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The causal effect of being born extremely preterm or extremely low birthweight on neurodevelopment and

Joy E Olsen1,2, Katherine J Lee1,3, Alicia J Spittle1,2,4

  • 1Murdoch Children's Research Institute, Melbourne, Victoria, Australia.

Acta Paediatrica (Oslo, Norway : 1992)
|September 8, 2021
PubMed

Insights

Children born extremely preterm (EP) or extremely low birthweight (ELBW) face significant risks in neurodevelopment and social-emotional skills by age two. Early developmental surveillance is crucial for these vulnerable infants.

Area of Science:

  • Neonatal development
  • Developmental pediatrics
  • Perinatal outcomes

Background:

  • Infants born extremely preterm (EP; <28 weeks' gestation) or with extremely low birthweight (ELBW; <1000 g) represent a high-risk population.
  • Understanding the long-term neurodevelopmental and social-emotional consequences of EP/ELBW birth is critical for early intervention and support.
  • Previous studies highlight potential developmental challenges, but causal effects require robust investigation.

Purpose of the Study:

  • To determine the causal impact of being born EP/ELBW versus term birth on neurodevelopmental outcomes at 2 years corrected age.
  • To assess the effect of EP/ELBW birth on social-emotional competence at 2 years corrected age.
  • To quantify developmental delays in cognitive, language, and motor domains, as well as social-emotional skills.

Main Methods:

  • A prospective geographical cohort study compared 205 infants born EP/ELBW with 201 term-born controls in Victoria, Australia.
  • Neurodevelopment and social-emotional assessments were conducted at 2 years corrected age using the Bayley Scales and Infant-Toddler Social and Emotional Assessment.
  • Statistical analyses, including adjusted linear and logistic regression, estimated mean differences and odds ratios for developmental delays.

Main Results:

  • Infants born EP/ELBW exhibited significantly higher rates of delay across all assessed domains compared to controls.
  • Odds ratios for delay were substantial: cognitive (3.7), language (5.3), motor (3.9), and social-emotional competence (4.1).
  • These findings indicate a clear adverse effect of EP/ELBW birth on early child development.

Conclusions:

  • Birth as extremely preterm or extremely low birthweight causally impacts cognitive, language, motor, and social-emotional development by 2 years corrected age.
  • The study underscores the necessity for close developmental surveillance in EP/ELBW survivors.
  • Particular attention should be paid to social-emotional development alongside traditional neurodevelopmental monitoring.
Abstract

Keywords:
causal effectextremely low birthweightextremely pretermneurodevelopmentsocial-emotional assessment

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