Profiles of Functioning in 5.5-Year-Old Very Preterm Born Children in France: The EPIPAGE-2 Study,Journal of the American Academy of Child and Adolescent Psychiatry

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Profiles of Functioning in 5.5-Year-Old Very Preterm Born Children in France: The EPIPAGE-2 Study
Journal of the American Academy of Child and Adolescent Psychiatry ( IF 9.2 ) Pub Date : 2021-09-08 , DOI: 10.1016/j.jaac.2021.09.001
E Sabrina Twilhaar ₁ , Véronique Pierrat ₂ , Laetitia Marchand-Martin ₁ , Valérie Benhammou ₁ , Monique Kaminski ₁ , Pierre-Yves Ancel ₃

Affiliation

Objective

Very preterm born children are at risk for impairments in multiple neurodevelopmental domains, but outcomes vary between individuals. The present study aimed to distinguish subgroups with distinct profiles of functioning across motor, cognitive, behavioral, and psychosocial domains. These profiles were related to neonatal and social/environmental factors.

Method

The sample included 1977 children born very preterm (<32 weeks’ gestation) in 2011 from the French population-based EPIPAGE-2 cohort. Using latent profile analysis, subgroups of children were distinguished based on their functioning at 5.5 years. The relation between outcome profiles and neonatal and social/environmental factors was tested using multivariable multinomial logistic regression analysis.

Results

Four subgroups with distinct outcome profiles were distinguished: no deficit in any domain (45%); motor and cognitive deficits without behavioral/psychosocial deficits (31%); primarily behavioral and psychosocial deficits (16%); and deficits in multiple domains (8%). Male sex (odds ratio [OR] = 2.1-2.7), bronchopulmonary dysplasia (OR = 2.1-2.8), low parental education level (OR = 1.8-2.1), and parental non-European immigrant status (OR = 2.3-3.0) were independently associated with higher odds for all suboptimal outcome profiles compared to the favorable outcome profile.

Conclusion

Among 5.5-year-old very preterm born children, subgroups can be distinguished with distinct outcome profiles that vary in severity, type, and combinations of deficits. This information is important for the development of interventions that are tailored to the needs of large subgroups of children across multiple domains of functioning. General neonatal and social/environmental factors may be useful for early identification of very preterm born children at risk for general rather than domain-specific impairments.

中文翻译：

法国 5.5 岁早产儿的功能概况：EPIPAGE-2 研究

客观的

早产儿在多个神经发育领域有受损的风险，但结果因人而异。本研究旨在区分在运动、认知、行为和心理社会领域具有不同功能特征的亚组。这些概况与新生儿和社会/环境因素有关。

方法

该样本包括 2011 年来自法国基于人群的 EPIPAGE-2 队列的 1977 名早产儿（妊娠<32 周）。使用潜在特征分析，根据 5.5 岁时的功能区分儿童亚组。使用多变量多项逻辑回归分析测试结果概况与新生儿和社会/环境因素之间的关系。

结果

区分了具有不同结果概况的四个亚组：任何领域均无缺陷（45%）；没有行为/心理社会缺陷的运动和认知缺陷（31%）；主要是行为和心理缺陷（16%）；多个领域的缺陷（8%）。男性（优势比 [OR] = 2.1-2.7）、支气管肺发育不良（OR = 2.1-2.8）、父母教育水平低（OR = 1.8-2.1）和父母非欧洲移民身份（OR = 2.3-3.0）与有利的结果概况相比，所有次优结果概况的几率都独立相关。