Related Experiment Video
Updated: Dec 13, 2025
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Neurodevelopmental Outcome and Adaptive Behavior in Preterm Multiples and Singletons at 1 and 2 Years of Corrected
Chiara Squarza1, Laura Gardon1, Maria Lorella Giannì1,2
1Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit (NICU), Milan, Italy.
Insights
Multiple birth in extremely preterm infants may impact neurodevelopment, with multiples showing lower scores in motor and social skills at one year. They also exhibit more behavioral issues, like externalizing problems, by two years.
Area of Science:
- Neonatal Development
- Perinatal Medicine
- Developmental Pediatrics
Background:
- Multiple births are associated with increased neurodevelopmental disability in preterm infants.
- Existing research on multiple birth's impact on neurodevelopmental outcomes is controversial.
Purpose of the Study:
- To compare neurodevelopmental and behavioral outcomes of multiples versus singletons.
- Focus on preterm infants born at or before 28 weeks gestational age.
- Assessment at 1 and 2 years of corrected age.
Main Methods:
- Cohort study of 86 preterm infants (≤28 weeks gestational age).
- Comparison between 34 multiples and 52 singletons.
- Utilized Griffiths Mental Development Scales and Child Behavior Checklist.
- ANOVA statistical analysis with p < 0.05 significance.
Main Results:
- No significant general difference in neurodevelopmental outcomes between multiples and singletons at 1 and 2 years.
- Multiples had lower scores in Locomotor and Personal-Social subscales at 1 year.
- Multiples showed higher rates of externalizing behavioral problems at 2 years.
Conclusions:
- Lower early neurodevelopmental scores in multiples may stem from environmental factors and altered maternal-infant interaction.
- Hyperstimulation in multiples could contribute to externalizing behaviors.
- Males appear more affected by the multiple birth condition than females.
Background:
Recent literature has investigated the role of multiple birth on neurodevelopmental outcomes of premature infants, especially extremely preterm ones. Multiple gestations are often associated to increased neurodevelopmental disability. Actually, research findings are controversial.
Objective:
To compare the neurodevelopmental and behavioral outcomes of multiples and singletons in a cohort of preterm infants ≤28 weeks gestational age at 1 and 2 years of corrected age.
Methods:
The study included 86 infants, born from January 2014 to September 2017 and enrolled in the follow-up program provided at authors' Institution. Exclusion criteria included: major brain lesions and malformations, severe neuro-sensorial deficits, genetic syndromes, single-twin survivors. Thirty four multiples were compared to 52 singletons, using the Griffiths Mental Development Scales and the Child Behavior Checklist 1½-5. Statistical analysis was based on ANOVA techniques to test group differences. A p < 0.05 was considered statistically significant.
Results:
The neurodevelopmental outcomes of multiples and singletons at 1 and 2 years of corrected age did not significantly differ at a general level (p > 0.05). Multiples showed significantly lower mean scores than singletons at 1 year in Locomotor (87.15 ± 11.94 vs. 92.48 ± 11.59) and Personal-Social (84.88 ± 10.25 vs. 89.63 ± 8.19) subscales. Considering the behavioral outcomes, higher rates of externalizing problems were observed in multiples at 2 years (54.27 ± 9.64 vs. 49.31 ± 10.39).
Conclusion:
The slightly lower neurodevelopmental outcome showed by multiples, especially in the gross-motor and personal-social domains at 1 year, might be related to the specific environmental condition they experience. Multiple birth may affect mother's sensitivity to infant's needs and infant's acquisition of emotional and behavioral regulation. This affects the separation process and the acquisition of the independent walking and other gross-motor skills. Being multiples might also induce an hyperstimulation and this could explain their higher vulnerability to externalizing problems (impulsiveness, hyperactivity, attention deficits). Additionally, males are more affected by the multiple condition than females.
More Related Videos
09:16Use of a Video Scoring Anchor for Rapid Serial Assessment of Social Communication in Toddlers
Published on: March 14, 2018
11:14A Novel Experimental and Analytical Approach to the Multimodal Neural Decoding of Intent During Social Interaction in Freely-behaving Human Infants
Published on: October 4, 2015
Related Concept Videos
01:19Autism Spectrum Disorder
These core symptoms manifest differently among individuals, ranging from mild to severe. The disorder's complexity extends beyond its clinical presentation, encompassing a diverse range of biological, cognitive, and sociocultural influences.
01:30Socioemotional Development during Infancy
Primary Temperament Types