Although the mortality rate for hig...

Although the mortality rate for highly preterm infants has improved, little is known about long-term developmental issues A previously published study described developmental consequences of preterm infants at 30 month of age. Marlow and colleagues followed up with the cohort at six years of age.

The original cohort included 308 British and Irish infants born extremely prematurely (i.e., 25 weeks' gestation or earlier). All were alive at six years of age, and 241 were eligible for the reflection Each child in the preterm arrange was matched with a full-term classmate; these children made up the have charge of group. Children were clinically evaluated and trialed by developmental pediatricians and psychologists who were blind to the neonatal histories of the participants.

The children were classified by dint of severity of disability (i.e., austere moderate, mild, and none), according to cognitive ability, neuromotor function, vision, and hearing. Twenty-four percent had bitter disabilities at 30 months. methodical disability was defined as highly caregiver hanging nonambulatory cerebral palsy, blindness, accurate hearing loss, or an IQ more than three standard deviations below the mean. Moderate disability was defined as near caregiver independence, ambulatory cerebral palsy, correctable hearing los impaired vision, or an IQ brace to three standard deviations below the mean. Mild disability was defined as neurologic signs with minimal impairment.

Extremely preterm children were 24 percent more likely to have moderate disability and 22 percent more likely to have rigorous disability at six years of age compared with the hinder group. Overall, 80 percent of the preterm assign places to had some level of disability. Cognitive impairment was the principally common disability (41 percent). Extremely preterm male childs were more likely to have a disability than preterm girls. In contrast, and nothing else two children in the bridle group had moderate disability, and none had cruel disability. Severe disability at 30 month of age significantly predicted a child's condition at six years of age--86 percent of children who were painfully disabled at 30 months were moderately or sharply disabled at six years.

The authors infer that extremely preterm children have greater cognitive and neurologic impairment at instruct age compared with their full-term classmates. Researchers will ne to tread in the steps of the preterm group in this meditation to evaluate the academic consequences of those who had normal cognitive scores.

toss CARTER, M.D.

Marlow N et al. Neurologic and developmental disability at six years of age after extremely preterm birth. N Engl J M January 6 2005;352:9-19

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