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Age-corrected development of preterm children: a population-based study
Inbal Goldshtein1, Guy Amit2, Meytal Avgil Tsadok3
1KI Research Institute, Kfar Malal, Israel. inbal@kinstitute.org.il.
Insights
Standard age correction accurately assesses preterm children
Area of Science:
- Pediatric Development
- Neonatal Care
- Developmental Pediatrics
Background:
- Standard practice involves calculating preterm children's age from their expected due date.
- Previous evidence on age correction accuracy is limited.
- Assessing accuracy in a large, diverse population is crucial.
Purpose of the Study:
- To evaluate the accuracy of standard age correction for preterm children.
- To compare developmental milestones between term and preterm infants.
- To identify potential underestimations in developmental assessments.
Main Methods:
- Utilized routine surveillance data from a national network of mother-child clinics.
- Included children without developmental delay at age 2 years.
- Calculated milestone attainment ages and compared between term and preterm groups before and after age correction.
Main Results:
- Analyzed data from 656,986 term and 52,662 preterm children.
- Without age correction, significant developmental gaps were observed in all preterm infants.
- Age correction resolved most gaps for moderate/late preterm but not for very/extremely preterm infants, showing residual delays of 1-2 months.
Conclusions:
- Standard age correction is adequate for moderate and late preterm children.
- It underestimates developmental delays in very and extremely preterm infants.
- Maturational delays persist in preterm children, necessitating accurate age correction for appropriate developmental assessment.
Background:
The standard practice to account for expected developmental lags in preterm children is calculating their age as if born on their expected delivery date. We aimed to assess the accuracy of standard age correction in a large and diverse population.
Methods:
Routine surveillance data was extracted from a national network of mother-child clinics covering over 70% of the Israeli population. We included children with no developmental delay at age 2 years old, to exclude chronic dysfunctions. For each milestone assessed before age 2 years old we calculated the age of 90% and 95% population-milestone attainment, and compared attainment age between term and preterm children, before and after age correction.
Results:
The study consisted of n = 656,986 and n = 52,662 term and preterm children respectively. Without age correction extensive gaps were observed in all domains, all degrees of prematurity and persisted throughout the first 2 years of life. With age correction most gaps were resolved among moderate/late preterm children, but not among extreme and very preterm, with residual gaps of at least 2 months for motor and 1 month for language-social development.
Conclusion:
While standard age correction accounts for maturational delay in late/moderate preterm children, it may underestimate the maturational delay among very/ extremely preterm children.
Impact:
Standard age correction is sufficient for late/moderate preterm children, and underestimates the maturational delay of extreme and very preterm children. Prior evidence on the accuracy of standard age correction across developmental domains and degrees of prematurity was limited to dated, small-scale data. Maturational delays persist throughout the first 2 years of life across all developmental domains and in all levels of prematurity. Developmental assessments without age correction may lead to unnecessary parental anxiety.
