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Impact of neonatal morbidity on the risk of developmental delay in late preterm infants
Sílvia Martínez-Nadal1, Xavier Demestre1, Luisa Schonhaut2
1Department of Pediatrics, Hospital de Barcelona-SCIAS, Barcelona, Spain.
Insights
Complicated late preterm infants (cLPI) show higher risks for developmental delay (DD) in communication at age 4, particularly with respiratory issues. Caesarean delivery is a key perinatal risk factor for DD.
Area of Science:
- Neonatal development
- Pediatric neurology
- Developmental pediatrics
Background:
- Late preterm infants (LPI) face increased risks of developmental delay (DD) compared to term-born infants.
- The specific links between perinatal complications and DD in LPI require further clarification.
Purpose of the Study:
- To compare DD risk at age 4 between complicated LPI (cLPI), uncomplicated LPI (uLPI), and term-born infants.
- To identify maternal and perinatal factors associated with DD risk.
- To analyze the association between perinatal morbidity and DD risk in LPI.
Main Methods:
- Retrospective cohort study of 163 LPI (47 cLPI, 116 uLPI) and 158 term infants.
- Developmental delay assessed using the Ages & Stages Questionnaires® 3rd Spanish version (ASQ3).
- Multivariate logistic regression analyzed associations between DD risk and maternal/perinatal factors.
Main Results:
- cLPI exhibited a higher risk of DD in the communication domain compared to term infants.
- Respiratory pathology in cLPI was linked to increased communication domain DD.
- Caesarean delivery emerged as the sole maternal perinatal risk factor for DD, particularly affecting gross motor development.
Conclusions:
- At 4 years, cLPI, especially those with respiratory morbidity, face a higher risk of communication delay.
- Caesarean delivery is identified as the primary perinatal risk factor for DD in this cohort.
Background:
Late preterm infants (LPI) have a higher risk of developmental delay (DD) than term-born infants. The association of perinatal complications with specific morbidity is not clear.
Aim:
(1) To compare the risk of DD at 4years of age between LPI who have presence or absence of any morbidity associated with the prematurity at birth, called complicated (cLPI) or uncomplicated (uLPI), and term-born infants, (2) to determine maternal and perinatal factors associated with risk of DD, and (3) to analyze, in LPI, the association between perinatal morbidity and risk of DD.
Methods:
A retrospective cohort study including 163 LPI - 47 cLPI and 116 uLPI - and 158 term-born infants (Terms) was conducted. Parents completed the Ages & Stages Questionnaires®3rd Spanish version (ASQ3). Risk of DD was defined as the presence of any ASQ3 domain scoring below the mean minus 2 SD. Association between risk of DD and maternal and perinatal factors was analysed using a multivariate logistic model. Incidence of risk of DD was analysed according to specific morbidity.
Results:
Compared to Terms, cLPI have a higher risk of DD in the communication domain. Respiratory pathology was associated with a higher risk in the communication domain. Caesarean delivery was the only maternal perinatal risk factor for DD, especially in gross motor domain.
Conclusions:
At the age of 4years cLPI, especially those with respiratory morbidity, had a higher risk of communication delay. Caesarean delivery was the only perinatal risk factor associated with risk of DD.
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