Arriving On Time Better Than Too Early

Premature babies have disabilities at higher rates than babies born on time

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Medicine has advanced considerably in the care of babies born extremely early. However, these babies are still at high risk for long-term problems, and every extra week counts.

A recent study found that children born before 27 weeks have higher rates of disability with each week early they were born.

Rates of blindness, hearing impairment and cognitive and language disabilities were higher among toddlers born extremely early when compared to toddlers born at full terms.

Every extra week in the womb among the extreme preemies reduced the likelihood of serious long-term disability.

"Attend all prenatal appointments."

The study, led by Fredrik Serenius, MD, PhD, of the Departments of Women’s and Children’s Health at Uppsala University in Sweden, looked at the neurodevelopment of toddlers who had been born extremely early.

The researchers included 707 babies in the study who had been born before 27 weeks of pregnancy between 2004 and 2007 in Sweden. Of these children, 491 of them (69 percent) survived to 2.5 years old.

The children who survived were compared to a group of 2.5-year-old children who had been born at full term. All these children were matched to the extremely premature children by sex, ethnicity and geographical location.

The researchers investigated the children's cognitive, language and motor development as well as symptoms of cerebral palsy or partial blindness or deafness.

The toddlers who had been born extremely early had average scores in cognitive, language and motor development that were approximately 10 percent lower than the scores of the children born on time.

While 0.3 percent of the children born at full term showed cognitive disability, 5 percent of the extremely premature children showed cognitive disability.

Severe cognitive disability appeared in 0.3 percent of the children born at full term and in 6.3 percent of the children born extremely early.

Moderate language disability existed in 9.4 percent of the extremely premature children and in 2.5 percent of the children born at full term.

Severe language disability showed up in 6.6 percent of the extremely premature toddlers and in none of the children born at full terms.

In addition, 0.1 percent of the children born at full term had cerebral palsy, compared to 7 percent of the children born as extreme preemies.

None of the children born on time had blindness or hearing impairment, but 0.9 percent of the extremely premature babies were blind, and 0.9 percent had impaired hearing.

Among all the children who had been born extremely early, 42 percent had no disability at all, 31 percent had a mild disability, 16 percent had moderate disability and 11 percent had severe disability.

The later the child was born, even when born extremely early, the less likely it was that the child had moderate or severe disability.

Among children born at 22 weeks, 60 percent had moderate or severe disability, whereas 51 percent of the babies born at 24 weeks had moderate or severe disability.

Among those born at 25 weeks, 27 percent had moderate or severe disability, and 17 percent of the babies born at 26 weeks had moderate or severe disability.

"Of children born extremely preterm and receiving active perinatal care, 73% had mild or no disability and neurodevelopmental outcome improved with each week of gestational age," the researchers wrote.

The study was published April 30 in JAMA. The research was funded by the Swedish Research Council, the Uppsala-Örebro Regional Research Council, the Research Council South East Region of Sweden, the Swedish government, The “Lilla Barnets Fond” Children’s fund, a regional agreement between the University of Umeå and Västerbotten County Council, and a regional agreement between Stockholm County Council and Karolinska Institute. No conflicts of interest were reported.

Reviewed by: 
Review Date: 
April 30, 2013
Last Updated:
August 14, 2013