title: Comparison in outcomes at two-years of age of very preterm infants born in 2000, 2005 and 2010.
abstract: OBJECTIVE
  To investigate alteration in 2-year neurological/behavioral outcomes of very preterm infants born in a French level three neonatal intensive care unit.
  
  
  METHODS
  We conducted a prospective, comparative study of very preterm infants born before 33 weeks' gestation at 5-year intervals in 2000, 2005 and 2010 at Rouen University Hospital. Neonatal mortality/morbidities, ante- and neonatal treatments, and at age 2 years motor, cognitive and behavioral data were collected by standardized questionnaires.
  
  
  RESULTS
  We included 536 very preterm infants. Follow-up rates at two years old were 78% in 2000, 93% in 2005 and 92% in 2010 respectively. No difference in gestational age, birthweight, neonatal mortality/morbidities was observed except a decrease in low grade subependymal/intraventricular hemorrhages. Care modifications concerned use of antenatal magnesium sulfate, breast-feeding and post-natal corticosteroid therapy. Significant improvement in motor outcome and dramatic decrease in cerebral palsy rates (12% in 2000, 6% in 2005, 1% in 2010, p<0.001) were observed, as were improvements in feeding behavior. Although a non significant difference to better psychosocial behavior was reported, there was no difference in cognitive outcome.
  
  
  CONCLUSIONS
  Improvement in neuromotor outcome and behavior was reported. This could be due to multiple modifications in care: including administration of magnesium sulfate to women at risk of preterm birth, increase in breast-feeding, decrease in low grade subependymal/intraventricular hemorrhages, and decrease in post-natal corticosteroid therapy, all of which require further investigation in other studies. Extended follow-up until school age is mandatory for better detection of cognitive, learning and behavioral disorders.
authors: Department of Neonatal Medicine, Rouen University Hospital, Rouen, Haute-Normandie, France; Equipe Region-Institut National de la Santé et de la Recherche Médicale, ERI 28, Neovasc, Institute for Biomedical Research and Innovation, School of Medicine, Rouen University, Rouen, Haute-Normandie, France.
authors: Lénaïg
authors: L
authors: Abily-Donval
authors: Department of Neonatal Medicine, Rouen University Hospital, Rouen, Haute-Normandie, France.
authors: Gaëlle
authors: G
authors: Pinto-Cardoso
authors: Department of Neonatal Medicine, Rouen University Hospital, Rouen, Haute-Normandie, France.
authors: Alexandra
authors: A
authors: Chadie
authors: Department of Neonatal Medicine, Rouen University Hospital, Rouen, Haute-Normandie, France.
authors: Anne-Marie
authors: AM
authors: Guerrot
authors: Department of Neonatal Medicine, Rouen University Hospital, Rouen, Haute-Normandie, France.
authors: Stéphanie
authors: S
authors: Torre
authors: Department of Neonatal Medicine, Rouen University Hospital, Rouen, Haute-Normandie, France.
authors: Stéphane
authors: S
authors: Rondeau
authors: Department of Neonatal Medicine, Rouen University Hospital, Rouen, Haute-Normandie, France; Equipe Region-Institut National de la Santé et de la Recherche Médicale, ERI 28, Neovasc, Institute for Biomedical Research and Innovation, School of Medicine, Rouen University, Rouen, Haute-Normandie, France.
authors: Stéphane
authors: S
authors: Marret
mesh_terms: D002657:Child Development / Q000502:physiology*; D002675:Child, Preschool; D003071:Cognition / Q000502:physiology*; D005247:Feeding Behavior / Q000502:physiology*; D005260:Female; D006801:Humans; D062071:Infant, Extremely Premature / Q000502:physiology*; D008297:Male; D009043:Motor Activity / Q000502:physiology*; D011446:Prospective Studies