Outcomes for children born at 25 weeks gestation or less

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The EPICure Study has provided us with excellent population based short- and long-term outcomes for a population-based cohort of infants born at 25 weeks gestation or less in 1995. At six years of age, these very preterm infants had median IQ scores 24 points lower than scores for a carefully selected peer group. Wolke et al now report extensive testing for language and school achievement and questions whether the language and learning deficits are specific problems or if they seem to simply reflect cognitive deficits resulting from the lower IQ scores. These children who were very preterm have global deficits that do not seem to target specific learning abilities. The great challenge for the future is to learn which factors contribute to the cognitive deficits in surviving very low gestational age infants. Better strategies should focus as much on better neurodevelopmental outcomes as on improved survival, and we do not know how to improve neurodevelopmental outcomes.