Babies born at 20 to 25 weeks of gestation are now surviving into young adulthood, and researchers are bringing them back for brain scans and lung tests to see if their teenage years allowed them to catch up on development. The EPICure study has tracked 309 extremely preterm children since 1995, finding high rates of disability, learning problems, and respiratory issues at age 11. This new phase, at age 19, asks a critical question: do these young adults close the gap with their peers, or do early deficits persist into adult life? Without this follow-up, doctors cannot know whether childhood assessments accurately predict adult outcomes, or whether adolescence offers a window for recovery. If the research succeeds, it will reshape how clinicians counsel parents of extremely preterm babies and target interventions. Knowing which childhood measures—cognitive, respiratory, or cardiovascular—best predict adult health could allow earlier, more focused treatments. The findings may also reveal whether early lung and blood vessel damage has lasting consequences for heart health in adulthood, informing long-term monitoring guidelines for a growing population of survivors.
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The EPICure study was established in 1995. All births between 20 and 25 weeks of gestation across the United Kingdom and Ireland were identified in a 10-month period. There were 309 surviving children from 4004 births, who have been followed up at 2 1/2, 6 and 11 years of age. The information from this study has been used to derive a range of policy and treatment options for extremely preterm babies. In view of the findings at 11y of continuing high rates of disability, learning problems, respiratory problems and psychological disturbances, and the suggestion from other more mature cohorts that adolescence may be a period of catch up, we propose to re-evaluate the subjects as young adults at 19 years. The reasons we need to do this are to see whether there has been catch up in terms of their development and to evaluate the longer-term effect of changes we have defined in respiratory function and cardiovascular development, which may have important long-term consequences for their adult life. Given the independence of the young people in the study we will arrange an appointment at the Study centre, based at UCL in Central London. This will allow us to carry out better assessments including a brain MR Scan. We will evaluate the following areas of functioning: cognition, executive function (attention, processing of information), memory, behaviour, respiratory function and blood vessel stiffness, and sensory thresholds. Our MRI scan will allow us to relate structural and functional measures to these outcomes using state-of-the-art analyses. In addition we will undertake a lifestyle interview with each child. The importance of these evaluations is several fold: we will be assessing children at the peak of their physical performance as they transition to adult life making this the best time to assess the effects of being born so early on growth, lungs and blood vessels and to work out how accurate our childhood assessments of these were; secondly we can evaluate how predictive our assessments of cognitive and executive performance were in childhood, or to what extent there is catch up over the teenage years; thirdly we can work out which are the key outcomes in adult life that matter and look back at the early life measures we have already collected and suggest better focused targeting of interventions to improve the young adult outcomes.
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