Related Experiment Video
Updated: Aug 25, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Preschool outcome of less than 801-gram preterm infants compared with full-term siblings
Howard W Kilbride1, Karla Thorstad, Donna K Daily
1Section of Neonatal Medicine, Department of Pediatrics, Children's Mercy Hospitals & Clinics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri 64108, USA. hkilbride@cmh.edu
Insights
Extremely low birth weight (ELBW) children show developmental delays compared to full-term siblings. Socioeconomic status impacts cognitive and language outcomes, but motor skills are linked to preterm status.
Area of Science:
- Neonatalogy
- Developmental Pediatrics
- Neuroscience
Background:
- Extremely low birth weight (ELBW) infants face higher risks of neurodevelopmental delay.
- Complications of prematurity can impair brain development and long-term cognitive outcomes.
- Postnatal environmental factors significantly influence cognitive development in ELBW children.
Purpose of the Study:
- To differentiate the effects of prematurity from environmental influences on growth and neurodevelopment.
- To compare neurodevelopmental outcomes between ELBW children and their full-term siblings.
Main Methods:
- A cohort of 25 ELBW children (<801g birth weight) and 25 full-term siblings were evaluated.
- Standardized medical, social, cognitive, motor, and language assessments were performed at 3 or 5 years of age.
- Outcomes were compared between groups, controlling for gender and socioeconomic status (SES).
Main Results:
- ELBW children exhibited lower physical growth (weight, height, head circumference) and cognitive scores (IQ, spelling, motor quotients).
- While overall language quotients were similar, receptive language measures were lower in ELBW children.
- High SES mitigated the negative impact of preterm status on cognitive and language scores, but not motor skills.
Conclusions:
- Both prenatal/birth factors (preterm status) and postnatal factors (SES) influence preschool cognitive and language functioning in ELBW children.
- Motor scores in ELBW children were significantly associated with preterm status, independent of SES.
- Sibling comparison highlights the interplay between prematurity and environment in ELBW child development.
Objective:
Extremely low birth weight (ELBW) infants are at greater risk for neurodevelopmental delay than full-term infants. Outcomes may be compromised secondary to abnormal brain development associated with complications of prematurity. Long-term cognitive outcome has also been reported to be significantly influenced by postnatal factors. The objective of this study was to clarify the effects of prematurity separate from environmental factors on growth and neurodevelopmental outcomes by comparing ELBW children with their full-term siblings.
Methods:
The study consisted of 25 ELBW children, a subset selected from a larger population of infants who were <801 g birth weight and enrolled in a longitudinal follow-up project from birth and their 25 full-term, full-weight siblings. Twenty-three sets of siblings were evaluated at 5 years of age and 2 sets at 3 years of age with standardized medical, social, cognitive, motor, and language testing. Physical and neurodevelopmental outcomes were compared between groups, controlling for gender and socioeconomic status (SES).
Results:
At follow-up, ELBW children were lighter, were shorter, and had smaller head circumference. The ELBW children had lower Stanford-Binet IQs (85 +/- 12 [mean +/- SD] and 95 +/- 11), with lower Stanford-Binet subtests except short-term memory and quantitative reasoning, lower spelling scores on the Wide Range Achievement Test, and lower Peabody motor quotients (79 +/- 11 and 92 +/- 17). Preschool Language Scale quotients were not different, but other receptive language measures were lower for ELBW children. High SES seemed to modify the impact of preterm status on cognitive and language but not motor scores. The mean IQ for high-SES ELBW children was equivalent to that of the low-SES term siblings.
Conclusions:
Preschool-age cognitive and language functioning in ELBW children seemed to be affected by both prenatal and birth influences (preterm status) and postnatal influences (SES variables). Motor scores were significantly related to preterm status but not to SES.
