title: Neurodevelopmental outcome of extremely preterm infants born to rural and urban residents' mothers in Australia.
abstract: BACKGROUND
  Rural and remote residents in Australia have long experienced unfavourable health outcomes compared to their urban counterparts.
  
  
  OBJECTIVE
  To study neurodevelopmental outcome at 2-3 years of age, corrected for prematurity of extremely preterm infants admitted to a regional neonatal Australian network from rural and urban regions (based on usual location of maternal residence).
  
  
  METHODS
  A multicenter population-based cohort study in which surviving urban and rural infants <29 weeks of gestation born between 1998 and 2004 underwent neurodevelopmental assessment at 2-3 years of age, corrected for prematurity by a developmental assessment team. Moderate/severe functional disability was defined as developmental delay (GQ or MDI>2 SD below the mean), cerebral palsy (aided for walking), sensorineural or conductive deafness (requiring amplification), and bilateral blindness (visual acuity <6/60 in the better eye).
  
  
  RESULTS
  Of the 1970 infants alive at 2-3 years of age, 268 (63.8%) rural and 1205 (77.7%) urban infants were evaluated. Infants lost to follow-up were of slightly higher gestational age and birth weight. Both rural and urban assessed groups were comparable in gestation and birth weight percentile. In comparison to their urban counterparts, the rural group had more outborn infants (19.8% vs. 4.6%, p<0.001). They, however, did not have an increased risk of moderate/severe functional disability (OR 0.77, 95% CI 0.52-1.23, p=0.176). This finding was not significantly altered by limiting the analysis to different gestational ages.
  
  
  CONCLUSIONS
  Extremely premature surviving young children from rural areas of residence do not seem to have an increased risk for moderate/severe functional disability.
authors.affiliation: The Clinical School, Australian National University, ACT, Australia.
authors.forename: Andrea N
authors.initials: AN
authors.lastname: Rodrigues
authors.affiliation: Neonatal Intensive Care Units' (NICUS) Data Collection, NSW Pregnancy and Newborn Services Network (PSN), Sydney Children's Hospitals Network, NSW, Australia.
authors.forename: Barbara
authors.initials: B
authors.lastname: Bajuk
authors.affiliation: Department of Newborn Care, Royal Hospital for Women, NSW, Australia; School of Women's and Children's Heath, University of New South Wales, NSW, Australia.
authors.forename: Julee
authors.initials: J
authors.lastname: Oei
authors.affiliation: Department of Newborn Care, Royal Hospital for Women, NSW, Australia; School of Women's and Children's Heath, University of New South Wales, NSW, Australia.
authors.forename: Kei
authors.initials: K
authors.lastname: Lui
authors.affiliation: The Clinical School, Australian National University, ACT, Australia; Department of Neonatology, Centenary Hospital for Women and Children, ACT, Australia. Electronic address: Abdel-Latif.Mohamed@act.gov.au.
authors.forename: Mohamed E
authors.initials: ME
authors.lastname: Abdel-Latif
mesh_terms: D000328:Adult; D001315:Australia; D002658:Developmental Disabilities / Q000453:epidemiology*; D005260:Female; D006801:Humans; D062071:Infant, Extremely Premature / Q000254:growth & development / Q000502:physiology*; D007231:Infant, Newborn; D008297:Male; D047928:Premature Birth / Q000453:epidemiology*; D012424:Rural Population / Q000706:statistics & numerical data*; D014505:Urban Population / Q000706:statistics & numerical data*
keywords: Low birth weight; Neurodevelopment; Outcome; Premature; Preterm; Rural