Objectives: Neurodevelopmental outcomes associated with preterm birth are of major health and educational concern. This study examined the neuromotor, cognitive, language and emotional/behavioural outcomes of a regional cohort of 4-year-old children born extremely preterm (EPT: 23–27 weeks’ gestation), very preterm (VPT: 28–33 weeks) and full term (FT: 38–41 weeks). Of particular interest were children’s risks of impairment across multiple neurodevelopmental domains.
Methods: Data were gathered as part of a prospective longitudinal study of 105 very preterm (⩽33 weeks gestation) and 107 FT children born during 1998–2000. At 4 years corrected age, children underwent a comprehensive multidisciplinary assessment that included a paediatric neurological examination, cognitive and language testing, and an assessment of child emotional and behavioural adjustment.
Results: At age 4 years, compared to FT children, EPT and VPT children had increased risks of cerebral palsy (EPT 18%, VPT 15%, FT 1%), cognitive delay (EPT 33%, VPT 36%, FT 13%), language delay (EPT 29%, VPT 29%, FT 10%) and emotional/behavioural adjustment problems (EPT 37%, VPT 13%, FT 11%). EPT and VPT children were three times more likely to have multiple domain impairments than FT children (EPT 30%, VPT 29%, FT 10%).
Conclusions: A substantial proportion of preschool children born very preterm show clinically significant problems in at least one neurodevelopmental domain, with impairment in multiple domains being common. There is a need to monitor preschool development across a range of functional domains and to consider the likely cascading effects of multiple impairments on later development.
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Funding This research was funded from grants from the Neurological Foundation of New Zealand, Research Council of New Zealand, Canterbury Medical Research Foundation, and the Lottery Grants Board.
Competing interests None.
Ethics approval All procedures and measures were approved by the regional ethics committee.