Developmental characteristics of late preterm infants at six and twelve months: A prospective study
Introduction
Late preterm infants (LPI) have been defined as infants born at 34 0/7 to 36 6/7 weeks (239–259 days) of gestation (Engle, 2006). This group comprises of 71% of all preterm births and has been increasing at a greater rate than all other preterm birth subgroups over the last two decades (Davidoff et al., 2006, Martin et al., 2006). In September 2006, the National Institute of Child Health and Human Development set a research agenda to better understand the short and long-term morbidities that may be associated with late-preterm births (Raju, Higgins, Stark, & Leveno, 2006). They pointed out the paucity of available data regarding long-term neuro-developmental outcome of LPI and expressed the need for studies that will estimate prevalence and risk factors for such morbidities. Following studies have shown that LPI are at higher risk for neonatal morbidities compared to infants born at term, but only few studies, mainly retrospective ones, assessed preschool and early school age outcome of LPI and found increased risk of developmental disabilities, emotional regulation difficulties and poorer academic achievements compared to infants born at term (Chyi et al., 2008, Morse et al., 2009, Tomashek et al., 2007, van Baar et al., 2009, Young et al., 2007). A major limitation of these studies is related to insufficient information (when provided) regarding the infants’ perinatal course and as such, inclusion of additional independent risk factors for developmental disabilities. Gurka et al. who compared healthy late-preterm infants with their full term counterparts from ages 4 through 15 years for a variety of cognitive, socioemotional, and behavioral outcomes, found that healthy LPI seem to have no real burdens regarding cognition, achievement, behavior, and socioemotional development throughout childhood (Gurka & Blackman, 2010).
The present study prospectively followed and assessed the developmental outcome of a cohort of LPI, from birth to the end of their first year of life.
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Participants
The study population consisted of 124 LPI of 34 0/7 to 35 6/7 weeks, born at Sheba Medical Center between January 1 and August 31, 2008 whose parents agreed to participate and who had complete developmental assessments at 6 and 12 months’ chronological age. One hundred and ten LPI who were eligible for the study were not included: 93 due to parental refusal, 15 did not complete follow up and two were excluded due to diagnoses of genetic disorders. Participants and non-participants were
Results
Maternal and infant medical and demographic characteristics of LPI and TI that participated in the study are shown in Table 1. Mothers of LPI were more likely to be married and had less education years but did not differ in their age or use of assisted reproduction. LPI gestations were more commonly multiple, complicated by hypertension or diabetes and delivered by emergent cesarean section. Respiratory distress that required oxygen treatment as well as phototherapy was more likely to occur in
Discussion
The present data suggests that complete developmental maturation does not occur by the end of the first year of life in LPI; however LPI functioned as expected by their corrected age. Among LPI infants low Griffith scores were associated with male gender, birth by emergent cesarean section and maternal education >14 years.
An increased risk for poor early school achievements has been reported in LPI. Morse et al. (2009) assessed healthy singleton LPI born in Florida. They found a 36% increased
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Influence of perinatal complications on the development of a sample of 36-month-old premature infants
2021, Infant Behavior and DevelopmentCitation Excerpt :On the other hand, it is difficult to compare our results with other studies of similar nature, since very few of them analyse the relation between medical variables and the development up to this age. Despite the aforementioned limitations, our results support studies that link perinatal risk factors with the neurological response and development in infants (González et al., 2016; Herbón et al., 2015; Morag et al., 2013). Our data support the idea that the areas of Motor skills and Language are those that present major imbalances in this population.
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