Correlation between initial neonatal and early childhood outcomes following preterm birth

  • Manuck T
  • Sheng X
  • Yoder B
 et al. 
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Abstract

Objective Neonatal diagnoses are often used as surrogate endpoints for longer-term outcomes. We sought to characterize the correlation between neonatal diagnoses and early childhood neurodevelopment. Study Design We conducted secondary analysis of a multicenter randomized controlled trial of antenatal magnesium sulfate vs placebo administered to women at imminent risk for delivery 2 SD below the mean. Data were analyzed by multiple regression models and area under receiver operating characteristic curves. Results A total of 1771 children met criteria. Children were delivered at a mean of 29.4 weeks' gestation. In all, 459 (25.9%) had neurodevelopmental impairment. In models controlling for gestational age at delivery, maternal education, maternal race, tobacco/alcohol/drug use during pregnancy, randomization to magnesium, fetal sex, and chorioamnionitis, individual neonatal morbidities were moderately predictive of childhood neurodevelopmental impairment (best model area under receiver operating characteristic curve, 0.68; 95% confidence interval, 0.65-0.71). Combinations of 2, 3, and 4 morbidities did not improve the prediction of neurodevelopmental impairment. Conclusion Approximately 1 in 4 previously preterm children had neurodevelopmental impairment at age 2 years. Prediction of childhood outcomes from neonatal diagnoses remains imperfect. © 2014 Mosby, Inc. All rights reserved.

Author-supplied keywords

  • neonatal outcomes
  • neurodevelopment
  • prematurity

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