title: Impact at age 11 years of major neonatal morbidities in children born extremely preterm.
abstract: BACKGROUND
  Uncertainty continues regarding the extent to which neonatal morbidities predict poor long-term outcome and functional abilities in extremely preterm infants.
  
  
  OBJECTIVE
  The goal of this study was to determine the impact of bronchopulmonary dysplasia (BPD), ultrasonographic signs of brain injury, and severe retinopathy of prematurity (ROP) on 11-year outcomes in infants born at <26 weeks' gestation.
  
  
  METHODS
  A total of 247 infants were born alive before 26 completed weeks of gestation from 1990 through 1992 in all of Sweden, and 98 (40%) survived to a postmenstrual age of 36 weeks. Main outcome measures were (1) poor outcome, defined as combined end point of death after 36 weeks' postmenstrual age or survival with at least 1 major disability at 11 years, and (2) consequences of chronic conditions in the survivors according to a validated instrument administered to parents.
  
  
  RESULTS
  Brain injury and severe ROP but not BPD correlated independently with poor outcome at 11 years of age. Among children who were free from BPD, brain injury, and severe ROP, 10% had a poor outcome. Corresponding rates with any 1, any 2, and all 3 neonatal morbidities were 19%, 58%, and 80%, respectively. Multivariate analysis revealed that brain injury and severe ROP were associated with high rates of consequences of chronic conditions.
  
  
  CONCLUSIONS
  In infants born extremely preterm who survive to a postmenstrual age of 36 weeks, severe ROP and brain injury separately predict the risk of death or major disability at 11 years of age. Thus, continued research to determine how to prevent these complications of prematurity is critical.
authors.affiliation: Institute of Clinical Sciences, Department of Pediatrics, University Hospital, SE-901 85 Umeå, Sweden. aijaz.farooqi@pediatri.umu.se
authors.forename: Aijaz
authors.initials: A
authors.lastname: Farooqi
authors.forename: Bruno
authors.initials: B
authors.lastname: Hägglöf
authors.forename: Gunnar
authors.initials: G
authors.lastname: Sedin
authors.forename: Fredrik
authors.initials: F
authors.lastname: Serenius
mesh_terms: D000367:Age Factors; D001930:Brain Injuries / Q000150:complications / Q000175:diagnosis / Q000401:mortality; D001997:Bronchopulmonary Dysplasia / Q000150:complications / Q000175:diagnosis / Q000401:mortality; D002648:Child; D015331:Cohort Studies; D002658:Developmental Disabilities / Q000453:epidemiology / Q000209:etiology*; D019988:Children with Disabilities / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D007363:Intensive Care Units, Neonatal; D015931:Intensive Care, Neonatal / Q000379:methods; D007859:Learning Disabilities / Q000453:epidemiology / Q000209:etiology*; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011247:Pregnancy; D011379:Prognosis; D012178:Retinopathy of Prematurity / Q000150:complications / Q000175:diagnosis / Q000401:mortality; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D015996:Survival Rate; D017741:Survivors; D013548:Sweden