Department of Population Health Sciences, George Davies Centre, University of Leicester, University Road, Leicester, LE1 7RH, UK.
Institute of Mental Health, University of Nottingham, Nottingham, UK.
Eur Child Adolesc Psychiatry. 2024 May;33(5):1517-1528. doi: 10.1007/s00787-023-02258-w. Epub 2023 Jul 11.
Children born extremely preterm (EP) are at increased risk of neurocognitive and behavioural morbidity. Here, we investigate whether behavioural outcomes have changed over time concomitant with increasing survival following EP birth.
Comparison of outcomes at 11 years of age for two prospective national cohorts of children born EP in 1995 (EPICure) and 2006 (EPICure2), assessed alongside term-born children. Behavioural outcomes were assessed using the parent-completed Strengths and Difficulties Questionnaire (SDQ), DuPaul Attention-Deficit/Hyperactivity Disorder Rating Scale (ADHD-RS), and Social Communication Questionnaire (SCQ).
In EPICure, 176 EP and 153 term-born children were assessed (mean age: 10.9 years); in EPICure2, 112 EP and 143 term-born children were assessed (mean age: 11.8 years). In both cohorts, EP children had higher mean scores and more clinically significant difficulties than term-born children on almost all measures. Comparing outcomes for EP children in the two cohorts, there were no significant differences in mean scores or in the proportion of children with clinically significant difficulties after adjustment for confounders. Using term-born children as reference, EP children in EPICure2 had significantly higher SDQ total difficulties and ADHD-RS hyperactivity impulsivity z-scores than EP children in EPICure.
Behavioural outcomes have not improved for EP children born in 2006 compared with those born in 1995. Relative to term-born peers, EP children born in 2006 had worse outcomes than those born in 1995. There is an ongoing need for long-term clinical follow-up and psychological support for children born EP.
极早产儿（EP）出生的儿童患神经认知和行为障碍的风险增加。在这里，我们研究了随着 EP 出生后存活率的提高，行为结果是否随时间发生了变化。
比较了 1995 年（EPICure）和 2006 年（EPICure2）两个前瞻性全国 EP 儿童队列在 11 岁时的结局，同时评估了足月出生的儿童。行为结果使用父母完成的长处与困难问卷（SDQ）、DuPaul 注意缺陷多动障碍评定量表（ADHD-RS）和社会沟通问卷（SCQ）进行评估。
在 EPICure 中，评估了 176 名 EP 和 153 名足月出生的儿童（平均年龄：10.9 岁）；在 EPICure2 中，评估了 112 名 EP 和 143 名足月出生的儿童（平均年龄：11.8 岁）。在两个队列中，EP 儿童在几乎所有测量指标上的平均得分和临床显著困难的比例都高于足月出生的儿童。在调整混杂因素后，比较两个队列中 EP 儿童的结局，发现平均得分或具有临床显著困难的儿童比例没有显著差异。与足月出生的儿童相比，EPICure2 中 EP 儿童的 SDQ 总分困难和 ADHD-RS 多动冲动 z 评分显著高于 EPICure 中的 EP 儿童。
与 1995 年出生的 EP 儿童相比，2006 年出生的 EP 儿童的行为结果没有改善。与 1995 年出生的儿童相比，2006 年出生的 EP 儿童的结局比 1995 年出生的儿童更差。对于 EP 出生的儿童，需要持续进行长期临床随访和心理支持。
