Neurodevelopment at 2 years in children born very preterm in 2001-2018.

INTRODUCTION: More active approach and increased survival rates of very preterm infants have raised concerns about their long-term neurodevelopment, especially regarding the cognitive outcome. METHODS: We included very preterm infants (gestational age <32 weeks and/or with birth weight ≤ 1500 g) born in 2001-2018 and attending clinical follow up at 2 years in Turku University Hospital, Finland. The prevalences of cognitive impairment (<-1 SD based on the Bayley scales) and cerebral palsy (CP) were described according to birth year: 2001-2006, 2007-2012, 2013-2018. RESULTS: We included 683 children (377 boys, 55.2%) born very preterm (mean gestational age 29.4 weeks, birth weight 1207 g). A total of 8.5% (53/623) of the children had cognitive impairment (-1 SD). Children born in 2007-2012 and in 2013-2018 had 30-50% lower odds for cognitive impairment at 2 years compared with children born in 2001-2006 (OR 0.7, CI95% 0.4-1.4, p = 0.3, and OR 0.5, CI95% 0.2-0.9, p = 0.03, respectively). CP was diagnosed in 4.7% (31/662). Children born in 2007-2012 and in 2013-2018 had 20-50% lower odds for CP compared with children born in 2001-2006 (OR 0.8, CI95% 0.4-1.7, p = 0.5, and OR 0.3, CI95% 0.1-0.8, p = 0.02, respectively). CONCLUSION: The prevalence of cognitive impairment at 2 years has not increased during 18-year period from the early 2000s. It could be suggested that the long-term neurodevelopment of very preterm infants has not worsened despite increased survival rates.