Count of Neonatal Morbidities Predicts Outcomes at Age 10 and 15 Years in Infants Born Extremely Preterm

Abstract

Objective

To assess whether a simple count of 5 common neonatal morbidities, including bronchopulmonary dysplasia (BPD), ultrasound-identified severe brain injury (SBI), severe retinopathy of prematurity (ROP), surgical necrotizing enterocolitis (NEC), and sepsis predict long-term neurocognitive impairment, general medical health, behavioral health, or quality of life (QOL) at age 10 and 15 years in children born extremely preterm.

Study design

Participants from the multicenter, prospective, longitudinal study extremely low gestational age newborns (ELGANs) were followed at ages 10 and 15 years and were categorized into groups with 0, 1, 2, or ≥3 neonatal morbidities (BPD, SBI, ROP, NEC, or sepsis). Long-term neurocognitive outcomes were assessed using latent profiles generated from standardized tests of intelligence and executive function. General medical health, behavioral health, and QOL were assessed using standardized assessments.

Results

Of 1198 participants who survived to age 10 889 (74.2%) and 694 (57.9%) were evaluated at age 10 and 15 years, respectively. The number of neonatal morbidities was linearly related to the probability of moderate-to-severe neurocognitive impairment at age 10 and 15 years, and the probability of motor impairment, legal blindness, severe hearing loss, number of health disorders, ≥2 health disorders, and poor QOL at age 10 years.

Conclusions

Among newborns born extremely preterm who survive long-term, a simple count of neonatal morbidities (including BPD, SBI, ROP, NEC, or sepsis) is linearly related to neurocognitive impairment, poor general health, and QOL.