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Preterm Neurodevelopmental Trajectories from 18 Months to 4.5 Years
Rhandi Christensen1, Vann Chau1, Anne Synnes2
1Division of Neurology, Department of Pediatrics, University of Toronto and The Hospital for Sick Children, Toronto, Ontario, Canada.
The Journal of Pediatrics
|April 5, 2023
Summary
Children born very preterm show stable cognitive and language development but increasing motor deficits by age 4.5. Continued developmental monitoring is crucial for these children.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Child Psychology
Background:
- Preterm birth is associated with neurodevelopmental challenges.
- Longitudinal data on cognitive, language, and motor development in very preterm infants are essential for understanding long-term outcomes.
Purpose of the Study:
- To assess the longitudinal trajectory of cognitive, language, and motor outcomes from 18 months to 4.5 years of age in children born very preterm.
Main Methods:
- Prospective cohort study of 163 very preterm infants (24-32 weeks gestation).
- Neurodevelopmental assessments using Bayley Scales (18 months, 3 years) and Wechsler Scales/Movement Assessment Battery (4.5 years).
- Brain MRI and clinical data analyzed using ANOVA, chi-squared tests, and linear regression.
Main Results:
- Cognitive and language trajectories remained stable from 18 months to 4.5 years.
- Motor impairment increased over time, with more children exhibiting deficits at 4.5 years.
- Below-average cognitive/language outcomes and severe motor impairment were linked to clinical risk factors and white matter injury.
Conclusions:
- Cognitive and language development are generally stable in very preterm children up to preschool age.
- Motor deficits tend to increase with age, highlighting a critical developmental window.
- Continued developmental surveillance is vital for identifying and supporting preterm children through preschool years.
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