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Improvement of developmental outcome between 24 and 36 months corrected age in very preterm infants
Bregje A Houtzager1, Bianca Gorter-Overdiek, Loekie Van Sonderen
1Emma Children's Hospital of the Academic Medical Center, Amsterdam, Netherlands. b.a.houtzager@amc.uva.nl
Insights
Very preterm infants showed improved developmental outcomes and test behavior between 24 and 36 months corrected age. Early developmental trajectories are linked to perinatal factors and test-taking behavior.
Area of Science:
- Neonatology
- Developmental Pediatrics
- Perinatal Medicine
Background:
- Very preterm infants face developmental challenges.
- Early developmental trajectories are crucial for long-term outcomes.
- Perinatal risk factors can influence infant development.
Purpose of the Study:
- To examine the early developmental course of very preterm infants.
- To investigate associations between perinatal risk factors and development.
- To analyze the relationship between test-taking behavior and development.
Main Methods:
- Longitudinal study of 146 infants born <30 weeks gestation or <1000g.
- Assessment at 24 and 36 months corrected age using Dutch Bayley Scales of Infant Development-II (BSID-II-NL).
- Neurological examinations and linear regression analyses for developmental change.
Main Results:
- Significant improvements in mental (6 points) and psychomotor (7 points) scores from 24 to 36 months.
- Reduced incidence of developmental problems at 36 months (32%) vs. 24 months (63%).
- Mental improvement linked to being small for gestational age or <28 weeks gestation; psychomotor improvement linked to avoiding indomethacin treatment. Difficult test behavior at 24 months predicted poorer 36-month outcomes.
Conclusions:
- Very preterm infants demonstrate improved developmental outcomes and test behavior by 36 months corrected age.
- Perinatal factors significantly influence developmental trajectories.
- Long-term follow-up and re-evaluation of children with difficult test behavior are recommended.
Aim:
To study early developmental course in preschool-aged very preterm infants and its association with perinatal risk factors and test-taking behaviour.
Methods:
Children born <30 weeks gestation and/or <1000g in the Academic Medical Center of Amsterdam were assessed at 24 and 36 months corrected age with the Dutch Bayley Scales of Infant Development-II (BSID-II-NL) and neurological examination. Linear regression analyses for developmental change were performed with perinatal risk factors.
Results:
One hundred and forty-six children, mean GA 28 weeks and mean birth weight 1043 g, participated. Mental and psychomotor scores improved significantly with 6 and 7 points, respectively, from 24 to 36 months (p < 0.01). Mild to severe problems on at least one domain occurred less often at 36 (32%) compared to 24 months (63%) (p < 0.01), using corrected scores. Mental improvement was associated with being born very small for gestational age or <28 weeks; psychomotor improvement was associated with not being treated with indomethacin. Difficult test behaviour occurred mostly at 24 months and was associated with non-optimal development at 36 months.
Conclusion:
Improved developmental outcome and test behaviour were found at 36 compared to 24 months in a cohort of very preterm children. Long-term outcome studies and retesting of behaviourally difficult children are recommended.
