TOPLINE:

Children born before 27 weeks of development show higher rates of neurodevelopmental disabilities at age 12, with 37.4% showing moderate-to-severe impairment compared with 4.6% in those born full-term. The infants were at an increased risk for autism spectrum disorder, attention-deficit/hyperactivity disorder, and developmental coordination disorder, with 59% of affected children having multiple disabilities.

METHODOLOGY:

• The study was conducted as part of the Extremely Preterm Infants in Sweden Study, which included all infants born prematurely (before 27 weeks of gestation) from April 2004 to March 2007.
• At age 12, 462 extremely premature infants who survived were analyzed alongside 373 infants born at term using verified clinical tests and intelligence assessments, which measured cognition, motor function, and behavior.
• Analysis included diagnoses from national health registers, including the Swedish National Patient Register and the Swedish National Prescribed Drug Register.
• Parents completed health questionnaires to provide additional information about each child’s conditions.

TAKEAWAY:

• Cognitive impairment was the most common disability, affecting one third of children born extremely premature. The prevalence of moderate-to-severe neurodevelopmental disabilities increased from 33.6% at age 6.5 years to 37.4% at age 12 years.
• Extremely premature children showed higher rates of moderate or severe neurodevelopmental disability than control individuals (37.4% vs 4.6%), with elevated rates of autism spectrum disorder (14.9% vs 2.4%; odds ratio [OR], 7.10; 95% CI, 3.48-15.1), attention-deficit/hyperactivity disorder (21.2% vs 8.9%; OR, 2.77; 95% CI, 1.81-4.26), and developmental coordination disorder (29.4% vs 5.8%).
• Among premature children with a moderate or severe neurodevelopmental disability, 59% had two or more co-occurring disabilities or disorders than 24.9% with no or mild disabilities.
• The mean cognitive ability score of those born extremely premature was 89.6 (SD, 15.6), which was lower than that of the control group at 105.1 (SD, 13.0); the mean difference was 15.5 (95% CI, 13.5-17.5; P < .001).
• Overall, 57.4% of children born extremely premature did not have moderate-to-severe neurodevelopmental disability and autism spectrum disorder, while 40.2% were free of autism spectrum disorder, attention-deficit/hyperactivity disorder, and developmental coordination disorder.

IN PRACTICE:

“Children born extremely preterm remain at high risk for neurodevelopmental disability at 12 years of age and exhibit a high prevalence of cognitive deficits…and behavioral problems, with a high rate of multidomain disability necessitating multidisciplinary follow-up,” the researchers of the study reported.

SOURCE:

The study was led by Fredrik Serenius, MD, PhD, Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden. It was published online in Pediatrics.

LIMITATIONS:

Cognition was not formally assessed for all extremely premature children. Researchers were aware which children were in the premature group during routine follow-ups, which may have introduced bias. The database in which infant data were collected may be less precise than the research data.

DISCLOSURES:

The authors reported having no relevant financial disclosures.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.