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Development and behaviour of 5-year-old very low birthweight infants

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Abstract

The place and time of birth influence the mortality of premature infants. We studied the effect of prematurity, time of birth, birth hospital level and district on the development and behaviour in a national cohort of 5-year-old Finnish very low birthweight infants (VLBWI). All surviving VLBWI (gestational age <32 weeks or birthweight ≤1,500 g) born in 2001–2002 in level II or III hospitals in Finland and full-term controls were included. The parents of 588 (64%) VLBWI and 176 (46%) controls returned the Five to Fifteen questionnaire (FTF) on the development and behaviour of their 5-year-old children. The questionnaire scores were linked to data from the National Medical Birth Register, the Hospital Discharge Register, the Register of Congenital Malformations and the Cause of Death Register. VLBWI had lower developmental and behavioural scores compared to the controls in all FTF domains. In VLBWI, the scores were less optimal, the lower the gestational age was. The time of birth, birth hospital level and district were not associated with the developmental and behavioural scores in VLBWI. In conclusion, short duration of pregnancy adversely influences development and behaviour in VLBWI. Despite differences previously demonstrated in mortality related to time and place of birth, there were no differences in developmental and behavioural scores in VLBWI according to the time of birth, birth hospital level or district. Thus, the survival advantage in level III hospitals seems not to be gained at the expense of behavioural or developmental problems.

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Abbreviations

FTF:

Five to Fifteen questionnaire

GA:

Gestational age

RR:

Rate ratio

SGA, AGA and LGA:

Small, appropriate and large birthweight for gestational age

VLBWI:

Very low birthweight infants

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Acknowledgments

Members of the Performance, Effectiveness, and Cost of Treatment Episodes (PERFECT) Preterm Infant Study Group include all authors, Miika Linna, and Mikko Peltola. This study was supported by the Finnish Academy (Research Program on Health Services Research), the South-West Finnish Fund of Neonatal Research, the University Hospital EVO Funds, and the Turku University Hospital Foundation. Special thanks to Dr. Marit Korkman for her advice on the use of the Five to Fifteen questionnaire.

Conflict of interest statement

All authors declare that they have no conflicts of interests relevant to this article to disclose.

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Authors and Affiliations

  1. Department of Pediatrics, Turku University Hospital, Kiinamyllynkatu 4–8, 20520, Turku, Finland

    Liisi Rautava, Emmi Korvenranta & Liisa Lehtonen

  2. Hospital for Children and Adolescents, Helsinki, Finland

    Sture Andersson

  3. National Institute for Health and Welfare, Helsinki, Finland

    Mika Gissler, Unto Häkkinen & Jaana Leipälä

  4. Department of Pediatrics, Oulu University Hospital, Oulu, Finland

    Mikko Hallman

  5. Turku University Hospital, Turku, Finland

    Heikki Korvenranta

  6. Department of Pediatrics, Tampere University Hospital, Tampere, Finland

    Outi Tammela

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  1. Liisi Rautava
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Correspondence to Liisi Rautava.

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For PERFECT Preterm Infant Study Group.

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Rautava, L., Andersson, S., Gissler, M. et al. Development and behaviour of 5-year-old very low birthweight infants. Eur Child Adolesc Psychiatry 19, 669–677 (2010). https://doi.org/10.1007/s00787-010-0104-x

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  • DOI: https://doi.org/10.1007/s00787-010-0104-x

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