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Published on: August 25, 2014
A Comparison of Neurodevelopmental Outcomes of Late Preterm Infants with Healthy Full-term Infants at Imam Khomeini
Soja Ziaei1, Hosein Dalili2, Mamak Shariat3
1Department of Neonatology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Insights
Late preterm infants show developmental delays, especially in motor and social skills. However, neurodevelopment is more influenced by health issues and NICU stay than by late preterm birth itself. Early intervention is key.
Area of Science:
- Neonatal Development
- Pediatric Neurology
- Developmental Pediatrics
Background:
- Late preterm infants (34-36 6/7 weeks' gestation) are vulnerable to brain injury due to critical maturation phases.
- Existing research lacks detail on specific neurodevelopmental domains affected in late preterm infants.
- This study addresses the need to compare neurodevelopment and social-emotional outcomes between late preterm and term-born infants.
Purpose of the Study:
- To compare the neurodevelopment and social-emotional development of late preterm infants with term-born controls at 18 months corrected age.
- To identify specific developmental domains impacted by late preterm birth.
- To explore factors influencing neurodevelopmental outcomes in this population.
Main Methods:
- A historical cohort study involving 122 infants (68 late preterm, 54 term-born) assessed at 18 months corrected age.
- Utilized the Ages and Stages Questionnaire (ASQ III) for neurodevelopmental and social-emotional assessment.
- Collected data on infant development at birth using a validated questionnaire based on the Gesell development assessment tool.
Main Results:
- Late preterm infants exhibited poorer motor and social-emotional competence at birth compared to term-born controls.
- At 18 months, late preterm infants performed worse in the fine motor domain.
- Neurodevelopmental outcomes were independent of late preterm birth but significantly related to underlying morbidity and NICU admission duration.
Conclusions:
- Late preterm birth alone does not solely determine neurodevelopmental outcomes.
- Co-morbidity and Neonatal Intensive Care Unit (NICU) admission are significant factors affecting neurodevelopment.
- Early diagnosis and intervention are crucial for improving neurodevelopmental outcomes in late preterm infants.
Objective:
There is evidence that multiple insults during 34 to 36 6/7 weeks' gestation critical phase of neuronal and glial maturation in these infants cause white and gray matter injury. While all of this underscores the potential vulnerability of the late preterm infant (LPI) to neuronal brain injury and poor developmental and long-term outcome, detail is lacking on the precise domains that are affected. This study aimed to compare neurodevelopment and social-emotional development between late preterm infants and term-born control infants at age 18 months.
Materials And Methods:
We studied 122 infants at corrected age of 18 months using ASQ III in a historical cohort study including 68 late preterm infants in two groups of 34 intervened(infants with regular developmental visits and appropriate active rehabilitation and follow up)and not intervened infants(infants with just one visit at Growth and Development Clinic without any intervention and follow up by parents) who were born in Imam Khomeini Hospital complex, Medical University of Tehran, Iran during 2017-2018 and 54 full term infants as control group. Data from the first visit of the Growth and Development Clinic at birth were collected using a self-made validated questionnaire according to the Gesell development assessment tool in three fields, including gross motor, fine motor, and social domains.
Results:
LPIs had poorer motor and social-emotional competence compared with controls at birth (P<0.001). They also performed more poorly than controls in the fine motor domain of development at 18 months (P=0.030). In comparison among the three groups, significant differences were observed in the gross motor (P = 0.005), fine motor (P = 0.030), and communication (P = 0.020) domains. After using logistic regression models, neurodevelopment in all domains at birth and 18 months of age was independent of late preterm birth but related to underlying morbidity and duration of Neonatal Intensive Care Unit (NICU) admission.
Conclusion:
Late preterm birth is not effective on neurodevelopment alone, but a history of co-morbidity or NICU admission at birth is an effective factor. Early diagnosis and intervention can improve the neurodevelopmental outcome of late preterm infants.
