Source:Pediatric Neurology
Author(s): Rachel G. Hirschberger, Karl C.K. Kuban, Thomas M. O'Shea, Robert M. Joseph, Tim Heeren, Laurie Douglass, Carl E. Stafstrom, Hernan Jara, Jean A. Frazier, Deborah Hirtz, Julie Rollins, Nigel Paneth
ObjectiveTo determine the prevalence of isolated and multiple neurodevelopmental impairments at age 10 years among children born extremely preterm (<28 weeks gestational age) and to offer a framework for categorizing neurological limitations.DesignA multicenter, prospective cohort follow-up study (Extremely Low Gestational Age Newborn Study) recruited 889 10 year-old children (92% of eligible children) born from 2002-2004. We assessed prevalence of cognitive impairment, measured by intelligent quotient (IQ) and tests of executive function, cerebral palsy (CP), autistic spectrum disorder (ASD), and epilepsy singly and in combination. The three-levels of impairment severity were: Category I: no major neurodevelopmental impairment. Category II: normal cognitive ability with CP, ASD, and/or epilepsy. Category III: children with cognitive impairment.Results214 of 873 children (25%) had cognitive impairment, 93 of 849 children (11%) had CP, 61 of 857 children (7%) had ASD, and 66 of 888 children (7%) had epilepsy. 19% of all children had 1 diagnosis, 10% had 2 diagnoses, 3% had 3 diagnoses, and none had 4 diagnoses. Decreasing gestational age was associated with increasing number of impairments (p<0.001). Half the children with cognitive impairment and a third of children with CP, ASD, or epilepsy had a single impairment. 601 (68% [95% CI, 64.5%-70.7%]) of children were in Category I, 74 (8% [95% CI, 6.6%-10.3%]) were in Category II, and 214 (24% [95% CI 21.7%-27.4%]) were in Category III.ConclusionsThree quarters of children had normal intellect at age 10 years; nearly 70% were free of neurodevelopmental impairment. 40% of those with impairments had multiple diagnoses.
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