EPICE cohort: two-year neurodevelopmental outcomes after very preterm birth
EPICE cohort: two-year neurodevelopmental outcomes after very preterm birth
复制标题
DOI：
10.1136/archdischild-2019-317418
复制
发表时间：
2020-07-01
影响因子：
4.4
通讯作者：
Johnson, Samantha J.
中科院分区：
文献类型：
--
作者：
Draper, Elizabeth S.;Zeitlin, Jennifer;Johnson, Samantha J.
目的采用标准化方法对2岁时国际早产儿(VPT)出生队列进行神经发育评估，以确定调整人口学、母婴特征后人群间神经发育障碍率的差异是否持续。设计前瞻性标准化队列研究。在10个欧洲国家设置15个地区。VPT出生：22(+0)-31(+6)周。数据收集标准化与妊娠相关的数据收集工具，出生、新生儿护理和2岁时的发育结果使用确认的父母填写的问卷进行校正。主要结果衡量粗略和标准化的患病率，通过使用固定效应模型比较按国家分组的地区之间的中到重度神经发育障碍的比率。结果父母报告的中重度神经发育障碍的比率为：17.3%(按国家分组的地区之间的范围为10.2%-26.1%)，粗略的标准化患病率为0.60到1.53。对人群、母婴因素进行调整后，总体变异率略有下降(0.65~1.30)。结论欧洲VPT人群中、重度神经发育损害率存在较大差异，在对已知人群、母婴因素进行调整后，这种差异仍持续存在。需要进一步的工作来调查包括护理质量和循证实践在内的其他因素是否对这些儿童的神经发育结果产生影响。
Objective To determine whether the variation in neurodevelopmental disability rates between populations persists after adjustment for demographic, maternal and infant characteristics for an international very preterm (VPT) birth cohort using a standardised approach to neurodevelopmental assessment at 2 years of age.Design Prospective standardised cohort study.Setting 15 regions in 10 European countries.Patients VPT births: 22(+0)-31(+6) weeks of gestation.Data collection Standardised data collection tools relating to pregnancy, birth and neonatal care and developmental outcomes at 2 years corrected age using a validated parent completed questionnaire.Main outcome measures Crude and standardised prevalence ratios calculated to compare rates of moderate to severe neurodevelopmental impairment between regions grouped by country using fixed effects models.Results Parent reported rates of moderate or severe neurodevelopmental impairment for the cohort were: 17.3% (ranging 10.2%-26.1% between regions grouped by country) with crude standardised prevalence ratios ranging from 0.60 to 1.53. Adjustment for population, maternal and infant factors resulted in a small reduction in the overall variation (ranging from 0.65 to 1.30).Conclusion There is wide variation in the rates of moderate to severe neurodevelopmental impairment for VPT cohorts across Europe, much of which persists following adjustment for known population, maternal and infant factors. Further work is needed to investigate whether other factors including quality of care and evidence-based practice have an effect on neurodevelopmental outcomes for these children.