FUNCTIONAL ABILITIES AT AGE 4 YEARS OF CHILDREN BORN BEFORE 29 WEEKS OF GESTATION

Objectives-To assess the rate of impairment and disability among babie s born very preterm and to investigate the association between such im pairment and gestational age at birth. Design--Cohort study of a geogr aphically defined population of babies. Setting-Oxford Regional Health Authority. Subjects-All babies born alive before 29 weeks of gestatio n to mothers resident in the region during 1984-6. Main outcome measur es-Survival rates and rates of impairment and disability among survivo rs at the age of 4 years. Results-Of the 342 babies, half (170) surviv ed to be discharged home. Of the 164 survivors to age 4 years, 153 (93 %) were assessed. A total of 35 (23%; 95% confidence interval 16% to 3 0%) were severely disabled and only 54 (35%; 28% to 43%) were unimpair ed. The risk of impairment and disability increased with decreasing ge stational age at birth (p < 0.003). Conclusions-With the increasing su rvival rate among babies born before 29 weeks of gestation, we need ur gently to establish reliable ways of monitoring the proportion of surv ivors who have a disability.