Early nasal continuous positive airway pressure in a cohort of the smallest infants in Denmark: neurodevelopmental outcome at five years of age.
OBJECTIVE
To evaluate neurodevelopmental outcome at age 5 y of age in a cohort of preterm children treated mainly with nasal continuous positive airway pressure (CPAP) in the neonatal period.


METHODS
A national prospective observational study was conducted in Denmark which included all 269 surviving children with a birthweight below 1000 g or a gestational age below 28 wk born in Denmark in between 1994 and 1995. A total of 164 children (61%) had been treated with nasal CPAP only in the neonatal period. A reference group (n = 76) of term children was studied in parallel.


RESULTS
Of the 269 surviving children, 252 (94%) were examined. Twenty-four children (10%) had cerebral palsy, and three children were blind. No case of hearing impairment was detected. Nineteen percent of the index children had an IQ score <-- 2 SD and 42% had an IQ score <-- 1 SD of the mean score of the reference group.


CONCLUSIONS
The intellectual development of children in this cohort treated with early nasal CPAP did not suggest a higher proportion of adverse effects on the brain compared to the published follow-up studies of preterm children treated with mechanical ventilation. In our population-based cohort, however, the survival rate for infants below 25 wk of gestation was relatively low and this may indicate a limit for the use of early nasal CPAP.
Hansen
Bo M
BM
Department of Neonatology, JMC Section 5021, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen O, Denmark. moelholm@dadlnet.dk
Hoff
B
B
Greisen
G
G
Mortensen
E L
EL
D000367:Age Factors; D000886:Anthropometry; D001921:Brain / Q000002:abnormalities*; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D002658:Developmental Disabilities / Q000453:epidemiology* / Q000503:physiopathology; D004185:Disability Evaluation; D004453:Echoencephalography; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D019370:Observation; D011175:Positive-Pressure Respiration / Q000379:methods*; D011446:Prospective Studies; D012121:Respiration, Artificial; D014786:Vision Disorders / Q000453:epidemiology / Q000503:physiopathology; D014792:Visual Acuity / Q000502:physiology