Neurodevelopmental outcome at early school age in a Swiss national cohort of very preterm children.

Details

Serval ID
serval:BIB_152884FEB305
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Neurodevelopmental outcome at early school age in a Swiss national cohort of very preterm children.
Journal
Swiss medical weekly
Author(s)
Pittet-Metrailler M.P., Mürner-Lavanchy I., Adams M., Bickle-Graz M., Pfister R.E., Natalucci G., Grunt S., Borradori Tolsa C.
Working group(s)
Swiss National Network And Follow-Up Group
ISSN
1424-3997 (Electronic)
ISSN-L
0036-7672
Publication state
Published
Issued date
20/05/2019
Peer-reviewed
Oui
Volume
149
Pages
w20084
Language
english
Notes
Publication types: Evaluation Study ; Journal Article
Publication Status: epublish
Abstract
Infants born very preterm are at higher risk of long-term neurodevelopmental problems than children born at term. Although there are increasing numbers of reports on outcomes from international cohorts of premature infants, a Swiss national report on infants after 2 years of age is lacking.
To describe neurodevelopmental outcomes at early school age of preterm children born in Switzerland with a special focus on the cognitive abilities.
This prospective national cohort study included children born alive before 30 weeks of gestation in 2006. At 5 years of age, children underwent a neurological examination and intelligence testing with the Kaufman Assessment Battery for Children first edition (K-ABC). We assessed the mental processing composite score (MPC) and its subscales to explore specific cognitive deficits. The primary outcome was cognitive impairment (MPC score <-1 standard deviation from the normative mean), motor impairment (cerebral palsy), or sensory impairment (any visual or hearing deficiency). The need for early intervention or therapies and the association of perinatal factors with cognitive impairment were secondary and tertiary outcomes. Logistic regression models were used to analyse associations between neonatal factors and cognitive outcome.
Of 289 survivors, 235 were assessed. Of the 199 children with results obtained from the K-ABC, 42 (21%) showed cognitive impairment and 80 (40%) showed impairment in short-term memory. Cerebral palsy was diagnosed in 14 (6%), and visual and auditory impairment in 36 (15%) and 12 (5%) children, respectively; 63 (27%) needed early intervention or therapies. Cognitive impairment was associated with low socioeconomic status, but not with gestational age, small birthweight for gestational age, bronchodysplasia, or significant brain injury. A total of 146 children (63%) survived without any impairment.
This is the first study to report neurodevelopmental outcomes at early school age in a Swiss cohort. The majority had favourable outcomes, but 21% of children demonstrated cognitive impairment, which was most pronounced in short-term memory. Our findings were similar to those of international cohorts and indicate that preterm children born before 300/7 gestational weeks, especially those living in unfavourable social environments, are at an increased risk of cognitive impairment and need close monitoring beyond early school age. Trial registration no: KEK-ZH-Nr.2014-0552 &nbsp.
Keywords
Child, Preschool, Cognition Disorders/epidemiology, Cognition Disorders/etiology, Female, Gestational Age, Humans, Infant, Extremely Premature/growth & development, Infant, Newborn, Infant, Premature, Diseases/epidemiology, Infant, Premature, Diseases/etiology, Logistic Models, Male, Neurodevelopmental Disorders/epidemiology, Neurodevelopmental Disorders/etiology, Neurologic Examination, Prospective Studies, Switzerland/epidemiology
Pubmed
Web of science
Open Access
Yes
Create date
17/06/2019 17:11
Last modification date
03/05/2020 6:02
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