Long term follow-up of extremely preterm neonates

Cohort studies have been used to investigate morbidity and mortality in preterm neonates since the early days of neonatal intensive care and have shown adverse sequelae in many of those who survive.1 Such studies have identified many perinatal risk factors that affect outcome. This has improved quality of care and led to a decrease in the incidence and severity of cerebral palsy in preterm neonates.2 Studies of children followed up into puberty identified risks of abnormalities in psychological development and behaviour associated with preterm birth that were not detectable at younger ages.3 Advances in neonatal intensive care in the 1990s mean that neonates who are born as early as 22-23 weeks’ gestational age are now offered active treatment. Two linked research papers from the EPICure 2 study (doi:10.1136/bmj.e7976 and doi:10.1136/bmj.e7961) look at trends in mortality and long term morbidity in this highly vulnerable group.4 5

Costeloe and colleagues report on survival and neonatal morbidity for babies born at 22-26 weeks’ gestation in England during 2006 and assess changes in …