The relationship of neurodevelopmental impairment to concurrent early childhood outcomes of extremely preterm infants.

Abstract

ObjectiveDetermine how neurodevelopmental impairment (NDI) relates to concurrent outcomes for children born extremely preterm.Study designRetrospective cohort study children born 22 0/7–26 6/7 weeks’ gestation at NICHD Neonatal Research Network hospitals. Outcomes were ascertained at 18–22 months’ corrected age.ResultOf 6562 children, 2618 (40%) died and 441 (7%) had no follow-up. Among the remaining 3483 children, 825 (24%), 1576 (45%), 657 (19%), and 425 (12%) had no, potential/mild, moderate, and severe NDI, respectively. Rehospitalization, respiratory medications, surgery, and medical support services were associated with greater NDI severity but affected >10% of children without NDI. Rehospitalization occurred in 40% of children with no NDI (mean (SD): 1.7 (1.3) episodes).ConclusionMedical, functional, and social outcomes at 18–22 months’ corrected age were associated with NDI; however, many children without NDI were affected. These data should contribute to counseling families and the design of studies for childhood outcomes beyond NDI.