A
Got it — this is a big one, and the key takeaway is basically:
By age 12, kids born extremely preterm (<27 weeks) have much higher rates of neurodevelopmental and behavioral diagnoses than term-born peers — and a lot of them have more than one issue at the same time.
Here’s a clean breakdown of what this paper is saying.
What the study was asking
They wanted a full “real life” picture of outcomes at age 12 for children born extremely preterm in Sweden, including:
classic neurodevelopmental disability (NDD): cognition, cerebral palsy, vision/hearing loss, epilepsy
ADHD, autism (ASD), developmental coordination disorder (DCD)
behavior problems
multimorbidity (co-occurring conditions)
Who was studied
National Swedish cohort
Born April 2004–March 2007
EXPRESS study
At age 12:
462 extremely preterm kids assessed
373 term-born controls
The headline results (EPT vs controls)
Moderate/severe NDD
37.4% vs 4.6%
Autism (ASD)
14.9% vs 2.41%
ADHD
21.2% vs 8.9%
DCD (coordination/motor disorder)
29.4% vs 5.7%
Behavioral problems
35.3% vs 8.13%
And all of these differences were highly statistically significant (P < .001).
The really important nuance: ASD/ADHD aren’t only in the “severe disability” group
A lot of people assume autism/ADHD mostly show up only when there’s major cognitive impairment. This study says no.
Among EPT kids with no/mild NDD (289 kids):
8.3% had ASD
14.5% had ADHD
Among EPT kids with moderate/severe NDD (173 kids):
26.0% had ASD
32.4% had ADHD
So yes, rates are higher in the more impaired group — but even the “milder” group still has elevated ASD/ADHD rates.
Multimorbidity (the part that matters most for real-world functioning)
This is the “stacking” problem.
In EPT kids with moderate/severe NDD:
59% had 2 or more co-occurring disabilities/disorders
In EPT kids with no/mild NDD:
24.9% still had comorbidity
So even when kids don’t meet criteria for major disability, a quarter still have multiple neurodevelopmental/behavioral conditions.
How many are “doing fine” by age 12?
This part is actually helpful and easy to misread.
In the total EPT cohort:
57.4% were free from moderate/severe NDD and ASD
Only 42.0% were free from ASD + ADHD + DCD
That second stat is kind of the gut-punch:
Even if you ignore severe NDD, more than half still have at least one of autism, ADHD, or DCD.
The conclusion in plain English
By early adolescence, children born extremely preterm are much more likely to have:
learning/cognitive disability
autism
ADHD
coordination/motor impairment
behavioral difficulties
and multiple conditions at once
So the authors argue strongly for multidisciplinary follow-up, not just “check vision/hearing and discharge.”
If you want, I can also:
turn this into a 1-slide summary (like for a journal club),
extract the “most clinically actionable” points,
or compare it to earlier EXPRESS follow-ups (6 years, etc.) and show what worsens vs stays stable.
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