title: Neurodevelopmental outcomes of extremely premature infants conceived after assisted conception: a population based cohort study.
abstract: OBJECTIVE
  To compare neurodevelopmental outcomes of extremely preterm infants conceived after assisted conception (AC) compared with infants conceived spontaneously (non-AC).
  
  
  METHODS
  Population-based retrospective cohort study.
  
  
  METHODS
  Geographically defined area in New South Wales and the Australian Capital Territory, Australia served by a network of 10 neonatal intensive care units.
  
  
  METHODS
  Infants <29 weeks' gestation born between 1998 and 2004.
  
  
  METHODS
  At 2-3 years corrected age, 1473 children were assessed with either the Griffiths Mental Developmental Scales or the Bayley Scales of Infant Development.
  
  
  METHODS
  Moderate/severe functional disability defined as developmental delay (Griffiths General Quotient or Bayley Mental Developmental Index >2 SD below the mean), cerebral palsy (unable to walk without aids), deafness (bilateral hearing aids or cochlear implant) or blindness (visual acuity <6/60 in the better eye).
  
  
  RESULTS
  Mortality and age at follow-up were comparable between the AC and non-AC groups. Developmental outcome was evaluated in 217 (86.5%) AC and 1256 (71.7%) non-AC infants. Using multivariate adjusted analysis, infants born after in-vitro fertilisation at 22-26 weeks' gestation (adjusted OR 1.79, 95% CI 1.05 to 3.05, p=0.03) but not at 27-28 weeks' gestation (adjusted OR 0.81, 95% CI 0.37 to 1.77; p=0.59) had higher rate of functional disability than those born after spontaneous conception.
  
  
  CONCLUSIONS
  AC is associated with adverse neurodevelopmental outcome among high risk infants born at 22-26 weeks' gestation. This finding warrants additional exploration.
authors.affiliation: Department of Neonatology, Centenary Hospital for Women and Children, PO Box 11, Woden ACT 2606, Australia. Abdel-Latif.Mohamed@act.gov.au
authors.forename: M E
authors.initials: ME
authors.lastname: Abdel-Latif
authors.forename: Barbara
authors.initials: B
authors.lastname: Bajuk
authors.forename: Meredith
authors.initials: M
authors.lastname: Ward
authors.forename: Ju Lee
authors.initials: JL
authors.lastname: Oei
authors.forename: Nadia
authors.initials: N
authors.lastname: Badawi
mesh_terms: D000328:Adult; D001315:Australia; D015331:Cohort Studies; D002658:Developmental Disabilities / Q000453:epidemiology*; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D062071:Infant, Extremely Premature / Q000254:growth & development*; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000453:epidemiology* / Q000401:mortality; D007363:Intensive Care Units, Neonatal; D009517:New South Wales; D017063:Outcome Assessment, Health Care; D011247:Pregnancy; D011446:Prospective Studies; D027724:Reproductive Techniques, Assisted / Q000009:adverse effects* / Q000401:mortality; D012189:Retrospective Studies; D055815:Young Adult