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Editorial
Stability of general cognition in children born extremely preterm as they grow older: good or bad news?
  1. Lex W Doyle1,2,3,4,
  2. Peter J Anderson3,4,5
  1. 1 Royal Women’s Hospital, Melbourne, Australia
  2. 2 Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Victoria, Australia
  3. 3 Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
  4. 4 Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Australia
  5. 5 Monash Institute of Cognitive & Clinical Neurosciences, Monash University, Melbourne, Australia
  1. Correspondence to Professor Lex W Doyle, Royal Women’s Hospital, Parkville, VIC 3052, Australia; lwd{at}unimelb.edu.au

https://doi.org/10.1136/archdischild-2017-313987

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    Does the IQ of children born extremely preterm (EP; <28 weeks’ gestation) catch-up to their peers as they transition into adolescence and adulthood, or does the cognitive deficit observed in early childhood persist, or even worsen? Because few quality long-term longitudinal studies exist, the answer is unclear. In Archives of Disease in Childhood, Linsell and colleagues addressed this important question using data from the EPICure study,1 which assessed cognitive functioning at 2.5, 6, 11 and 19 years of age in survivors born <26 weeks’ gestational age in the UK and the Ireland over 10 months in 1995. Their major finding was that poor cognitive function in EP survivors persists throughout childhood into late adolescence/early adulthood. They also identified several variables associated with worse cognitive performance in the preterm group, including male sex, neonatal brain injury, gestational age <25 weeks and having a mother with a lower education level.

    The authors are to be commended for following their cohort for so long to provide contemporary data for the highest risk group of preterm survivors. One of the main challenges with long-term follow-up studies is maintaining high retention, and, as expected, the follow-up rates in this study tailed off as the cohort aged. A strength of the study was that they were able to compare results with term-born controls at 6, 11 and 19 years, but the follow-up rate in the control group was also low by 19 years of age. The problem with low follow-up rates is that the outcome for those who do …

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    Footnotes

    • Funding Supported by a Centre of Research Excellence Grant number 1060733 from the National Health and Medical Research Council of Australia.

    • Competing interests None declared.

    • Provenance and peer review Commissioned; internally peer reviewed.