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Developmental delay in healthy premature infants at age two years: implications for early intervention
1Wellesley Center for Research on Women, Massachusetts 02181-8259.
Insights
Healthy preterm infants show lower mental development scores by 24 months. Early caregiving environments significantly impact preterm infant development, highlighting the need for continued follow-up.
Area of Science:
- Developmental Psychology
- Neonatal Research
- Pediatric Health
Background:
- Preterm infants often face developmental challenges compared to full-term infants.
- Assessing developmental trajectories in healthy preterm infants is crucial for early intervention.
- The influence of environmental factors on development is a key area of research.
Purpose of the Study:
- To compare the developmental outcomes of healthy full-term and preterm infants.
- To identify factors influencing mental development in infants.
- To investigate the role of the caregiving environment in preterm infant development.
Main Methods:
- Longitudinal study assessing 94 healthy infants (full-term and preterm) at 3 and 24 months corrected age.
- Utilized the Bayley Scales of Infant Development to measure Mental Development Index (MDI) and Psychomotor Development Index (PDI).
- Employed regression analyses incorporating environmental and infant temperament variables, including the Home Observation for the Measurement of the Environment (HOME) scale.
Main Results:
- Preterm infants scored significantly lower on the MDI at 24 months, but not PDI, compared to full-term infants.
- Nine factors, including environmental and temperament variables, explained 36% of the variance in MDI scores.
- The caregiving environment (HOME total score) contributed more to the variance in preterm infant development, despite similar high HOME scores between groups.
Conclusions:
- Healthy preterm infants require ongoing developmental follow-up due to potential MDI deficits.
- Early caregiving environments play a significant role in the later development of preterm infants, even in middle-class populations.
- These findings underscore the importance of supportive home environments for optimizing outcomes in low birth weight preterm infants.
Abstract:
Ninety-four healthy full-term and preterm infants, who differed because of immaturity, not medical or social risk factors, were assessed at 3 and 24 months of age. Preterm infants scored significantly lower on the Bayley Mental Development Index (MDI), but not the Psychomotor Development Index (PDI) compared with full-term infants at 24 months (age corrected for prematurity). Nine factors, which included a combination of environmental and infant temperament variables, accounted for 36% of the variance in MDI scores. Separate regression analyses by infant group found that the caregiving environment, Home Observation for the Measurement of the Environment (HOME total score), contributed more to the variance in preterm than full-term development, despite the fact that the HOME scores were high and did not differ between groups at 2 years of age. These findings provide further evidence of the need to continue developmental follow-up for healthy low birth weight (LBW) preterm infants and of the important influence of early caregiving factors on later development, even for middle-class, LBW preterm infants.