Two-thirds of adolescents who received active perinatal care after extremely preterm birth had mild or no disabilities.
OBJECTIVE
Active perinatal care (APC) increases the survival of extremely preterm (EPT) infants, but may increase the rate of disabilities. We examined neurodevelopmental outcomes in adolescents aged 10-15 years who were born EPT and received APC in two Swedish tertiary care centres.


METHODS
Cognitive function was assessed using the Wechsler Intelligence Scale for Children, and neurosensory impairments were assessed by reviewing the case records and a standard parent health questionnaire. The outcomes were compared to term-born controls.


RESULTS
We assessed 132 EPT adolescents and 103 controls. The rates of cerebral palsy, moderate to severe visual impairment and moderate to severe hearing impairment were 9%, 4% and 6%, respectively, for the EPT children and zero for the controls. Serious cognitive impairment was present in 31% of the EPT adolescents and 5% of the controls. Combining impairments across domains showed that 34% of EPT adolescents had moderate and severe disabilities compared with 5% of the controls. Impairments were more common at 23-24 weeks of gestational age (43%) than at 25 weeks (28.4%).


CONCLUSIONS
Two-thirds (66%) of adolescents born EPT who received APC had mild or no disabilities. Our results are relevant for healthcare providers and clinicians counselling families.
Institute of Clinical Sciences, Department of Pediatrics, University of Umeå, Umeå, Sweden.
A
A
Holsti
Institute of Clinical Sciences, Department of Pediatrics, University of Umeå, Umeå, Sweden.
M
M
Adamsson
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
F
F
Serenius
Institute of Clinical Sciences, Child and Adolescent Psychiatry, University of Umeå, Umeå, Sweden.
B
B
Hägglöf
Institute of Clinical Sciences, Department of Pediatrics, University of Umeå, Umeå, Sweden. aijaz.farooqi@umu.se.
A
A
Farooqi
D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D002657:Child Development; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology*; D002658:Developmental Disabilities / Q000453:epidemiology*; D005260:Female; D005865:Gestational Age; D006801:Humans; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D018743:Perinatal Care / Q000379:methods / Q000592:standards*; D012720:Severity of Illness Index; D012923:Social Class; D016019:Survival Analysis; D013548:Sweden / Q000453:epidemiology; D013995:Time; D014888:Wechsler Scales
Active perinatal care; Cognitive function; Extremely preterm children; Long-term outcome; Neurodevelopmental outcome