| EPICure: facts and figures: why preterm labour should be treated. | |
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MedLine Citation:
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PMID: 17206960 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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K Costeloe; |
Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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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:
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Created Date: 2007-01-08 Completed Date: 2007-04-24 Revised Date: 2008-03-25 |
Medline Journal Info:
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Nlm Unique ID: 100935741 Medline TA: BJOG Country: England |
Other Details:
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Languages: eng Pagination: 10-2 Citation Subset: AIM; IM |
Affiliation:
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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 |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Cerebral Palsy
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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:
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BJOG. 2008 Apr;115(5):674-5 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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