Related Experiment Video
Updated: Jul 17, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Risk profiles of motor deficits in preterm infants: a cluster analysis approach
Lisa Middendorf1, Julia Jaekel2,3,4, Alexandra Gellhaus5
1Department of Pediatrics I, Neonatology, Pediatric Intensive Care and Pediatric Neurology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany. lisa.middendorf@uk-essen.de.
Insights
Identifying combined maternal, neonatal, and social risks is key for preterm infant development. High social or neonatal risks, but not maternal risks alone, were linked to poorer outcomes at 3 months.
Area of Science:
- Developmental Pediatrics
- Neonatal Research
- Public Health
Background:
- Preterm infants are at elevated risk for developmental impairments.
- Maternal pregnancy complications, neonatal morbidity, and social adversity can cumulatively worsen these risks.
- Understanding the interplay of these factors is crucial for early intervention.
Purpose of the Study:
- To identify clusters of maternal, neonatal, and social risk factors in preterm infant-mother dyads.
- To investigate the association between these risk clusters and infant cognitive/motor outcomes.
- To inform targeted follow-up strategies for vulnerable preterm infants.
Main Methods:
- Two-step cluster analysis of data from 222 mother-preterm infant dyads.
- Risk factors included maternal, neonatal, and social variables.
- Mixed-effects linear regression models assessed outcomes at 3 and 12 months corrected age.
Main Results:
- Four distinct risk profiles were identified, ranging from low risk to high risk in specific domains.
- Infants in high social risk and high neonatal risk profiles showed significantly lower 3-month motor scores compared to the low-risk group.
- No significant difference in outcomes was found for the high maternal risk profile alone.
Conclusions:
- An intersectional approach is essential for understanding developmental vulnerability in preterm infants.
- Simultaneous assessment of maternal, neonatal, and social risks aids in early identification.
- Person-centered risk profiles highlight the need for individualized, multidisciplinary follow-up care.
Background:
Preterm infants face increased risks of developmental impairments. Maternal pregnancy complications, neonatal morbidity, and social adversity may additively increase these risks.
Objective:
This study aimed to identify intersecting maternal, neonatal, and social risk factors clustering within mother and preterm infant dyads, and to examine their prospective associations with infants' cognitive and motor outcomes.
Methods:
Data from 222 mother and preterm infant dyads were analyzed using two-step cluster analysis based on maternal, neonatal, and social risk factors. Mixed-effects linear regression models assessed differences in outcomes at 3 months (MOS-R) and 12 months (Bayley III) corrected age according to identified risk profiles.
Results:
Four risk profiles emerged. The low-risk profile (A) represented minimal maternal, neonatal, and social adversity. At 3 months, infants in the high social (C) and high neonatal risk (D) profile had lower MOS-R scores compared with profile A (C: coefficient = -2.27, 95% CI [-3.46, -1.07], p < 0.01; D: -3.75 [-5.40, -2.08], p < 0.01). No difference was observed for the high maternal risk profile (B).
Conclusion:
These findings emphasize an intersectional approach to understanding developmental vulnerability in preterm infants. Simultaneous consideration of maternal, neonatal, and social risks is crucial for early identification and targeted follow-up of at-risk families.
Impact:
This study demonstrates that maternal, neonatal, and social risk factors occur in distinct clusters among preterm infant-mother dyads. Person-centered risk profiles reflect different etiological pathways Findings emphasize the need for intersectional risk screening to guide individualized multidisciplinary follow-up care for preterm infants.
