Neurodevelopmental outcome at 5.5 years in Dutch preterm infants born at 24-26 weeks' gestational age: the EPI-DAF study

Pauline E. van Beek (Corresponding author), Monique Rijken, Lisa Broeders, Hendrik J. ter Horst, Corine Koopman-Esseboom, Ellen de Kort, A.R.C. Laarman, S.M. Mulder-de Tollenaer, Katerina Steiner, Renate M.C. Swarte, Elke van Westering-Kroon, Guid Oei, Aleid G. Leemhuis, Peter Andriessen

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OBJECTIVE: After lowering the Dutch threshold for active treatment from 25 to 24 completed weeks' gestation, survival to discharge increased by 10% in extremely preterm live born infants. Now that this guideline has been implemented, an accurate description of neurodevelopmental outcome at school age is needed.

DESIGN: Population-based cohort study.

SETTING: All neonatal intensive care units in the Netherlands.

PATIENTS: All infants born between 240/7 and 266/7 weeks' gestation who were 5.5 years' corrected age (CA) in 2018-2020 were included.

MAIN OUTCOME MEASURES: Main outcome measure was neurodevelopmental outcome at 5.5 years. Neurodevelopmental outcome was a composite outcome defined as none, mild or moderate-to-severe impairment (further defined as neurodevelopmental impairment (NDI)), using corrected cognitive score (Wechsler Preschool and Primary Scale of Intelligence Scale-III-NL), neurological examination and neurosensory function. Additionally, motor score (Movement Assessment Battery for Children-2-NL) was assessed. All assessments were done as part of the nationwide, standardised follow-up programme.

RESULTS: In the 3-year period, a total of 632 infants survived to 5.5 years' CA. Data were available for 484 infants (77%). At 5.5 years' CA, most cognitive and motor (sub)scales were significantly lower compared with the normative mean. Overall, 46% had no impairment, 36% had mild impairment and 18% had NDI. NDI-free survival was 30%, 49% and 67% in live born children at 24, 25 and 26 weeks' gestation, respectively (p<0.001).

CONCLUSIONS: After lowering the threshold for supporting active treatment from 25 to 24 completed weeks' gestation, a considerable proportion of the surviving extremely preterm children did not have any impairment at 5.5 years' CA.

Originele taal-2Engels
Pagina's (van-tot)272-278
Aantal pagina's7
TijdschriftArchives of Disease in Childhood : Fetal and Neonatal Edition
Nummer van het tijdschrift3
Vroegere onlinedatum27 nov. 2023
StatusGepubliceerd - mei 2024


PvB, MR, AGvW-L, PA and EPI-DAF study group had a substantial contribution to the methodological design of the study. MR, HJtH, CK-E, EdK, ARCL, SMM, KS, RMS, EvW-K and AGvW-L had a substantial contribution to data acquisition, being the principal investigators of the 10 Dutch perinatal centres. PvB, MR, LB, AGvW-L and PA had a substantial contribution to the analysis and interpretation of the data. PvB wrote the first draft of the manuscript. PA was responsible for the financial funding of the project and supervised the project. PvB and PA are guarantors.

Stichting Tiny & Anny van Doorne Fonds


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