title: Neurodevelopmental disability through 11 years of age in children born before 26 weeks of gestation.
abstract: BACKGROUND
  To assess functional disability in children born before 26 weeks of gestation at 11 years of age and the stability of findings in individuals between 6 and 11 years of age.
  
  
  METHODS
  Of 307 surviving children born in 1995, 219 (71%) were assessed at 11 years of age alongside 153 classmates. Children were evaluated by using standardized tests of cognitive ability and clinical condition at both ages.
  
  
  RESULTS
  Using classmate data to determine reference ranges, serious cognitive impairment (score of less than -2 SD) was present in 40% of extremely preterm children and 1.3% of classmates (odds ratio [OR]: 50 [95% confidence interval (CI): 12-206]) at 11 years of age. Overall, 38 (17%) extremely preterm children had cerebral palsy; moderate or severe impairment of neuromotor function, vision, and hearing was present in 10%, 9%, and 2% of these children, respectively. Combining impairment across domains, 98 (45%) extremely preterm children had serious functional disability compared with 1% of the classmates (OR: 61 [95% CI: 15-253]); this was more common in boys than girls (OR: 1.8 [95% CI: 1.0-3.1]) and in those born at 23 or 24 weeks' gestation compared with those born at 25 weeks' gestation (OR: 1.8 [95% CI: 1.0-3.1]). The prevalence of serious functional disability was 46% at 6 years of age and 45% at 11 years of age. Using multiple imputation to correct for selective dropout, it is estimated that 50% (95% CI: 44%-57%) of extremely preterm children are free of serious disability at 11 years of age.
  
  
  CONCLUSIONS
  Extremely preterm children remain at high risk for neurodevelopmental disability at 11 years of age compared with term peers. The prevalence of disability remained stable between 6 and 11 years of age, and large individual shifts in classification of disability were unusual.
authors: Neonatology, Institute for Women's Health, University College London, London, United Kingdom. sam.johnson@nottingham.ac.uk
authors: Samantha
authors: S
authors: Johnson
authors: Joe
authors: J
authors: Fawke
authors: Enid
authors: E
authors: Hennessy
authors: Vicky
authors: V
authors: Rowell
authors: Sue
authors: S
authors: Thomas
authors: Dieter
authors: D
authors: Wolke
authors: Neil
authors: N
authors: Marlow
mesh_terms: D001925:Brain Damage, Chronic / Q000453:epidemiology*; D002547:Cerebral Palsy / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D002658:Developmental Disabilities / Q000453:epidemiology*; D019988:Children with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000453:epidemiology*; D007859:Learning Disabilities / Q000453:epidemiology; D008297:Male; D009483:Neuropsychological Tests; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011596:Psychomotor Disorders / Q000453:epidemiology; D012016:Reference Values; D006113:United Kingdom