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

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 240/7 and 266/7 weeks’ gestation who were 5.5 years’ corrected age (CA) in 2018–2020 were included. Main outcome measures Main outcome measure was neurode... Mehr ...

Verfasser: van Beek, Pauline E
Rijken, Monique
Broeders, Lisa
ter Horst, Hendrik J
Koopman-Esseboom, Corine
de Kort, Ellen
Laarman, A R C
Mulder - de Tollenaer, S M
Steiner, Katerina
Swarte, Renate M C
van Westering-Kroon, Elke
Oei, Guid
Leemhuis, Aleid G
Andriessen, Peter
Dokumenttyp: TEXT
Erscheinungsdatum: 2024
Verlag/Hrsg.: BMJ Publishing Group Ltd
Schlagwörter: Original research
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-28992212
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : http://fn.bmj.com/cgi/content/short/109/3/272

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 240/7 and 266/7 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.