1. Health Outcomes at 2 Years Corrected Age: RGH NICU Graduate Cohort 2007-2011
A W Allman
Sept 2014

2. Background and Context
BAPM/RCPCH working group
“Classification of health status at 2 years as a perinatal outcome”
Marlow et al 2008
Recommended FU at corrected age of 2 years for all infants <32 weeks or <1500g
Standardised outcome data
“Working group recommends all neonatal services plan to develop their follow up service to include a formal assessment using the Bayley III developmental scale”

3. The Team Dr AA Dr Sarmistha Maity Sr Becky Graves Sr Lisa Jones
Babies < 32 weeks who have received intensive care at RGH
Bayley’s assessment and HSQ
Serennu, NHH, community
Babies born from 2007

4. Health Status at 2 Years Severe neurodevelopmental disability (SND)
CP GMFCS level 3,4,5
Cognitive function <-3 SD below norm
Hearing – nil
SAL – no words
Vision - blind
Moderate neurodevelopmental disability (MND)
CP GMFCS level 2
Cognitive function -2SD to -3SD below norm
Hearing loss, aided
SAL < 5 words
Vision – mod reduced

5. Summary Outcomes Outcome 2007-2011 Number (%)
Admitted for intensive care
368
Survived to discharge
328
Survived to 2yrs CGA
318 (86%)
Information available
155 (49%)
Death or disability (MND and SND) at 2 yrs CGA (% admitted for intensive care)
87 (24%)
Total disability at 2 yrs CGA (% of children assessed)
37 out of 155 (24%)
(76% disability free)
MND (% children assessed)
32 out of 155 (21%)
SND (% children assessed)
5 out of 155 (3%)
Survival free of ND impairment (% children assessed)
118 out of 155 (76%)

6. Survival at 2 Years by Gestation

7. Death or Disability of those admitted to NNU – by gestation

8. Disability in Survivors Assessed n=155 (49%)

9. Disability in survivors assessed by gestation

10. Pattern of disability at 2 years

11. Cumulative outcome Extreme prematurity (22-25 weeks)
Number (%)
Admitted for intensive care 53
Survived to discharge
32 (60%)
Survived at 2 yrs CGA
26 (49%)
Information available
14 (54%)
Death or disability (MND+SND) at 2 yrs CGA (% admitted for intensive care)
31 (58%)
Total disability at 2 yrs CGA (% of children assessed)
5 (36%)
Moderate neurodevelopmental disability (MND) (% of children assessed)
4 (29%)
Severe neurodevelopmental disability (SND) (% of children assessed)
1 (7%)
Survival free of neurodevelopmental impairment (% of children assessed)
9 (64%)

12. Outcomes in survivors assessed (extreme prematurity) n=14

13. Conclusions <32 weeks RGH 5 year cohort 2007-2011
86% of infants admitted survived to 2 yrs
Health outcome available in 49% of survivors, all through standardised assessment
Combined death or disability was 24%
76% of survivors assessed were free of moderate to severe disability
Serious visual impairment was rare

14. Conclusions Data comparable to major studies BUT BEWARE Small numbers
51% of survivors not assessed