Early motor trajectories and distinct psychopathological profiles in adolescents born very and extremely preterm

In recent decades, advances in neonatal care have led to a substantial reduction in mortality associated with prematurity. However, preterm birth remains the leading contributor to long-term neurodevelopmental impairment across the lifespan. The present study aimed to longitudinally assess neurodevelopmental outcomes in individuals born very preterm (VPT) or extremely preterm (EPT) and to retrospectively investigate associations between early neurodevelopmental trajectories and psychopathological and functional profiles in adolescence.

The study included 52 adolescents aged 14-18 years, drawn from an original cohort of 118 individuals born before 31 weeks of gestation between 2005 and 2011. Neonatal clinical and anamnestic data were collected, and early neurodevelopment within the first two years of life was assessed using the Bayley Scales of Infant and Toddler Development, Second Edition. Fifteen years later, participants underwent a multidimensional follow-up assessment via self-administered questionnaires delivered through a secure web-based platform. Both participants and one parent completed a comprehensive psychopathological evaluation, including the Child Behavior Checklist (CBCL), Autism Spectrum Quotient (AQ), Obsessive-Compulsive Inventory (OCI), Prodromal Questionnaire-16 (PQ-16), and Inventory of Psychotic-Like Anomalous Self-Experiences (IPASE).

The mean gestational age was 28 weeks (SD = 1.8; range: 23-31), and the mean birth weight was 1,120.8 g (SD = 322.4). VPT individuals showed higher AQ scores, suggesting increased vulnerability to autistic traits, whereas EPT individuals exhibited higher CBCL Attention Problems scores, consistent with ADHD-related features. Latent Profile Analysis identified a two-profile solution: Profile 1 ("High autism traits") was characterized by elevated AQ scores and relatively low OCI, PQ-16, and IPASE scores, whereas Profile 2 ("High psychotic and OCD traits") showed markedly elevated PQ-16, IPASE and OCI scores. Hierarchical multiple regression analyses revealed that the Psychomotor Development Index slope was the only significant predictor of later social functioning (B = -5.782, β = -.289, p = .040), with more favorable early motor trajectories associated with fewer social difficulties in adolescence.

Very and extremely preterm birth are associated with long-term neurodevelopmental and psychopathological vulnerability. Early motor development appears to be a key predictor of later social functioning, potentially shaping distinct developmental trajectories toward autism-related features or psychosis vulnerability.