title: Predicting neurosensory disabilities at two years of age in a national cohort of extremely premature infants.
abstract: BACKGROUND
  Extreme prematurity carries a high risk of neurosensory disability.
  
  
  OBJECTIVE
  Examine which information obtained pre-, peri- and postnatally may be predictive of neurosensory disabilities at 2 years of age.
  
  
  METHODS
  Prospective observational study of all infants born in Norway in 1999 and 2000 with gestational age (GA) 22-27 completed weeks or birth weight (BW) of 500-999 g.
  
  
  METHODS
  Incidence of neurosensory disabilities.
  
  
  RESULTS
  Of 373 surviving children, 30 (8%) had major neurosensory disabilities (26 CP, 6 blind, 3 deaf), and a further 46 (12%) had minor visual or hearing disabilities. The rate of major neurosensory disabilities was 19 of 99 (19%) for children with GA 23-25 vs. 8 of 189 (4%) for GA 26-27 weeks (p<0.001). In a multivariable model, only morbidities detected in the neonatal intensive care unit (NICU) were associated with major neurosensory disabilities; adjusted odds ratios (95% confidence intervals) were 68.6 (18.7, 252.2) for major abnormalities on cerebral ultrasound, 6.8 (1.7, 27.4) for retinopathy of prematurity (ROP) grade>2, 3.2 (1.0, 9.7) for ROP grade 1-2, 6.5 (1.9, 22.3) for prolonged use (> or = 21 days) of steroid treatment for lung disease and 3.1 (1.0, 9.4) for clinical chorioamnionitis. The visual outcome was strongly related to the degree of ROP (p<0.001), and all who had a normal hearing screen in the NICU had normal hearing at 2 years.
  
  
  CONCLUSIONS
  NICU morbidities, rather than GA or intrauterine growth are the significant predictors of major neurosensory disabilities among extreme prematurity surviving to discharge from the NICU.
authors.affiliation: Department of Clinical Medicine, University of Bergen, Bergen, Norway. ktle@helse-bergen.no
authors.forename: Katrine Tyborg
authors.initials: KT
authors.lastname: Leversen
authors.forename: Kristian
authors.initials: K
authors.lastname: Sommerfelt
authors.forename: Arild
authors.initials: A
authors.lastname: Rønnestad
authors.forename: Per Ivar
authors.initials: PI
authors.lastname: Kaaresen
authors.forename: Theresa
authors.initials: T
authors.lastname: Farstad
authors.forename: Janne
authors.initials: J
authors.lastname: Skranes
authors.forename: Ragnhild
authors.initials: R
authors.lastname: Støen
authors.forename: Irene Bircow
authors.initials: IB
authors.lastname: Elgen
authors.forename: Siren
authors.initials: S
authors.lastname: Rettedal
authors.forename: Geir Egil
authors.initials: GE
authors.lastname: Eide
authors.forename: Lorentz M
authors.initials: LM
authors.lastname: Irgens
authors.forename: Trond
authors.initials: T
authors.lastname: Markestad
mesh_terms: D002547:Cerebral Palsy / Q000453:epidemiology*; D002675:Child, Preschool; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D016015:Logistic Models; D015233:Models, Statistical; D009664:Norway / Q000453:epidemiology; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012178:Retinopathy of Prematurity / Q000453:epidemiology*; D012678:Sensation Disorders / Q000453:epidemiology*