title: Neonatal factors associated with alteration of palatal morphology in very preterm children: the EPIPAGE cohort study.
abstract: BACKGROUND
  Altered palatal morphology has been observed among some preterm children, with possible consequences on chewing, speaking and esthetics, but determinants remain unknown.
  
  
  OBJECTIVE
  To explore the role of neonatal characteristics and neuromotor dysfunction in alteration of palatal morphology at 5 years of age in very preterm children.
  
  
  METHODS
  Prospective population-based cohort study.
  
  
  METHODS
  1711 children born between 22 and 32 weeks of gestation in 1997 or born between 22 and 26 weeks of gestation in 1998 were included in the study. They all had a medical examination at 5 years of age.
  
  
  METHODS
  Alteration of palatal morphology.
  
  
  RESULTS
  The prevalence of altered palatal morphology was 3.7% in the overall sample, 5.1% among boys and 2.2% among girls (adj OR: 2.52; 95%CI: 1.44-4.42). The risk for altered palatal morphology was higher for lower gestational age (adj OR: 0.85; 95%CI: 0.74-0.97 per week), small-for-gestational age children (adj OR: 2.11; 95%CI: 1.20-3.72) or children intubated for more than 28 days (adj OR: 3.16; 95%CI: 1.11-8.98). Altered palatal morphology was more common in case of cerebral palsy or moderate neuromotor dysfunction assessed at 5 years. Results were basically the same when neuromotor dysfunction was taken into account, except for intubation.
  
  
  CONCLUSIONS
  Male sex, low gestational age, small-for-gestational age and long intubation have been identified as probable neonatal risk factors for alteration of palatal morphology at 5 years of age in very preterm children. Further studies are needed to confirm these results.
authors.affiliation: Institut National de la Santé et de la Recherche Médicale Unit 953, Epidemiological Research Unit in Perinatal Health, Children and Women's Health, Villejuif, France. alice.germa@inserm.fr
authors.forename: Alice
authors.initials: A
authors.lastname: Germa
authors.forename: Stéphane
authors.initials: S
authors.lastname: Marret
authors.forename: Gérard
authors.initials: G
authors.lastname: Thiriez
authors.forename: Sylvaine
authors.initials: S
authors.lastname: Rousseau
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Hascoët
authors.forename: Liselotte
authors.initials: L
authors.lastname: Paulsson-Björnsson
authors.forename: Björn
authors.initials: B
authors.lastname: Söderfeldt
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Ancel
authors.forename: Béatrice
authors.initials: B
authors.lastname: Larroque
authors.forename: Monique
authors.initials: M
authors.lastname: Kaminski
authors.forename: Cathy
authors.initials: C
authors.lastname: Nabet
mesh_terms: D002675:Child, Preschool; D015897:Comorbidity; D002658:Developmental Disabilities / Q000453:epidemiology / Q000209:etiology / Q000473:pathology*; D005260:Female; D047109:Fetal Development; D005602:France / Q000453:epidemiology; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D008297:Male; D019957:Motor Skills Disorders / Q000453:epidemiology / Q000209:etiology / Q000473:pathology*; D009056:Mouth Abnormalities / Q000150:complications / Q000453:epidemiology / Q000473:pathology*; D010159:Palate / Q000002:abnormalities* / Q000503:physiopathology; D011247:Pregnancy; D047928:Premature Birth; D011446:Prospective Studies