Behavioral Outcome at 3 Years of Age in Very Preterm Infants: The EPIPAGE Study

Delobel‐Ayoub, Malika; Kaminski, Monique; Marret, Stéphane; Burguet, A.; Marchand, Laëtitia; Nguyen, Sylvie; Matis, Jacqueline; Thiriez, Gérard; Fresson, Jeanne; Arnaud, Catherine; Poher, M; Larroque, Béatrice

doi:10.1542/peds.2005-2310

Cited by 153 publications

(129 citation statements)

References 43 publications

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“…The EPIPAGE study (19) investigated behavioral problems in preterm children. They found that at 3 years of age these children are more likely to have behavioral difficulties (problems with peers, behavioral problems, and hyperactivity) than full-term children, even after controlling for the influence of demographic characteristics and neonatal complications.…”

Section: Personal and Social Development Studiesmentioning

confidence: 99%

“…Since the 1990s, improvements in perinatal and neonatal care units have led to increased survival rates (from 5% to 10%) even when the gestational age at birth is younger (18,19). Thus, in the last decade there has been a striking increase in investigations into how birth weight and gestational age influence psycho-neurological development.…”

Section: Introductionmentioning

confidence: 99%

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Early Psychological Development of Very Preterm and/or Low Birth Weight Children: A Review of the Literature

2015

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Objective -The aim of this paper is to describe the psychological development in three areas (cognitive, communicative-linguistic and social-emotional domains) of very preterm children and/or low birth weight, aged from 0 to 6 years, to discover if problems exist and if these difficulties remain, decrease or increase over time, up to 6 years of age, through of review of studies done in this population. Materials and methods -Seven databases were searched. The search yielded 975 studies and those related to cognitive, communicative-linguistic and social-emotional development in children without physical problems, ranging in age from birth to 6 years, gestational age less than 32 weeks and/or birth-weight less than 2499 grams were analyzed. Most of the 47 studies analyzed were conducted after 2005, focused on children aged 3-5 years, and compared preterm and full-term infants. ResultsThe studies agree that preterm children differ in many developmental domains but there is no consensus on others. Several studies found a close association between the three different areas analyzed. Conclusion -Early intervention of preterm and/or low birth weight children is the most important way to prevent and/or reduce academic, communicative and social-emotional (anxiety/depression) problems, and improve long-term adaptation to the environment, self-regulation, communication skills, social competence and academic performance in general.

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Section: Personal and Social Development Studiesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Early Psychological Development of Very Preterm and/or Low Birth Weight Children: A Review of the Literature

2015

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Section: E30mentioning

confidence: 99%

“…A global indicator of behavioral difficulties was obtained by adding the first 4 scores. 11 The cutoff points were defined such that approximately 10% of children born at term were considered to be at risk for behavioral problems.The propensity-score (PS) method was used to reduce indication bias in assessing the relation between LDA and outcomes. 12,13 The PS can be defined as a patient's probability of receiving LDA conditional on his or her individual observed covariates.…”

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confidence: 99%

Prenatal Low-Dose Aspirin and Neurobehavioral Outcomes of Children Born Very Preterm

et al. 2010

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WHAT'S KNOWN ON THIS SUBJECT:Aspirin given to the mother in high-risk pregnancies seems to produce a moderate reduction of several different risks such as preeclampsia; delivery before 37 weeks of gestation; and fetal growth restriction. WHAT THIS STUDY ADDS:A low dose of prenatal aspirin treatment was not associated with adverse neonatal or long-term outcomes.abstract OBJECTIVE: Low-dose aspirin (LDA) given during pregnancy may alter brain development in very preterm infants. We report the short-and long-term outcomes of very preterm infants according to LDA treatment. PATIENTS AND METHODS: Data were from the Etude Epidemiologique des Petites Ages Gestationnels (EPIPAGE) cohort study, which included all infants born before 33 weeks of gestation in 9 French regions in 1997. This study was restricted to 656 children who were born to 584 women with an obstetric history of placental vascular disease or with chronic hypertension or renal or autoimmune diseases. The main outcome measures were mortality, cerebral lesions, and outcome at 5 years of age, which were measured by a diagnosis of cerebral palsy; behavioral difficulties, which were assessed with the Strength and Difficulties Questionnaire; and cognitive impairment, which was measured by the mental processing composite scale of the Kaufman Assessment Battery for Children (an IQ-equivalent measure of cognitive ability in 2 dimensions: sequential and simultaneous processing scores). RESULTS: LDA treatment was administered to 125 of 584 (21%) mothers and was not significantly associated with mortality, cerebral lesions, cerebral palsy, or global cognitive impairment of the children at 5 years of age. The proportion of low simultaneous processing scores (Ͻ70) was lower in the group with LDA (7% vs 19% without LDA; P ϭ .04). This association was not significant after adjustment for propensity score, prognostic factors, and social class (adjusted odds ratio [aOR] Learning to protect the preterm brain is a challenging priority in view of the disturbingly high rate of long-term neurosensory, cognitive, and behavioral disabilities in very preterm infants. 1 A large number of studies have examined the multifactorial origin of cerebral lesions (subependymal/intraventricular hemorrhages [SEH/IVH]) and white matter injuries [WMIs]) and later neurodisabilities, which involve acute/subacute ischemic/inflammatory antenatal or perinatal events combined with deprivation of placental hormonal or growth factors caused by preterm birth. 2 Aspirin given to the mother in high-risk pregnancies may cross the placenta. 3 Aspirin is well tolerated by the fetus and seems to produce a moderate reduction of several different risks (preeclampsia, delivery before 37 weeks of gestation, and fetal growth restriction) without increasing infant bleeding. 4 Nevertheless, the long-term effects of aspirin on preterm children are unknown. Aspirin inhibits cyclooxygenase 1 (COX 1) and COX 2. Because COX 2 plays a role in the dendritic arborization involved in the developing areas that are responsible...

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“…Postmenstrual age at NICU discharge will be documented, as poorer behavioural outcomes are associated with longer length of hospital stay 118 .…”

Section: Perinatal Data Collectionmentioning

confidence: 99%

The relationship between brain structure and function of very preterm infants, and the ability to predict neurodevelopmental outcomes

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Behavioral Outcome at 3 Years of Age in Very Preterm Infants: The EPIPAGE Study

Abstract: Very preterm children have a higher risk of behavioral problems at 3 years of age compared with term-born children. Health and neurodevelopmental status of the child were significantly associated with behavioral difficulties.

Cited by 153 publications

References 43 publications

Early Psychological Development of Very Preterm and/or Low Birth Weight Children: A Review of the Literature

Early Psychological Development of Very Preterm and/or Low Birth Weight Children: A Review of the Literature

Prenatal Low-Dose Aspirin and Neurobehavioral Outcomes of Children Born Very Preterm

The relationship between brain structure and function of very preterm infants, and the ability to predict neurodevelopmental outcomes

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