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Long-Term Neurodevelopmental Outcomes of Late Preterm Children: A Pilot Study on the Role of Early Nutrition
Augusto Biasini1, Francesca Agostini2, Marcello Stella3
1Donor Human Milk Bank Italian Association (AIBLUD), 20126 Milan, Italy.
Insights
Early nutrition significantly impacts cognitive development in late preterm children. Breastfeeding and formula feeding showed better outcomes than mixed feeding, highlighting protective factors for development.
Area of Science:
- Pediatrics
- Developmental Psychology
- Neuroscience
Background:
- Late preterm birth (34-36 weeks gestation) affects ~5% of births.
- Children born late preterm are at risk for neurodevelopmental issues but often excluded from follow-up.
- Human milk feeding is recognized for child health benefits, yet its interaction with late preterm development is understudied.
Purpose of the Study:
- To investigate the relationship between early nutrition (human milk, formula, mixed feeding) and cognitive development in school-aged late preterm children.
- To explore the influence of maternal and paternal perceptions of child behavior on cognitive outcomes.
- To identify protective factors for cognitive and emotional development in this population.
Main Methods:
- Study included late preterm children aged 8-12 years.
- Cognitive development assessed using Wechsler Intelligence Scale for Children-III (WISC-III).
- Neonatal/growth data collected by pediatricians; parental Child Behavior Checklist (CBCL) used for emotional/behavioral profiles.
Main Results:
- Children fed human milk or formula scored higher on cognitive tests than those on mixed feeding.
- Early feeding type, maternal perception of externalizing behaviors, and paternal perception of externalizing behaviors significantly predicted cognitive development.
- Mixed feeding was associated with lower cognitive scores.
Conclusions:
- Early nutrition and perceived externalizing difficulties are potential factors influencing cognitive development in late preterm children.
- Promoting protective factors like breastfeeding is recommended for future research and interventions.
- Further investigation into the role of parental perception of behavior is warranted.
Abstract:
Background: Late preterm delivery accounts for approximately 5% of all births. Although there is a growing body of literature recognizing that children born late preterm are at risk for mild neurodevelopmental issues, these children are often excluded from follow-up programs. From a preventive perspective, it could be useful to promote protective factors for child development. Among these, human milk feeding is highly recommended due to its advantages for child health and development. However, there is limited research on the complex interactions between late preterm birth, human milk feeding, and subsequent cognitive and emotional development. This paper aims to explore these interactions. Methods: This study focuses on late preterm children aged 8 to 12 years who are attending school. A trained psychologist conducted assessments of cognitive development using the Wechsler Intelligence Scale for Children-III (WISC-III). Additionally, the family pediatrician gathered neonatal and current growth data, while parents completed the Child Behavior Checklist 6-18 (CBCL) regarding their child's emotional and behavioral profile. Results: A significant impact of early nutrition on children's cognitive development was observed, with those fed human or formula milk scoring higher than those in the mixed milk group. Additionally, early feeding, high maternal and low paternal perception of externalizing difficulties significantly predicted children's cognitive development. Conclusions: The study suggests the potential role of early nutrition and externalizing difficulties in the cognitive development of late preterm children at school age. Therefore, the inclusion of protective factors such as breastfeeding should be encouraged in future research.
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