Brain injury in very preterm children and neurosensory and cognitive disabilities during childhood: the EPIPAGE cohort study.

<h4>Objective</h4>To investigate the association of motor and cognitive/learning deficiencies and overall disabilities in very preterm (VPT) children and their relations to gestational age (GA) and brain lesions.<h4>Design setting and participants</h4>EPIPAGE is a longitudina...

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Autores principales:	Stéphane Marret, Laetitia Marchand-Martin, Jean-Charles Picaud, Jean-Michel Hascoët, Catherine Arnaud, Jean-Christophe Rozé, Patrick Truffert, Béatrice Larroque, Monique Kaminski, Pierre-Yves Ancel, EPIPAGE Study Group
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/48d7bc89b7d540229f0288a6ea32d852
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spelling	oai:doaj.org-article:48d7bc89b7d540229f0288a6ea32d8522021-11-18T07:47:02ZBrain injury in very preterm children and neurosensory and cognitive disabilities during childhood: the EPIPAGE cohort study.1932-620310.1371/journal.pone.0062683https://doaj.org/article/48d7bc89b7d540229f0288a6ea32d8522013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23658763/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Objective</h4>To investigate the association of motor and cognitive/learning deficiencies and overall disabilities in very preterm (VPT) children and their relations to gestational age (GA) and brain lesions.<h4>Design setting and participants</h4>EPIPAGE is a longitudinal population-based cohort study of children born before 33 weeks' gestation (WG) in 9 French regions in 1997-1998. Cumulating data from all follow up stages, neurodevelopmental outcomes were available for 90% of the 2480 VPT survivors at 8 years. Main outcomes were association of motor and cognitive deficiencies and existence of at least one deficiency (motor, cognitive, behavioral/psychiatric, epileptic, visual, and/or hearing deficiencies) in three GA groups (24-26, 27-28, and 29-32WG) and four groups of brain lesions (none, minor, moderate, or severe).<h4>Results</h4>VPT had high rates of motor (14%) and cognitive (31%) deficiencies. Only 6% had an isolated motor deficiency, 23% an isolated cognitive one and 8% both types. This rate reached 20% among extremely preterm. Psychiatric disorders and epilepsy were observed in 6% and 2% of children, respectively. The risks of at least one severe or moderate deficiency were 11 and 29%. These risks increased as GA decreased; only 36% of children born extremely preterm had no reported deficiency. Among children with major white matter injury (WMI), deficiency rates reached 71% at 24-26WG, 88% at 27-28WG, and 80% at 29-32WG; more than 40% had associated motor and cognitive deficiencies. By contrast, isolated cognitive deficiency was the most frequent problem among children without major lesions.<h4>Conclusions</h4>In VPT, the lower the GA, the higher the neurodisability rate. Cerebral palsy is common. Impaired cognitive development is more frequent. Its occurrence in case without WMI or early motor disorders makes long-term follow up necessary. The strong association between motor impairments, when they exist, and later cognitive dysfunction supports the hypothesis of a common origin of these difficulties.Stéphane MarretLaetitia Marchand-MartinJean-Charles PicaudJean-Michel HascoëtCatherine ArnaudJean-Christophe RozéPatrick TruffertBéatrice LarroqueMonique KaminskiPierre-Yves AncelEPIPAGE Study GroupPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 5, p e62683 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Stéphane Marret Laetitia Marchand-Martin Jean-Charles Picaud Jean-Michel Hascoët Catherine Arnaud Jean-Christophe Rozé Patrick Truffert Béatrice Larroque Monique Kaminski Pierre-Yves Ancel EPIPAGE Study Group Brain injury in very preterm children and neurosensory and cognitive disabilities during childhood: the EPIPAGE cohort study.
description	<h4>Objective</h4>To investigate the association of motor and cognitive/learning deficiencies and overall disabilities in very preterm (VPT) children and their relations to gestational age (GA) and brain lesions.<h4>Design setting and participants</h4>EPIPAGE is a longitudinal population-based cohort study of children born before 33 weeks' gestation (WG) in 9 French regions in 1997-1998. Cumulating data from all follow up stages, neurodevelopmental outcomes were available for 90% of the 2480 VPT survivors at 8 years. Main outcomes were association of motor and cognitive deficiencies and existence of at least one deficiency (motor, cognitive, behavioral/psychiatric, epileptic, visual, and/or hearing deficiencies) in three GA groups (24-26, 27-28, and 29-32WG) and four groups of brain lesions (none, minor, moderate, or severe).<h4>Results</h4>VPT had high rates of motor (14%) and cognitive (31%) deficiencies. Only 6% had an isolated motor deficiency, 23% an isolated cognitive one and 8% both types. This rate reached 20% among extremely preterm. Psychiatric disorders and epilepsy were observed in 6% and 2% of children, respectively. The risks of at least one severe or moderate deficiency were 11 and 29%. These risks increased as GA decreased; only 36% of children born extremely preterm had no reported deficiency. Among children with major white matter injury (WMI), deficiency rates reached 71% at 24-26WG, 88% at 27-28WG, and 80% at 29-32WG; more than 40% had associated motor and cognitive deficiencies. By contrast, isolated cognitive deficiency was the most frequent problem among children without major lesions.<h4>Conclusions</h4>In VPT, the lower the GA, the higher the neurodisability rate. Cerebral palsy is common. Impaired cognitive development is more frequent. Its occurrence in case without WMI or early motor disorders makes long-term follow up necessary. The strong association between motor impairments, when they exist, and later cognitive dysfunction supports the hypothesis of a common origin of these difficulties.
format	article
author	Stéphane Marret Laetitia Marchand-Martin Jean-Charles Picaud Jean-Michel Hascoët Catherine Arnaud Jean-Christophe Rozé Patrick Truffert Béatrice Larroque Monique Kaminski Pierre-Yves Ancel EPIPAGE Study Group
author_facet	Stéphane Marret Laetitia Marchand-Martin Jean-Charles Picaud Jean-Michel Hascoët Catherine Arnaud Jean-Christophe Rozé Patrick Truffert Béatrice Larroque Monique Kaminski Pierre-Yves Ancel EPIPAGE Study Group
author_sort	Stéphane Marret
title	Brain injury in very preterm children and neurosensory and cognitive disabilities during childhood: the EPIPAGE cohort study.
title_short	Brain injury in very preterm children and neurosensory and cognitive disabilities during childhood: the EPIPAGE cohort study.
title_full	Brain injury in very preterm children and neurosensory and cognitive disabilities during childhood: the EPIPAGE cohort study.
title_fullStr	Brain injury in very preterm children and neurosensory and cognitive disabilities during childhood: the EPIPAGE cohort study.
title_full_unstemmed	Brain injury in very preterm children and neurosensory and cognitive disabilities during childhood: the EPIPAGE cohort study.
title_sort	brain injury in very preterm children and neurosensory and cognitive disabilities during childhood: the epipage cohort study.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/48d7bc89b7d540229f0288a6ea32d852
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Brain injury in very preterm children and neurosensory and cognitive disabilities during childhood: the EPIPAGE cohort study.

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