Predictors of persistent and changing developmental problems of preterm children

Area of Science:

• Pediatrics
• Developmental Psychology
• Public Health

Background:

• Accurate prediction of developmental problems in preterm-born children is essential for timely and targeted interventions.
• Understanding the trajectory of developmental issues from early childhood to school entry is critical.

Purpose of the Study:

• To identify perinatal and social factors associated with persistent, emerging, and resolving developmental problems in early-preterm (EP) and moderately-and-late-preterm (MLP) children.
• To assess the predictive value of these factors for developmental outcomes from before to after school entry.

Main Methods:

• A longitudinal observational cohort study involving 341 EPs and 565 MLPs.
• Developmental problems were assessed using the Ages and Stages Questionnaire at ages 4 and 5.
• Logistic regression analyses were employed to examine associations between 48 perinatal and social factors and developmental problem trajectories.

Main Results:

• Persistent problems were observed in 8.7% of EPs and 4.3% of MLPs; emerging problems affected 5.1% of EPs and 1.9% of MLPs.
• Key predictors for persistent problems included maternal chronic mental illness, male sex, small-for-gestational age (SGA) birth, and multiparity.
• Prolonged premature rupture of membranes (PPROM) in MLPs predicted emerging problems. The inclusion of identified risk factors improved prediction model variance from 3.0% to 21.9%.

Conclusions:

• Few perinatal and social factors consistently predicted developmental problems across both EP and MLP groups.
• Neonatal conditions like SGA and PPROM in MLPs are associated with persistent developmental issues.
• Identifying specific risk factors significantly enhances the prediction of developmental problems in preterm children, enabling better intervention strategies.