Background

Neurodevelopmental trajectories of preterm children may have changed due to changes in care and in society. We aimed to compare neurodevelopmental trajectories in early and moderately late preterm children, measured using the Developmental (D)-score, in two cohorts born 15 years apart.

Methods

We included early preterm and moderately late preterm children from two Dutch cohorts (LOLLIPOP, 2002–2003 and ePREM, 2016–2017). ePREM counterparts were matched to LOLLIPOP participants by gestational age and sex. D-score trajectories were summarized by a multilevel model with random intercepts and random slopes, and multigroup analyses were used to test if the intercepts and slopes differed across cohorts.

Results

We included 1686 preterm children (1071 moderately late preterm, 615 early preterm) from LOLLIPOP, and matched these with 1686 ePREM counterparts. The neurodevelopmental trajectories of the two cohorts were mostly similar. For early preterm children, we found no statistically significant differences. For moderately late preterm children, both the intercept (43.0 vs. 42.3, p < 0.001) and slope (23.5 vs. 23.9, p = 0.002) showed some, but only clinically minor, differences.

Conclusion

Developmental trajectories, measured using the D-score, in the first four years of life are comparable and stable across a period of 15 years for both early and moderately late preterm children.

Impact

• Neurodevelopmental trajectories are similar for early and moderately late preterm children born 15 years apart and thus seem quite stable in time.

• The validated Developmental score visualizes these trajectories based on developmental milestone attainment

• Because of its stability over time, the Developmental score trajectory may aid clinicians in neurodevelopmental assessment of preterm children as this simplifies monitoring and interpretation, similar to a growth chart.

中文翻译：

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相隔 15 岁出生的中晚期和早期早产儿神经发育轨迹的稳定性

背景

由于护理和社会的变化，早产儿的神经发育轨迹可能发生了变化。我们的目的是比较早期和中晚期早产儿的神经发育轨迹，使用发育 (D) 评分来测量，两组出生时间相隔 15 岁。

方法

我们纳入了来自两个荷兰队列的早期早产儿和中晚期早产儿（LOLLIPOP，2002-2003 年和 ePREM，2016-2017 年）。 ePREM 对应者按胎龄和性别与 LOLLIPOP 参与者进行匹配。 D 分数轨迹通过具有随机截距和随机斜率的多级模型进行总结，并使用多组分析来测试不同群组的截距和斜率是否存在差异。

结果

我们纳入了 LOLLIPOP 中的 1686 名早产儿（1071 名中晚期早产儿，615 名早期早产儿），并将这些儿童与 1686 名 ePREM 儿童进行匹配。两个队列的神经发育轨迹大多相似。对于早期早产儿，我们发现没有统计学上的显着差异。对于中晚期早产儿，截距（43.0 vs. 42.3，p  < 0.001）和斜率（23.5 vs. 23.9，p  = 0.002）都显示出一些差异，但只是临床上的微小差异。

结论

使用 D 分数衡量的早产儿和中晚期早产儿在生命前四年的发育轨迹在 15 年期间具有可比性和稳定性。

影响

• 相隔 15 岁出生的早期和中晚期早产儿的神经发育轨迹相似，因此在时间上似乎相当稳定。

• 经过验证的发展分数根据发展里程碑的实现可视化这些轨迹

• 由于其随时间的稳定性，发育评分轨迹可以帮助临床医生对早产儿进行神经发育评估，因为这简化了监测和解释，类似于生长图。