Neurodevelopmental outcomes of extremely premature infants conceived after assisted conception: a population based cohort study
Date
2012
Authors
Mohamed, Abdel-Latif
Bajuk, Barbara
Ward, Meredith
Oei, Ju Lee
Badawi, Nadia
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Volume Title
Publisher
B M J Group
Abstract
To compare neurodevelopmental outcomes of extremely preterm infants conceived after assisted conception (AC) compared with infants conceived spontaneously (non-AC). Population-based retrospective cohort study. Geographically defined area in New South Wales and the Australian Capital Territory, Australia served by a network of 10 neonatal intensive care units. Infants <29 weeks' gestation born between 1998 and 2004. At 2-3 years corrected age, 1473 children were assessed with either the Griffiths Mental Developmental Scales or the Bayley Scales of Infant Development. Moderate/severe functional disability defined as developmental delay (Griffiths General Quotient or Bayley Mental Developmental Index >2 SD below the mean), cerebral palsy (unable to walk without aids), deafness (bilateral hearing aids or cochlear implant) or blindness (visual acuity <6/60 in the better eye). Mortality and age at follow-up were comparable between the AC and non-AC groups. Developmental outcome was evaluated in 217 (86.5%) AC and 1256 (71.7%) non-AC infants. Using multivariate adjusted analysis, infants born after in-vitro fertilisation at 22-26 weeks' gestation (adjusted OR 1.79, 95% CI 1.05 to 3.05, p=0.03) but not at 27-28 weeks' gestation (adjusted OR 0.81, 95% CI 0.37 to 1.77; p=0.59) had higher rate of functional disability than those born after spontaneous conception. AC is associated with adverse neurodevelopmental outcome among high risk infants born at 22-26 weeks' gestation. This finding warrants additional exploration.
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Keywords: adult; article; Australia; cohort analysis; developmental disorder; disability; female; follow up; growth, development and aging; human; infertility therapy; mortality; newborn; newborn intensive care; outcome assessment; pregnancy; prematurity; prospecti
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Source
Archives of Disease in Childhood. Fetal and Neonatal Edition
Type
Journal article
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2037-12-31