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Neurodevelopmental and behavioral outcomes of very preterm infants: latent profile analysis in the Environmental
Marie Camerota1,2, Elisabeth C McGowan3, Judy Aschner4,5
1Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA. marie_camerota@brown.edu.
Insights
Latent profile analysis identified four neurobehavioral profiles in very preterm infants at age 2. Most infants had mild delays, while some faced severe impairments or co-occurring issues, aiding targeted interventions.
Area of Science:
- Developmental Pediatrics
- Neuroscience
- Child Psychology
Background:
- Very preterm infants (<33 weeks gestation) face significant risks for neurodevelopmental impairments.
- Previous research often focused on single-domain outcomes, limiting a holistic view.
- A child-centered approach is needed to understand complex neurodevelopmental profiles.
Purpose of the Study:
- To describe 2-year neurobehavioral profiles in very preterm infants using latent profile analysis (LPA).
- To identify distinct subgroups based on cognitive, motor, and behavioral outcomes.
- To hypothesize that profiles would differ in impairment severity and co-occurrence.
Main Methods:
- Utilized data from the Environmental influences on Child Health Outcomes (ECHO) Program.
- Included 2036 children born <33 weeks gestation with neurobehavioral assessments at age 2.
- Applied LPA to cognitive, motor, and behavioral data (Bayley Scales, CBCL, M-CHAT, CP diagnosis).
Main Results:
- Identified four distinct neurobehavioral profiles in very preterm infants.
- Approximately 85% of children exhibited no/mild neurodevelopmental delay and low behavioral problems.
- Around 15% showed severe neurodevelopmental impairments, with 5% having co-occurring issues.
Conclusions:
- Child-centered LPA offers a comprehensive description of neurodevelopment post-preterm birth.
- Distinct profiles can guide tailored clinical interventions for specific developmental needs.
- This approach enhances understanding for both clinical practice and research.
Background:
Very preterm infants are at high risk for neurodevelopmental impairments. We used a child-centered approach (latent profile analysis [LPA]) to describe 2-year neurobehavioral profiles for very preterm infants based on cognitive, motor, and behavioral outcomes. We hypothesized that distinct outcome profiles would differ in the severity and co-occurrence of neurodevelopmental and behavioral impairment.
Methods:
We studied children born <33 weeks' gestation from the Environmental influences on Child Health Outcomes Program with at least one neurobehavioral assessment at age 2 (Bayley Scales of Infant and Toddler Development, Child Behavior Checklist, Modified Checklist for Autism in Toddlers, cerebral palsy diagnosis). We applied LPA to identify subgroups of children with different patterns of outcomes.
Results:
In 2036 children (52% male; 48% female), we found four distinct neurobehavioral profiles. Most children (~85%) were categorized into one of two profiles characterized by no/mild neurodevelopmental delay and a low prevalence of behavioral problems. Fewer children (~15%) fell into one of two profiles characterized by severe neurodevelopmental impairments. One profile consisted of children (5%) with co-occurring neurodevelopmental impairment and behavioral problems.
Conclusion:
Child-centered approaches provide a comprehensive, parsimonious description of neurodevelopment following preterm birth and can be useful for clinical and research purposes.
Impact:
Most research on outcomes for children born very preterm have reported rates of impairment in single domains. Child-centered approaches describe profiles of children with unique combinations of cognitive, motor, and behavioral strengths and weaknesses. We capitalized on data from the nationwide Environmental influences on Child Health Outcomes Program to examine these profiles in a large sample of children born <33 weeks gestational age. We found four distinct neurobehavioral profiles consisting of different combinations of cognitive, motor, and behavioral characteristics. This information could aid in the development of clinical interventions that target different profiles of children with unique developmental needs.
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