Predicting Long-Term Survival Without Major Disability for Infants Born Preterm

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: To describe the long-term neurodevelopmental and cognitive outcomes for children born preterm.

STUDY DESIGN: In this retrospective cohort study, information on children born in Western Australia between 1983 and 2010 was obtained through linkage to population databases on births, deaths, and disabilities. For the purpose of this study, disability was defined as a diagnosis of intellectual disability, autism, or cerebral palsy. The Kaplan-Meier method was used to estimate the probability of disability-free survival up to age 25 years by gestational age. The effect of covariates and predicted survival was examined using parametric survival models.

RESULTS: Of the 720 901 recorded live births, 12 083 children were diagnosed with disability, and 5662 died without any disability diagnosis. The estimated probability of disability-free survival to 25 years was 4.1% for those born at gestational age 22 weeks, 19.7% for those born at 23 weeks, 42.4% for those born at 24 weeks, 53.0% for those born at 25 weeks, 78.3% for those born at 28 weeks, and 97.2% for those born full term (39-41 weeks). There was substantial disparity in the predicted probability of disability-free survival for children born at all gestational ages by birth profile, with 5-year estimates of 4.9% and 10.4% among Aboriginal and Caucasian populations, respectively, born at 24-27 weeks and considered at high risk (based on low Apgar score, male sex, low sociodemographic status, and remote region of residence) and 91.2% and 93.3%, respectively, for those at low risk (ie, high Apgar score, female sex, high sociodemographic status, residence in a major city).

CONCLUSIONS: Apgar score, birth weight, sex, socioeconomic status, and maternal ethnicity, in addition to gestational age, have pronounced impacts on disability-free survival.

Original languageEnglish
JournalThe Journal of Pediatrics
DOIs
Publication statusE-pub ahead of print - 4 Sep 2019

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Premature Infants
Gestational Age
Apgar Score
Parturition
Western Australia
Live Birth
Cerebral Palsy
Autistic Disorder
Birth Weight
Social Class
Intellectual Disability
Population
Cohort Studies
Retrospective Studies
Mothers
Databases

Cite this

@article{ac46a85b0f5b40d59d0c6445b2cd459d,
title = "Predicting Long-Term Survival Without Major Disability for Infants Born Preterm",
abstract = "OBJECTIVE: To describe the long-term neurodevelopmental and cognitive outcomes for children born preterm.STUDY DESIGN: In this retrospective cohort study, information on children born in Western Australia between 1983 and 2010 was obtained through linkage to population databases on births, deaths, and disabilities. For the purpose of this study, disability was defined as a diagnosis of intellectual disability, autism, or cerebral palsy. The Kaplan-Meier method was used to estimate the probability of disability-free survival up to age 25 years by gestational age. The effect of covariates and predicted survival was examined using parametric survival models.RESULTS: Of the 720 901 recorded live births, 12 083 children were diagnosed with disability, and 5662 died without any disability diagnosis. The estimated probability of disability-free survival to 25 years was 4.1{\%} for those born at gestational age 22 weeks, 19.7{\%} for those born at 23 weeks, 42.4{\%} for those born at 24 weeks, 53.0{\%} for those born at 25 weeks, 78.3{\%} for those born at 28 weeks, and 97.2{\%} for those born full term (39-41 weeks). There was substantial disparity in the predicted probability of disability-free survival for children born at all gestational ages by birth profile, with 5-year estimates of 4.9{\%} and 10.4{\%} among Aboriginal and Caucasian populations, respectively, born at 24-27 weeks and considered at high risk (based on low Apgar score, male sex, low sociodemographic status, and remote region of residence) and 91.2{\%} and 93.3{\%}, respectively, for those at low risk (ie, high Apgar score, female sex, high sociodemographic status, residence in a major city).CONCLUSIONS: Apgar score, birth weight, sex, socioeconomic status, and maternal ethnicity, in addition to gestational age, have pronounced impacts on disability-free survival.",
author = "Jenny Bourke and Kingsley Wong and Ravisha Srinivasjois and Gavin Pereira and Shepherd, {Carrington C J} and White, {Scott W} and Fiona Stanley and Helen Leonard",
year = "2019",
month = "9",
day = "4",
doi = "10.1016/j.jpeds.2019.07.056",
language = "English",
journal = "The Journal of Pediatrics",
issn = "0022-3476",
publisher = "Mosby International",

