[Neurologic development in premature infants under 33 weeks of gestational age: determination of risk of neurological abnormalities in a prospective regional survey with a control group].
OBJECTIVE
The purpose of this population-based study was to compare the incidence of neurodevelopmental disability and its risk factors between preterm and full-term infants matched as control group.


METHODS
The preterm cohort included 203 infants born between 25 and 33 weeks of gestational age in the region of Franche-Comté (France) during a two-year-period. The control group included 196 full-term infants born in the same maternities. Survival up to the date of follow-up was 171/203 (84%) for preterms and 195/196 (99.5%) for full-term infants (uncorrected age, mean 12 months). Neurodevelopmental assessments were performed by pediatricians or physicians on 164/171 surviving preterms (96% follow-up) and 179/195 full-terms (92%).


RESULTS
Thirty-two (19.5%) preterm infants had disability, ten of these (6%) showing severe disability. Five (2.8%) full-term infants had disability, one of these (.5%) having severe disability. Risk factors predicting a disability included in a multivariate approach: prematurity (odds-ratio [OR]: 7.8), maternal age > 37 (OR: 3.0), lack of profession for both parents (OR: 3.7), male gender (OR: 2.9). The pediatrician observed a disability more frequently than the physician (OR: 2.46). Likewise, risk factors predicting a severe disability included: prematurity (OR: 10.8), lack of profession for both parents (OR: 5.8) and monochorial twin-placentation (OR: 4.5).


CONCLUSIONS
Prematurity is not the only risk factor to be taken into account for neurodevelopmental evaluation of premature infants, but its influence still remains widely predominant.
CHU de Besançon, France.
A
A
Burguet
A
A
Menget
E
E
Monnet
H
H
Allemand
A
A
Gasca-Avanzi
V
V
Laithier
C
C
Fromentin
R
R
Destuynder
J P
JP
Schaal
P
P
Wackenheim
D002657:Child Development; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D005865:Gestational Age; D006306:Health Surveys; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D015999:Multivariate Analysis; D009422:Nervous System Diseases / Q000453:epidemiology*; D009421:Nervous System Malformations; D011446:Prospective Studies; D012307:Risk Factors
Devenir neurologique des prématurés de moins de 33 semaines: détermination du risque d'anomalie neurologique dans une enquête régionale prospective avec groupe témoin.