Developmental Trajectories of Very Preterm Infants and Implications for Routine Neurodevelopmental Follow-Up

Area of Science:

• Neonatal development
• Pediatric neurodevelopmental outcomes
• Longitudinal infant studies

Background:

• Very preterm infants face risks for neurodevelopmental challenges.
• Early cognitive assessments are crucial for identifying potential delays.
• Longitudinal tracking is essential to understand developmental trajectories.

Purpose of the Study:

• To assess the longitudinal cognitive development of very preterm infants from 1 to 5 years corrected age.
• To evaluate the predictive accuracy of the Bayley Scales of Infant and (Toddler) Development (BSID(T)D) at 1 and 2 years for preschool cognitive outcomes.

Main Methods:

• 499 very preterm infants were assessed longitudinally.
• Cognitive outcomes were measured using BSID-II/BSITD-III at 1 and 2 years.
• Full-scale intelligence quotient (IQ) was evaluated at 5 years corrected age.

Main Results:

• Most infants showed normal cognitive outcomes at 1, 2, and 5 years (92.2%, 80.3%, 80.9% respectively).
• The 2-year BSID(T)D assessment showed stronger prediction for cognitive delay (AUC 0.88) and IQ scores (R²=46%) at 5 years compared to the 1-year assessment (AUC 0.77, R²=36%).

Conclusions:

• The 1-year BSID(T)D assessment has limited predictive value for preschool cognitive outcomes.
• The 2-year BSID(T)D assessment is a more effective predictor of cognitive development at preschool age.
• Combining 1- and 2-year BSID(T)D assessments provides the optimal prediction for preschool cognitive outcomes.