英国医学会：英格兰与威尔士2008～2018共11年间所生早产儿的两年神经发育数据分析

Two-year neurodevelopmental data for preterm infants born over an 11-year period in England and Wales, 2008–2018: a retrospective study using the National Neonatal Research Database 

1. http://orcid.org/0000-0002-2340-1507 Emily van Blankenstein1,2, Tia Sodiwala1, Julia Lanoue1,  http://orcid.org/0000-0002-2093-0681 Neena Modi1,2,  http://orcid.org/0000-0002-6112-2277 Sabita N Uthaya1,2,  http://orcid.org/0000-0002-2898-553X Cheryl Battersby1,2 on behalf of the UK Neonatal Collaborative
2. Correspondence to Dr Cheryl Battersby, Medicine, Imperial College London, London SW10 9NH, UK; c.battersby@imperial.ac.uk

Abstract

Objective United Kingdom guidelines recommend all infants born <30 weeks’ gestation receive neurodevelopmental follow-up at 2 years corrected age. In this study, we describe completeness and results of 2-year neurodevelopmental records in the National Neonatal Research Database (NNRD).

Design This retrospective cohort study uses data from the NNRD, which holds data on all neonatal admissions in England and Wales, including 2year follow-up status.

Patients We included all preterm infants born <30 weeks’ gestation between 1 January 2008 and 31 December 2018 in England and Wales, who survived to discharge from neonatal care.

Main outcome measures Presence of a 2-year neurodevelopmental assessment record in the NNRD, use of standardised assessment tools, results of functional 2-year neurodevelopmental assessments (visual, auditory, neuromotor, communication, overall development).

Results Of the 41 505 infants included, 24 125 (58%) had a 2-year neurodevelopmental assessment recorded. This improved over time, from 32% to 71% for births in 2008 and 2018, respectively.

Of those with available data: 0.4% were blind; 1% had a hearing impairment not correctable with aids; 13% had <5 meaningful words, vocalisations or signs; 8% could not walk without assistance and 9% had severe (≥12 months) developmental delay.

Conclusions The proportion of infants admitted to neonatal units in England and Wales with a 2-year neurodevelopmental record has improved over time. Rates of follow-up data from recent years are comparable to those of bespoke observational studies. With continual improvement in data completeness, the potential for use of NNRD as a source of longer-term outcome data can be realised.