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PMID: 15724037 Published · ppublish English Journal Article

The EPICure study: associations and antecedents of neurological and developmental disability at 30 months of age following extremely preterm birth.

Archives of disease in childhood. Fetal and neonatal edition ·Vol. 90 ·No. 2 ·2005-03-00 ·Pages F134-40

Wood NS, Costeloe K, Gibson AT, Hennessy EM, Marlow N, Wilkinson AR, EPICure Study Group

Abstract

To describe perinatal factors associated with later morbidity among extremely preterm children at 30 months of age corrected for prematurity. Of 308 surviving children born at <or=25 weeks gestation in the United Kingdom and Ireland from March to December 1995, 283 (92%) were evaluated at 30 months of age corrected for prematurity. Cerebral palsy, severe motor disability, and Bayley scores were used as dependent variables in sequential multiple regression analyses to identify factors associated with adverse outcomes. Adverse outcomes were consistently more common in boys. Factors related to perinatal illness, ultrasound evidence of brain injury, and treatment (particularly postnatal steroids) were associated with adverse motor outcomes (cerebral palsy, disability or Bayley psychomotor development index). Increasing duration of postnatal steroid treatment was associated with poor motor outcomes. A score was developed for severe motor disability with good negative predictive value. In contrast, mental development was associated with a broader range of factors: ethnic group, maternal educational level, the use of antenatal steroids, and prolonged rupture of membranes in addition to chronic lung disease. Male sex is a pervasive risk factor for poor outcome at extremely low gestations. Avoidable or effective treatment factors are identified, which may indicate the potential for improving outcome.

MeSH Terms
Cerebral Palsy/chemically induced,etiology Child, Preschool Cognition Disorders/etiology Cohort Studies Developmental Disabilities/chemically induced,etiology Female Gestational Age Humans Infant, Newborn Infant, Premature Male Morbidity Movement Disorders/etiology Prognosis Psychomotor Disorders/etiology Regression Analysis Risk Factors Steroids/adverse effects
Chemicals
Steroids
Authors & Affiliations
7 authors, click to expand affiliations / ORCID
Wood N S
Academic Division of Child Health, Level E East Block, Queens Medical Centre, Nottingham NG7 2UH, UK.
Costeloe K
Gibson A T
Hennessy E M
Marlow N
Wilkinson A R
EPICure Study Group
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Article Info
Journal
Archives of disease in childhood. Fetal and neonatal edition
Abbr.
Arch Dis Child Fetal Neonatal Ed
ISSN
1359-2998
DOI
10.1136/adc.2004.052407
Published
2005-03-00
Pages
F134-40
Language
English
Region
England
NLM ID
9501297
PMCID
PMC1721849
Subset
IM
Grants
Medical Research Council · G0401525 · United Kingdom
External Links
PubMed source DOI: 10.1136/adc.2004.052407 PMC Full Text View journal details
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