title: Voice problems in school-aged children following very preterm birth.
abstract: OBJECTIVE
  Very preterm children may be at risk of voice abnormalities (dysphonia). Risk factors previously identified in extremely preterm children include female gender, multiple intubations, complicated intubation and very low birth weight. This study sought to identify the prevalence of dysphonia in very preterm children, at school age.
  
  
  METHODS
  Children born between 23 and 32 weeks' gestation were included in this prospective observational study. Participants were randomly selected from a sample stratified by gestational age and number of intubations, and were aged between 5 and 12 years at the time of assessment. Clinical voice assessments were conducted by a speech pathologist, and a diagnosis of dysphonia was made based on the presence and severity of disturbance to the voice. Retrospective chart review identified medical and demographic characteristics.
  
  
  RESULTS
  178 participants were assessed. The prevalence of dysphonia in this cohort was 61%. 31% presenting with significant dysphonia, that is, voice disturbance of greater than mild in severity. Female gender (p=0.009), gestational age (p=0.031) and duration of intubation (p=0.021) were significantly associated with dysphonia although some preterm children with dysphonia were never intubated.
  
  
  CONCLUSIONS
  Significant voice abnormalities were observed in children born at up to 32 weeks' gestation, with intubation a major contributing factor.
  
  
  BACKGROUND
  ACTRN12613001015730.
authors.affiliation: Centre for Neonatal Research and Education, School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia.|School of Psychology and Speech Pathology, Curtin University, Perth, Australia.
authors.forename: Victoria
authors.identifier: http://orcid.org/0000-0003-1332-1471
authors.initials: V
authors.lastname: Reynolds
authors.affiliation: Centre for Neonatal Research and Education, School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia.|School of Psychology and Social Science, Faculty of Health, Engineering and Science, Edith Cowan University, Perth, Western Australia, Australia.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Meldrum
authors.affiliation: Centre for Neonatal Research and Education, School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia.|Department of Neonatal Paediatrics, King Edward Memorial Hospital and Princess Margaret Hospital for Children, Subiaco, Western Australia, Australia.
authors.forename: Karen
authors.initials: K
authors.lastname: Simmer
authors.affiliation: Centre for Neonatal Research and Education, School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia.|Department of Otolaryngology and Head and Neck Surgery, Princess Margaret Hospital for Children, Subiaco, Western Australia, Australia.|School of Surgery, University of Western Australia, Perth, Western Australia, Australia.
authors.forename: Shyan
authors.initials: S
authors.lastname: Vijayasekaran
authors.affiliation: Centre for Neonatal Research and Education, School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia.|Department of Neonatal Paediatrics, King Edward Memorial Hospital and Princess Margaret Hospital for Children, Subiaco, Western Australia, Australia.|Health Department of Western Australia, State Child Development Centre, Perth, Western Australia, Australia.
authors.forename: Noel
authors.initials: N
authors.lastname: French
mesh_terms: D002648:Child; D002675:Child, Preschool; D055154:Dysphonia / Q000209:etiology*; D005260:Female; D005865:Gestational Age; D006801:Humans; D062071:Infant, Extremely Premature; D007442:Intubation, Intratracheal / Q000706:statistics & numerical data; D008297:Male; D015588:Observer Variation; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D014904:Western Australia
keywords: Ent; Neonatology; Neurodevelopment; Outcomes research