}

TY - JOUR

T1 - Predicting Long-Term Survival Without Major Disability for Infants Born Preterm

AU - Bourke, Jenny

AU - Wong, Kingsley

AU - Srinivasjois, Ravisha

AU - Pereira, Gavin

AU - Shepherd, Carrington C J

AU - White, Scott W

AU - Stanley, Fiona

AU - Leonard, Helen

PY - 2019/9/4

Y1 - 2019/9/4

N2 - OBJECTIVE: To describe the long-term neurodevelopmental and cognitive outcomes for children born preterm.STUDY DESIGN: In this retrospective cohort study, information on children born in Western Australia between 1983 and 2010 was obtained through linkage to population databases on births, deaths, and disabilities. For the purpose of this study, disability was defined as a diagnosis of intellectual disability, autism, or cerebral palsy. The Kaplan-Meier method was used to estimate the probability of disability-free survival up to age 25 years by gestational age. The effect of covariates and predicted survival was examined using parametric survival models.RESULTS: Of the 720 901 recorded live births, 12 083 children were diagnosed with disability, and 5662 died without any disability diagnosis. The estimated probability of disability-free survival to 25 years was 4.1% for those born at gestational age 22 weeks, 19.7% for those born at 23 weeks, 42.4% for those born at 24 weeks, 53.0% for those born at 25 weeks, 78.3% for those born at 28 weeks, and 97.2% for those born full term (39-41 weeks). There was substantial disparity in the predicted probability of disability-free survival for children born at all gestational ages by birth profile, with 5-year estimates of 4.9% and 10.4% among Aboriginal and Caucasian populations, respectively, born at 24-27 weeks and considered at high risk (based on low Apgar score, male sex, low sociodemographic status, and remote region of residence) and 91.2% and 93.3%, respectively, for those at low risk (ie, high Apgar score, female sex, high sociodemographic status, residence in a major city).CONCLUSIONS: Apgar score, birth weight, sex, socioeconomic status, and maternal ethnicity, in addition to gestational age, have pronounced impacts on disability-free survival.

AB - OBJECTIVE: To describe the long-term neurodevelopmental and cognitive outcomes for children born preterm.STUDY DESIGN: In this retrospective cohort study, information on children born in Western Australia between 1983 and 2010 was obtained through linkage to population databases on births, deaths, and disabilities. For the purpose of this study, disability was defined as a diagnosis of intellectual disability, autism, or cerebral palsy. The Kaplan-Meier method was used to estimate the probability of disability-free survival up to age 25 years by gestational age. The effect of covariates and predicted survival was examined using parametric survival models.RESULTS: Of the 720 901 recorded live births, 12 083 children were diagnosed with disability, and 5662 died without any disability diagnosis. The estimated probability of disability-free survival to 25 years was 4.1% for those born at gestational age 22 weeks, 19.7% for those born at 23 weeks, 42.4% for those born at 24 weeks, 53.0% for those born at 25 weeks, 78.3% for those born at 28 weeks, and 97.2% for those born full term (39-41 weeks). There was substantial disparity in the predicted probability of disability-free survival for children born at all gestational ages by birth profile, with 5-year estimates of 4.9% and 10.4% among Aboriginal and Caucasian populations, respectively, born at 24-27 weeks and considered at high risk (based on low Apgar score, male sex, low sociodemographic status, and remote region of residence) and 91.2% and 93.3%, respectively, for those at low risk (ie, high Apgar score, female sex, high sociodemographic status, residence in a major city).CONCLUSIONS: Apgar score, birth weight, sex, socioeconomic status, and maternal ethnicity, in addition to gestational age, have pronounced impacts on disability-free survival.

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U2 - 10.1016/j.jpeds.2019.07.056

DO - 10.1016/j.jpeds.2019.07.056

M3 - Article

JO - The Journal of Pediatrics

JF - The Journal of Pediatrics

SN - 0022-3476

ER -