Citation
Background
It is known that children born preterm are at increased risk of neonatal and postneonatal deaths compared with those born full term, and many preterm infants face short- and long-term complications including neurodevelopmental conditions. Although many studies have investigated survival in preterm infants and some have investigated disability in survivors, few have combined both of these outcomes.
What we did
There were 720,901 infants born live from 1983-2010 at a gestational age ≥ 22 weeks, of whom 92% were born ≥37 weeks. We defined disability as a diagnosis of intellectual disability, autism, or cerebral palsy and determined the probability of survival to 1, 5, 10, 15, 20 and 25 years free from a disability diagnosis for each gestational age category.
What we found
The estimated probability of disability-free survival to 25 years was 4.1% (gestational age 22 weeks), 19.7% (23 weeks), 42.4% (24 weeks), 53.0% (25 weeks), 78.3% (28 weeks) and 97.2% for those born full term (39-41 weeks). This probability was influenced by perinatal and sociodemographic factors, with Aboriginal children and those born with lower Apgar scores at particularly elevated risk. Babies born 22-23 weeks gestation had a probability of survival without disability of 22% at one year, 16% at ten years and 13% at 25 years. This increased for those born 28-31 weeks to 70% at one year, 62% at ten years and to 59% at 25 years. We also found that survival without disability has increased in preterm babies born at 22-32 weeks gestation from 70% in the 1980s to >80% in 2000-2010.
What it means
The survival of preterm infants without a diagnosis of intellectual disability, autism or cerebral palsy has continued to improve with the increasing use of active interventions. However sociodemographic and perinatal factors play a role in the outcomes.