The Perinatal Adverse events and Special Trends in Cognitive Trajectory (PLASTICITY) - pre-protocol for a prospective longitudinal follow-up cohort study

Abstract

Prospective follow-up studies on long term effects of pre- and perinatal adverse conditions in adulthood are rare. We will continue to follow the prospective cohort of initially 1196 subjects with predefined at-delivery risk factors out of 22,359 consecutive deliveries during 1971-74 at a single maternity hospital. The risk cohort and 93 controls have been followed up with a comprehensive clinical program at 5, 9, and 16 years of age and by questionnaire at the age of 30 years. Major medical events known to affect the development and growth of the brain, or cognitive functions and personality have been documented. Here we present a pre-protocol for the project, which we will call PLASTICITY, whose aim is to follow consenting subjects and controls into mid-adulthood and beyond, and to explore how the neonatal risk factors modulate neurodevelopmental and neurodegenerative processes such as learning disabilities, ADHD, aging, early onset mild cognitive impairment and even dementia. Our first focus is on the neurological and cognitive outcomes at age 40 years, using detailed neurological, neuropsychological, neuroimaging, genetic, blood chemistry and registry based methods. Results will be expected to offer information on the risk of neurological, psychiatric, metabolic and other medical consequences as well as the need for health and social services at the brink of middle age, when new degenerative phenomena are known to emerge. The evaluation at age 40 years will serve as a baseline for later aging studies. We welcome all comments and suggestions, which we will apply in finalizing details and inviting collaboration.

Carriership of two copies of C9orf72 hexanucleotide repeat intermediate-length alleles is a risk factor for ALS in the Finnish population

“…The first of the new control cohorts is the PLASTICITY cohort [ 11 ], which consists of originally 1196 individuals born in 1971–74 in the Helsinki metropolitan area who had at least one predefined pre- or perinatal risk factor (e.g. birth weight ≤ 2000 g, Apgar score < 7, respiratory distress syndrome, diabetic mother, septic infection).…”

Adult neurobehavioral outcome of hyperbilirubinemia in full term neonates—a 30 year prospective follow-up study

“…This coincides with periods before and after entering school (at the age of 7 in Finland). The assessment methods have been described in detail elsewhere ( Hokkanen, Launes & Michelsson, 2013 ). To summarize, a structured neurological assessment was carried at 5 and at 9 years of age out using the Neurodevelopmental Screen developed by Michelsson et al ( Michelsson, Ylinen & Donner, 1981 ; Lindahl, Michelsson & Donner, 1988 ).…”

Mortality in individuals with childhood ADHD or subthreshold symptoms – a prospective perinatal risk cohort study over 40 years

“…A total of 1196 infants with predefined perinatal risks born in a single maternity unit in Helsinki, Finland in years 1971–1974 were included in the study. The perinatal risks have been described in detail elsewhere, and included hyperbilirubinemia, birth weight < 2000 g, Apgar score < 7, respiratory distress, maternal diabetes, hypoglycemia, septicemia, or neurological symptoms [ 23 , 24 ]. Participants with severe disabilities or death before age 5 ( n = 202) were excluded [ 25 ].…”

“…The cohort was followed at 5 and 9 years of age and underwent comprehensive medical and developmental assessments [ 23 ]. Latest in-person follow-up was conducted at age 40 [ 26 ].…”