Document Detail


EPICure: facts and figures: why preterm labour should be treated.
MedLine Citation:
PMID:  17206960     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The principal objective of the EPICure studies was to determine both short- and long-term outcomes of extremely preterm birth. Data were collected for all births before 26 completed weeks of gestation in the UK and Republic of Ireland for 10 months in 1995. Of 811 infants admitted to neonatal units, 314 (39%) survived. Of these, 283 (92%) were assessed at 2.5 years and 241 (78%) at 6 years, together with a comparator group selected from classmates in normal schools. At 6 years, 32 (13%) of those assessed had disabling cerebral palsy and 31 (13%) had severe sensory impairment. Cognitive impairment was a more frequent adverse outcome: the mean intelligence quotient (IQ) was 82 (SD 19). Fifty children (21%) had IQs > 3 SD less than that of the comparator group, and in 48 children (20%), IQ was 2-3 SD less than that of the comparator group. Infants whose mothers had received antenatal steroids had fewer severely abnormal head scan findings. In this population, abnormal head scan findings are independent predictors of reduced, severe motor disability at 2.5 years. Using step-wise logistic regression analysis, postnatal transfer was associated with severe motor disability; prolonged membrane rupture with reduced Mental Development Index (MDI) and antenatal steroid with increased MDI. It is clear that factors around the time of birth are critical in determining outcome, irrespective of later complications during neonatal intensive care. Since 1995, there is good evidence of improved survival, but it is not clear whether or not the number of survivors with severe adverse outcomes has changed. A new cohort of births <27 completed weeks is currently being collected in English maternity units. Data collection around the time of birth is more detailed than in 1995 in order to better explore the relationship between perinatal factors and later outcomes.
Authors:
K Costeloe;
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  BJOG : an international journal of obstetrics and gynaecology     Volume:  113 Suppl 3     ISSN:  1470-0328     ISO Abbreviation:  BJOG     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2007-01-08     Completed Date:  2007-04-24     Revised Date:  2008-03-25    
Medline Journal Info:
Nlm Unique ID:  100935741     Medline TA:  BJOG     Country:  England    
Other Details:
Languages:  eng     Pagination:  10-2     Citation Subset:  AIM; IM    
Affiliation:
Academic Unit for Child Health, Queen Mary's School of Medicine and Dentistry, University of London, Homerton University Hospital, London, UK. Kate.Costeloe@homerton.nhs.uk
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MeSH Terms
Descriptor/Qualifier:
Cerebral Palsy / epidemiology*,  etiology
Child
Child, Preschool
Cognition Disorders / epidemiology*,  etiology
Female
Follow-Up Studies
Great Britain / epidemiology
Humans
Infant, Newborn
Intensive Care Units, Neonatal
Ireland / epidemiology
Obstetric Labor, Premature / epidemiology*,  therapy*
Outcome Assessment (Health Care)
Pregnancy
Comments/Corrections
Erratum In:
BJOG. 2008 Apr;115(5):674-5

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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