 576 babies evaluated after birth in 2006, 13.4% (n=77) were categorised as having severe impairment and 11.8% (n=68) moderate impairment. The prevalence of neurodevelopmental impairment was significantly associated with length of gestation, with greater impairment as gestational age decreased: 45% at 22-23 weeks, 30% at 24 weeks, 25% at 25 weeks, and 20% at 26 weeks (P<0.001). Cerebral palsy was present in 83 (14%) survivors. Mean developmental quotients were lower than those of the general population (normal values 100 (SD 15)) and showed a direct relation with gestational age: 80 (SD 21) at 22-23 weeks, 87 (19) at 24 weeks, 88 (19) at 25 weeks, and 91 (18) at 26 weeks. These results did not differ significantly after imputation. Comparing imputed outcomes between the 2006 and 1995 cohorts, the proportion of survivors born between 22 and 25 weeks’ gestation with severe disability, using 1995 definitions, was 18% (95% confidence interval 14% to 24%) in 1995 and 19% (14% to 23%) in 2006. Fewer survivors had shunted hydrocephalus or seizures. Survival of babies admitted for neonatal care increased from 39% (35% to 43%) in 1995 to 52% (49% to 55%) in 2006, an increase of 13% (8% to 18%), and survival without disability increased from 23% (20% to 26%) in 1995 to 34% (31% to 37%) in 2006, an increase of 11% (6% to 16%). Conclusion Survival and impairment in early childhood are both closely related to gestational age for babies born at less than 27 weeks’ gestation. Using multiple imputation to account for the high proportion of missing values, a higher proportion of babies admitted for neonatal care now survive without disability, particularly those born at gestational ages 24 and 25 weeks.</abstract><cop>England</cop><pub>British Medical Journal Publishing Group</pub><pmid>23212880</pmid><doi>10.1136/bmj.e7961</doi><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0959-8138 |
| ispartof | BMJ (Online), 2012-12, Vol.345 (dec04 3), p.e7961-e7961 |
| issn | 0959-8138 1756-1833 1756-1833 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3514471 |
| source | Jstor Complete Legacy; MEDLINE; BMJ Journals - NESLi2 |
| subjects | Age Babies Births Blindness - diagnosis Blindness - epidemiology Blindness - etiology Cerebral palsy Cerebral Palsy - diagnosis Cerebral Palsy - epidemiology Cerebral Palsy - etiology Child, Preschool Children Developmental Disabilities - diagnosis Developmental Disabilities - epidemiology Developmental Disabilities - etiology England - epidemiology Families & family life Female Follow-Up Studies Gestational Age Hearing loss Hearing Loss - diagnosis Hearing Loss - epidemiology Hearing Loss - etiology Humans Hydrocephalus Infant Infant Mortality - trends Infant, Extremely Premature Infant, Newborn Infant, Premature, Diseases - diagnosis Infant, Premature, Diseases - epidemiology Infant, Premature, Diseases - etiology Intensive Care, Neonatal - statistics & numerical data Intensive Care, Neonatal - trends Intervention Logistic Models Lost to Follow-Up Male Maternal & child health Morbidity Neonates Neurodevelopmental disorders Newborn babies Outcome Assessment, Health Care Paralysis Pediatrics Premature babies Preschool education Prevalence Prospective Studies Psychological Tests Risk Factors Seizures Standard deviation Survival |
| title | Neurological and developmental outcome in extremely preterm children born in England in 1995 and 2006: the EPICure studies |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-19T00%3A42%3A50IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Neurological%20and%20developmental%20outcome%20in%20extremely%20preterm%20children%20born%20in%20England%20in%201995%20and%202006:%20the%20EPICure%20studies&rft.jtitle=BMJ%20(Online)&rft.au=Moore,%20Tamanna&rft.date=2012-12-04&rft.volume=345&rft.issue=dec04%203&rft.spage=e7961&rft.epage=e7961&rft.pages=e7961-e7961&rft.issn=0959-8138&rft.eissn=1756-1833&rft_id=info:doi/10.1136/bmj.e7961&rft_dat=%3Cproquest_pubme%3E1223430618%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1778072754&rft_id=info:pmid/23212880&rfr_iscdi=true |