Intensity of perinatal care for extreme preterm births and neurodevelopmental outcomes at age 5½: the EPIPAGE-2 cohort study
Objective To explore the impact of intensity of perinatal (‘survival-focused’) care on outcomes at 5½ years for two groups of survivors: those born at 24–26 and at 27–28 weeks of gestation.Design Prospective, population-based national cohort.Setting France, 2011.Patients Children surviving to 5½ yea...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2025-07-01
|
| Series: | BMJ Paediatrics Open |
| Online Access: | https://bmjpaedsopen.bmj.com/content/9/1/e003531.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849708462271889408 |
|---|---|
| author | François Goffinet Babak Khoshnood Pierre-Yves Ancel Monique Kaminski Jennifer Zeitlin Laetitia Marchand-Martin Marie-Laure Charkaluk Veronique Pierrat Xavier Durrmeyer Catherine Gire Andrei Scott Morgan Sabrina Twilhaar Laurence Foix-L’Hélias Caroline Diguisto Julie Blanc |
| author_facet | François Goffinet Babak Khoshnood Pierre-Yves Ancel Monique Kaminski Jennifer Zeitlin Laetitia Marchand-Martin Marie-Laure Charkaluk Veronique Pierrat Xavier Durrmeyer Catherine Gire Andrei Scott Morgan Sabrina Twilhaar Laurence Foix-L’Hélias Caroline Diguisto Julie Blanc |
| author_sort | François Goffinet |
| collection | DOAJ |
| description | Objective To explore the impact of intensity of perinatal (‘survival-focused’) care on outcomes at 5½ years for two groups of survivors: those born at 24–26 and at 27–28 weeks of gestation.Design Prospective, population-based national cohort.Setting France, 2011.Patients Children surviving to 5½ years who were born at <29 weeks gestation.Interventions Intensity of perinatal care, defined at the hospital level, categorised into three based on the ratio of babies of 24–25 weeks of gestation admitted into neonatal intensive care to the number of fetuses alive at maternal admission to hospital subsequently delivered at 24–25 weeks gestation.Main outcome measures Neurodevelopmental disability (NDD—none, mild, moderate or severe) comprising cognitive, behavioural, sensory and motor abilities.Results Among 3217 births, 472 children born at 24–26 weeks and 633 born at 27–28 weeks survived. At 24–26 weeks, compared with children born in low-intensity hospitals, children born in high-intensity hospitals had the lowest levels of mild (33.9%) and moderate–severe (21.9%) NDD (ORs 0.42, 0.20–0.88 and 0.47, 0.20–1.12, respectively); no difference was found between hospitals of low and medium intensity. At 27–28 weeks of gestation, no differences were seen between hospitals of any intensity level (p=0.75).Conclusions No evidence was found to support concerns that survival-focused perinatal care is associated with increased long-term NDDs in children born extremely preterm or at a higher gestational age. |
| format | Article |
| id | doaj-art-b6eb09eb28304a9db70ce181e81917a2 |
| institution | DOAJ |
| issn | 2399-9772 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Paediatrics Open |
| spelling | doaj-art-b6eb09eb28304a9db70ce181e81917a22025-08-20T03:15:38ZengBMJ Publishing GroupBMJ Paediatrics Open2399-97722025-07-019110.1136/bmjpo-2025-003531Intensity of perinatal care for extreme preterm births and neurodevelopmental outcomes at age 5½: the EPIPAGE-2 cohort studyFrançois Goffinet0Babak Khoshnood1Pierre-Yves Ancel2Monique Kaminski3Jennifer Zeitlin4Laetitia Marchand-Martin5Marie-Laure Charkaluk6Veronique Pierrat7Xavier Durrmeyer8Catherine Gire9Andrei Scott Morgan10Sabrina Twilhaar11Laurence Foix-L’Hélias12Caroline Diguisto13Julie Blanc145 Maternity Unit of Port Royal, Assistance Publique—Hôpitaux de Paris, Cochin Hospital, Paris, FranceObstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Center of Research in Epidemiology and Statistics (CRESS), Institut National de la Santé et de la Recherche Médicale (INSERM), INRA, Université de Paris, Paris, FranceOPPaLE (Obstetric, perinatal, paediatric life course epidemiology), INSERM UMR 1153, Paris, FranceINSERM, UMR 953, Epidemiological Research in Perinatal Health and Women`s and Children Health, Villejuif, France1 Centre for Research in Epidemiology and Statistics Obstetrical Perinatal and Pediatric Epidemiology Research Team, Paris, Île-de-France, France1 Epidemiology and Statistics Research Center/CRESS, INSERM, INRAE, Paris Cité University, Paris, France2 Department of Neonatology, Saint Vincent de Paul Hospital, GHICL, F -59800 Lille, FranceService de Médecine Néonatale, Hôpital Jeanne de Flandre, Lille Cedex, France1 Faculty of Health, Paris Est Creteil University, 94000 Creteil, Val de Marne, FranceNeonatology, Assistance Publique Hopitaux de Marseille, Marseille, France1 Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Centre of Research in Epidemiology and StatisticS (CRESS), Université Paris Cité, INSERM, INRAE, Paris, F-75006, France7 Department of Psychology, University of Warwick, Coventry, UKObstetric, Perinatal, Paediatric and Lifecourse Epidemiology (OPPaLE) team, Centre for Research in Epidemiology and Statistics (CRESS) UMR1153, INSERM, Paris, FranceMaternité Olympe de Gouges, Centre Hospitalier Régional Universitaire Tours, Université de Tours, Tours, France2University Hospital, ophthalmology, Dijon, FranceObjective To explore the impact of intensity of perinatal (‘survival-focused’) care on outcomes at 5½ years for two groups of survivors: those born at 24–26 and at 27–28 weeks of gestation.Design Prospective, population-based national cohort.Setting France, 2011.Patients Children surviving to 5½ years who were born at <29 weeks gestation.Interventions Intensity of perinatal care, defined at the hospital level, categorised into three based on the ratio of babies of 24–25 weeks of gestation admitted into neonatal intensive care to the number of fetuses alive at maternal admission to hospital subsequently delivered at 24–25 weeks gestation.Main outcome measures Neurodevelopmental disability (NDD—none, mild, moderate or severe) comprising cognitive, behavioural, sensory and motor abilities.Results Among 3217 births, 472 children born at 24–26 weeks and 633 born at 27–28 weeks survived. At 24–26 weeks, compared with children born in low-intensity hospitals, children born in high-intensity hospitals had the lowest levels of mild (33.9%) and moderate–severe (21.9%) NDD (ORs 0.42, 0.20–0.88 and 0.47, 0.20–1.12, respectively); no difference was found between hospitals of low and medium intensity. At 27–28 weeks of gestation, no differences were seen between hospitals of any intensity level (p=0.75).Conclusions No evidence was found to support concerns that survival-focused perinatal care is associated with increased long-term NDDs in children born extremely preterm or at a higher gestational age.https://bmjpaedsopen.bmj.com/content/9/1/e003531.full |
| spellingShingle | François Goffinet Babak Khoshnood Pierre-Yves Ancel Monique Kaminski Jennifer Zeitlin Laetitia Marchand-Martin Marie-Laure Charkaluk Veronique Pierrat Xavier Durrmeyer Catherine Gire Andrei Scott Morgan Sabrina Twilhaar Laurence Foix-L’Hélias Caroline Diguisto Julie Blanc Intensity of perinatal care for extreme preterm births and neurodevelopmental outcomes at age 5½: the EPIPAGE-2 cohort study BMJ Paediatrics Open |
| title | Intensity of perinatal care for extreme preterm births and neurodevelopmental outcomes at age 5½: the EPIPAGE-2 cohort study |
| title_full | Intensity of perinatal care for extreme preterm births and neurodevelopmental outcomes at age 5½: the EPIPAGE-2 cohort study |
| title_fullStr | Intensity of perinatal care for extreme preterm births and neurodevelopmental outcomes at age 5½: the EPIPAGE-2 cohort study |
| title_full_unstemmed | Intensity of perinatal care for extreme preterm births and neurodevelopmental outcomes at age 5½: the EPIPAGE-2 cohort study |
| title_short | Intensity of perinatal care for extreme preterm births and neurodevelopmental outcomes at age 5½: the EPIPAGE-2 cohort study |
| title_sort | intensity of perinatal care for extreme preterm births and neurodevelopmental outcomes at age 5 1 2 the epipage 2 cohort study |
| url | https://bmjpaedsopen.bmj.com/content/9/1/e003531.full |
| work_keys_str_mv | AT francoisgoffinet intensityofperinatalcareforextremepretermbirthsandneurodevelopmentaloutcomesatage51⁄2theepipage2cohortstudy AT babakkhoshnood intensityofperinatalcareforextremepretermbirthsandneurodevelopmentaloutcomesatage51⁄2theepipage2cohortstudy AT pierreyvesancel intensityofperinatalcareforextremepretermbirthsandneurodevelopmentaloutcomesatage51⁄2theepipage2cohortstudy AT moniquekaminski intensityofperinatalcareforextremepretermbirthsandneurodevelopmentaloutcomesatage51⁄2theepipage2cohortstudy AT jenniferzeitlin intensityofperinatalcareforextremepretermbirthsandneurodevelopmentaloutcomesatage51⁄2theepipage2cohortstudy AT laetitiamarchandmartin intensityofperinatalcareforextremepretermbirthsandneurodevelopmentaloutcomesatage51⁄2theepipage2cohortstudy AT marielaurecharkaluk intensityofperinatalcareforextremepretermbirthsandneurodevelopmentaloutcomesatage51⁄2theepipage2cohortstudy AT veroniquepierrat intensityofperinatalcareforextremepretermbirthsandneurodevelopmentaloutcomesatage51⁄2theepipage2cohortstudy AT xavierdurrmeyer intensityofperinatalcareforextremepretermbirthsandneurodevelopmentaloutcomesatage51⁄2theepipage2cohortstudy AT catherinegire intensityofperinatalcareforextremepretermbirthsandneurodevelopmentaloutcomesatage51⁄2theepipage2cohortstudy AT andreiscottmorgan intensityofperinatalcareforextremepretermbirthsandneurodevelopmentaloutcomesatage51⁄2theepipage2cohortstudy AT sabrinatwilhaar intensityofperinatalcareforextremepretermbirthsandneurodevelopmentaloutcomesatage51⁄2theepipage2cohortstudy AT laurencefoixlhelias intensityofperinatalcareforextremepretermbirthsandneurodevelopmentaloutcomesatage51⁄2theepipage2cohortstudy AT carolinediguisto intensityofperinatalcareforextremepretermbirthsandneurodevelopmentaloutcomesatage51⁄2theepipage2cohortstudy AT julieblanc intensityofperinatalcareforextremepretermbirthsandneurodevelopmentaloutcomesatage51⁄2theepipage2cohortstudy |