Comparing behavioural outcomes in children born extremely preterm between 2006 and 1995: the EPICure studies

BackgroundChildren born extremely preterm (EP) are at increased risk of neurocognitive and behavioural morbidity. Here, we investigate whether behavioural outcomes have changed over time concomitant with increasing survival following EP birth.MethodsComparison of outcomes at 11 years of age for two prospective national cohorts of children born EP in 1995 (EPICure) and 2006 (EPICure2), assessed alongside term-born children. Behavioural outcomes were assessed using the parent-completed Strengths and Difficulties Questionnaire (SDQ), DuPaul Attention-Deficit/Hyperactivity Disorder Rating Scale (ADHD-RS), and Social Communication Questionnaire (SCQ).ResultsIn EPICure, 176 EP and 153 term-born children were assessed (mean age: 10.9 years); in EPICure2, 112 EP and 143 term-born children were assessed (mean age: 11.8 years). In both cohorts, EP children had higher mean scores and more clinically significant difficulties than term-born children on almost all measures. Comparing outcomes for EP children in the two cohorts, there were no significant differences in mean scores or in the proportion of children with clinically significant difficulties after adjustment for confounders. Using term-born children as reference, EP children in EPICure2 had significantly higher SDQ total difficulties and ADHD-RS hyperactivity impulsivity z-scores than EP children in EPICure.ConclusionsBehavioural outcomes have not improved for EP children born in 2006 compared with those born in 1995. Relative to term-born peers, EP children born in 2006 had worse outcomes than those born in 1995. There is an ongoing need for long-term clinical follow-up and psychological support for children born EP.

Automated summary

This study investigates whether the behavioral outcomes of extremely preterm (EP) children have changed over time with increasing survival rates. It compares the behavioral outcomes at age 11 for two national cohorts of EP children born in 1995 (EPICure) and 2006 (EPICure2), along with term-born children. The results show that EP children have higher mean scores and more clinically significant difficulties compared to term-born children in almost all measures. Furthermore, the behavioral outcomes for EP children born in 2006 are worse than those born in 1995. Long-term clinical follow-up and psychological support are needed for EP children.