title: [Neurodevelopmental outcome at 3 years of age of infants born at less than 26 weeks].
abstract: OBJECTIVE
  To describe the neurodevelopmental outcome and perinatal factors associated with favorable outcome among extremely preterm children at 3 years of age.
  
  
  METHODS
  All infants born before 26 weeks of gestation between 2007 and 2011, admitted to intensive care units participating in a French regional network (western PACA-southern Corsica) were included. Perinatal data were collected to assess the main neonatal morbidities. At 3 years of age, the children's neurodevelopment was assessed by trained physicians participating in the follow-up network. Children were classified according to their disability: none, moderate, or severe. Using logistic regression, we determined the perinatal factors associated with the absence of disability at 3 years of age.
  
  
  RESULTS
  One hundred and sixty-two very preterm newborns were admitted to neonatal intensive care units. At discharge the survival rate was 62% (101). Rates of survival increased with gestational age (33% at 23 weeks, 57% at 24 weeks and 68% at 25 weeks). Among the 101 surviving extremely preterm children, 66 were evaluated at 3 years. The perinatal characteristics were not significantly different from those of the children lost to follow-up. Overall, 56% of extremely preterm children had no disability and 6% had severe disability. Cerebral palsy was diagnosed in 13% of children. At 3 years of age, the main perinatal factors associated with no disability were short duration of mechanical ventilation (OR=0.96 [0.93-0.99]; P=0.03) and complete course of prenatal corticosteroids (OR=4.7 [1.2-17.7]; P=0.02).
  
  
  CONCLUSIONS
  As mortality rates continue to decrease for very preterm infants, concerns are rising about their long-term outcome. In this high-risk population, improving perinatal care remains a challenge to improve long-term outcome.
authors.affiliation: Service de néonatologie, pôle femmes-parents-enfants, hôpital de la Conception, Aix-Marseille université, Assistance publique-Hôpitaux de Marseille, 13005 Marseille, France. Electronic address: odeline.delmas@ap-hm.fr.
authors.forename: O
authors.initials: O
authors.lastname: Delmas
authors.affiliation: Service de néonatologie, pôle femmes-parents-enfants, hôpital de la Conception, Aix-Marseille université, Assistance publique-Hôpitaux de Marseille, 13005 Marseille, France; Réseau naître et devenir, PACA Ouest-Corse du Sud, 13015 Marseille, France.
authors.forename: P
authors.initials: P
authors.lastname: Garcia
authors.affiliation: Réseau naître et devenir, PACA Ouest-Corse du Sud, 13015 Marseille, France.
authors.forename: V
authors.initials: V
authors.lastname: Bernard
authors.affiliation: Réseau naître et devenir, PACA Ouest-Corse du Sud, 13015 Marseille, France; Centre d'action médicosociale précoce, hôpital Nord, Aix-Marseille université, Assistance publique-Hôpitaux de Marseille, 13015 Marseille, France.
authors.forename: M
authors.initials: M
authors.lastname: Fabre
authors.affiliation: Service de réanimation pédiatrique et néonatale, hôpital Nord, Aix-Marseille université, Assistance publique-Hôpitaux de Marseille, 13015 Marseille, France.
authors.forename: R
authors.initials: R
authors.lastname: Vialet
authors.affiliation: Service de néonatologie, pôle femmes-parents-enfants, hôpital de la Conception, Aix-Marseille université, Assistance publique-Hôpitaux de Marseille, 13005 Marseille, France.
authors.forename: F
authors.initials: F
authors.lastname: Boubred
authors.affiliation: Service de néonatologie, pôle femmes-parents-enfants, hôpital de la Conception, Aix-Marseille université, Assistance publique-Hôpitaux de Marseille, 13005 Marseille, France.
authors.forename: L
authors.initials: L
authors.lastname: Fayol
mesh_terms: D002547:Cerebral Palsy / Q000453:epidemiology; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D005938:Glucocorticoids / Q000627:therapeutic use; D017052:Hospital Mortality; D006801:Humans; D062071:Infant, Extremely Premature / Q000254:growth & development*; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008297:Male; D011247:Pregnancy; D011295:Prenatal Care; D012121:Respiration, Artificial / Q000706:statistics & numerical data
chemical_list: D005938:Glucocorticoids