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Effect of biomedical complications on very and extremely preterm children's language
Virginia Varela-Moraga1, Benjamín Diethelm-Varela2, Miguel Pérez-Pereira3
1Departamento de Fonoaudiología, Facultad de Medicina, Universidad de Chile, Santiago, Chile.
Insights
Very and extremely preterm children show language delays. Medical complications did not significantly impact language development outcomes compared to gestational age alone. Both preterm groups had lower language scores than full-term peers.
Area of Science:
- Developmental Pediatrics
- Neonatology
- Linguistics
Background:
- Preterm birth is associated with developmental delays, particularly in language.
- Previous studies may have confounding factors like medical complications, affecting conclusions on gestational age's impact.
- Controlling for biomedical complications is crucial for understanding preterm developmental trajectories.
Purpose of the Study:
- To compare language development at 24 months corrected age in full-term, low-risk preterm, and high-risk preterm children.
- To investigate the influence of medical complications on language development in preterm infants.
- To differentiate the effects of gestational age versus medical complications on early language acquisition.
Main Methods:
- Compared three groups: full-term (FT), low-risk preterm (LRPT), and high-risk preterm (HRPT) children at 24 months corrected age.
- Utilized the Communicative Development Inventories (CDI) for language assessment (vocabulary, sentence complexity, MLU3).
- Employed the Ages and Stages Questionnaire-3 (ASQ-3) to evaluate other developmental domains.
Main Results:
- Both LRPT and HRPT groups showed significantly lower language scores than the FT group.
- No significant language development differences were found between LRPT and HRPT groups, though HRPT scores were lowest.
- Preterm groups exhibited delays in communicative development compared to full-term peers, confirmed by ASQ-3.
Conclusions:
- Very and extremely low gestational age significantly impacts language development.
- Medical complications did not create a significant difference in language outcomes between preterm groups.
- Gestational age appears to be a primary factor in early language delays for preterm infants.
Introduction:
Very and extremely preterm children have been found to show delays in the development of language in early years. In some investigations, however, a rigorous control of biomedical complications, such as Periventricular Leukomalacia (PVL), Intraventricular Hemorrhage (IVH) or Bronchopulmonary Dysplasia (BPD), does not always exist. For that reason, a confounding effect of low gestational age and biomedical complications may lead to erroneous conclusions about the effect of gestational age.
Methods:
In this investigation we compare language development [use of words, sentence complexity and mean length of the three longest utterances (MLU3)] of three groups of Chilean children at 24 months of age (corrected age for preterm children). The first group was composed of 42 healthy full-term children (Full term group: FT), the second group of 60 preterm children born below 32 gestational weeks without medical complications (low risk preterm group: LRPT), and the third group was composed of 64 children below 32 gestational weeks who had medical complications (High risk preterm group: HRPT). The three groups were similar in terms of gender distribution, maternal education, and socio-economic environment. The instrument used to assess language was the Communicative Development Inventories (CDI). In addition, the Ages and Stages Questionnaire-3 (ASQ-3) was also used to assess other developmental dimensions.
Results:
The results indicate that HRPT and LRPT children obtained significantly lower results than the FT group in the three language measures obtained through the CDI. No significant differences were observed between the HRPT and the LRPT groups, although the HRPT obtained the lowest results in the three CDI measures. The results obtained through the administration of the ASQ-3 confirm the delay of both preterm groups in communicative development when compared to the FT group. No significant differences between the FT and the PT groups were observed in gross motor, fine motor and problem solving dimensions of the ASQ-3. The LRPT group obtained results that were significantly higher than those of the FT group and the HRPT group in gross motor development.
Discussion:
These results seem to indicate that the area of language development is particularly influenced by very or extremely low gestational age.
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