Neurodevelopmental outcomes following late and moderate prematurity: Population-based cohort study

Objective. There is a paucity of data relating to neurodevelopmental outcomes in infants born late and moderately preterm (LMPT; 32[SUPERSCRIPT +0]-36[SUPERSCRIPT +6] weeks). This paper present results of a prospective, population-based study of 2-year outcomes following LMPT birth. Design.1130 LMPT and 1255 term-born children were recruited at birth. At 2-years corrected age, parents completed a questionnaire to assess neurosensory (vision, hearing, motor) impairments and the Parent Report of Children’s Abilities-Revised to identify cognitive impairment. Relative Risks for adverse outcomes were adjusted for sex, socio-economic status, small for gestational age and weighted to account for over-sampling of term-born multiples. Risk factors for cognitive impairment were explored using multivariable analyses. Results. Parents of 638 (57%) LMPT infants and 765 (62%) controls completed questionnaires. Among LMPT infants, 1.6% had neurosensory impairment compared with 0.3% of controls (RR 4.89, 95% CI 1.07, 22.25). Cognitive impairments were the most common adverse outcome: LMPT 6.3%; controls 2.4% (RR 2.09, 95% CI 1.19, 3.64). LMPT infants were at twice the risk for neurodevelopmental disability (RR 2.19, 95% CI 1.27, 3.75). Independent risk factors for cognitive impairment in LMPT infants were male sex, socio-economic disadvantage, non-white ethnicity, preeclampsia and not receiving breast milk at discharge. Conclusions. Compared with term-born peers, LMPT infants are at double the risk for neurodevelopmental disability at 2 years of age, with the majority of impairments observed in the cognitive domain. Male sex, socio-economic disadvantage and preeclampsia are independent predictors of low cognitive scores following LMPT birth.