Developmental Trajectories in Very Preterm Born Children Up to 8 Years: A Longitudinal Cohort Study

Pauline E. van Beek (Corresponding author), Iris E. van der Horst, Josse Wetzer, Anneloes L. van Baar, Brigitte Vugs, Peter Andriessen

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12 Citaten (Scopus)
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Aim: Long-term outcome data in preterm children is often limited to cross-sectional measurement of neurodevelopmental impairment (NDI) at the corrected age of 24-36 months. However, impairments may only become overt during childhood or resolve with time, and individual trajectories in outcome over time may vary. The primary aim of this study was to describe NDI in very preterm born children at three subsequent ages of 2, 5, and 8 years of age. As a secondary aim, a longitudinal analysis was performed on the individual longitudinal trajectories in NDI from 2 to 8 years of age. Methods: Single-center prospective cohort study including children born between 1990 and 2011 below 30 weeks' gestation and followed into 2019. The outcome measurement was NDI assessed at 2, 5, and 8 years of age. NDI is a composite score that includes cognitive, neurological, visual, and auditory functions, in which problems were categorized as none, mild, moderate, or severe. Cognitive function measured as total DQ/IQ score was assessed by standardized psychometric tests. Neurological, visual, and auditory functions were assessed by the neonatologist. Results: In total, 921 children were eligible for follow-up, of whom 726 (79%) children were assessed. No NDI was seen in 54, 54, and 62%, mild NDI was seen in 31, 36, and 30%, and moderate-to-severe NDI was seen in 15, 9.2, and 8.6% of the children at 2, 5, and 8 years, respectively. From 2 to 8 years, 63% of the children remained in the same NDI category, 20% of the children improved to a better NDI category, and 17% deteriorated toward a worse NDI category. No differences were found in baseline characteristics of infants that improved or deteriorated. Extreme prematurity, male gender and low parental education were associated with worse NDI status at all time points. Although we observed considerable individual variation over time in NDI status, the course of the trajectories in NDI were not associated with gestation, gender, and parental education. Conclusions: Continued follow-up until school life is essential in order to provide optimal and individually focused referrals and care when needed.

Originele taal-2Engels
Aantal pagina's10
TijdschriftFrontiers in Pediatrics
StatusGepubliceerd - 10 mei 2021

Bibliografische nota

Copyright © 2021 van Beek, van der Horst, Wetzer, van Baar, Vugs and Andriessen.


PB, AB, BV, and PA contributed to the conception of the study. PB, IH, JW, and BV organized the database. PB performed the statistical analysis. PB and IH wrote the first draft of the manuscript. PA was responsible for the financial funding of the project and overall supervision. All authors contributed to the interpretation of the results, critically reviewed the manuscript, and approved the submitted version.

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