Growth, Health and Development in Children Born Extremely Preterm
Condition: Infant, Extremely Low Birth Weight; Lung Diseases, Obstructive; Disorder of Bone Density and Structure, Unspecified; Cognition Disorders; Neurobehavioral Manifestations
MeSH terms: Bone Diseases; Lung Diseases; Lung Diseases, Obstructive; Neurobehavioral Manifestations; Birth Weight; Cognition Disorders
Study type: Observational

Summary: 
      Background: In a national Norwegian cohort of children born before 28 weeks gestation or with
      a birth weight less than 1000 g born in 1999 and 2000, 372 survived. Compared with earlier
      studies survival increased for the most immature infants, but at the cost of more early
      complications and a high rate of impairments, while the less immature children had fewer
      early complications and less impairments detectable within 5 years. These changes show the
      importance of monitoring outcome as treatment modalities change. Large brain haemorrhages
      were highly predictive of severe disabilities, but we have not found good predictive factors
      for milder impairments such as cognitive, behavioural and motor difficulties. However, at 5
      years later function may be difficult to predict, and the children's potentials are better
      understood after completing several years in school. Objectives: The children will be
      re-examined at age 11 in order to assess their physical and mental health, and cognitive,
      motor and social function, and to determine if early life events and development at 2 and 5
      years are predictive of long term health and functioning. MRI-studies, including functional
      MRI will be performed to examine if different outcomes related to brain function can be
      explained by differences in brain development. Methods: For all, data will be collected from
      the compulsory national test in 5th grade and questionnaires to the child, parents and
      teacher. For children in Western Norway (n=87) extensive examinations of lung and brain
      function, including clinical diagnostic tests and MRI, will be added. For all aspects of the
      study the investigators have appropriate current and historic reference populations for
      comparison. Implications: Knowledge on causes and of early predictions of outcome is needed
      to give appropriate advice to families, professionals and society, and to develop preventive
      programs.
    

Detailed description: 
      Questionnaires to parents: On general and neurosensory developmental Health (spesific
      questionnaire for the study) and pulmonary health (ISAAC-questionnaire). Mental Health and
      social functioning: Strengths and Difficulties (SDQ) questionnaire (also completed by
      Teachers), ASSQ and BRIEF.

      Addtions for children born in the Western Norway Regional Health Authority:

      All the children (n=52) and matched Controls born at term have measurements of height, weight
      and blood pressures, pulminary function tests, MRI and functional MRI of the brain,
      Assessment of bone mineralization and distribution of fat and muscle (DXA). Blood is
      collected in a biobank for assessment of inflammatory variables.
    

Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        All extremely preterm infants (gestational age < 28 weeks or birth weight < 1000 g born in
        Norway in 1999 and 2000 and still living at age 11 years. Postal survey on outcome. In
        addition a subgroup (80 out of 365)living in Western Norway will be examined with respect
        to general health, lung function, mental development, quality of life and cerebral imaging
        (fMRI)
      
Biospecimen description: 
      On a subpopulation blood for inflammatory parameters will be collected
    
Keywords: extremely premature infant; follow-up; behavior; growth; mental health; lung function; spirometry; muscle mass; bone density; magnetic Resonance imaging