A Comparison of Neurodevelopmental Outcomes of Late Preterm Infants with Healthy Full-term Infants at Imam Khomeini Hospital, 2019-2020.

Abstract

Objective: There is evidence that multiple insults during 34 to 36 6/7 weeks' gestation critical phase of neuronal and glial maturation in these infants cause white and gray matter injury. While all of this underscores the potential vulnerability of the late preterm infant (LPI) to neuronal brain injury and poor developmental and long-term outcome, detail is lacking on the precise domains that are affected. This study aimed to compare neurodevelopment and social-emotional development between late preterm infants and term-born control infants at age 18 months.

Materials and methods: We studied 122 infants at corrected age of 18 months using ASQ III in a historical cohort study including 68 late preterm infants in two groups of 34 intervened(infants with regular developmental visits and appropriate active rehabilitation and follow up)and not intervened infants(infants with just one visit at Growth and Development Clinic without any intervention and follow up by parents) who were born in Imam Khomeini Hospital complex, Medical University of Tehran, Iran during 2017-2018 and 54 full term infants as control group. Data from the first visit of the Growth and Development Clinic at birth were collected using a self-made validated questionnaire according to the Gesell development assessment tool in three fields, including gross motor, fine motor, and social domains.

Results: LPIs had poorer motor and social-emotional competence compared with controls at birth (P<0.001). They also performed more poorly than controls in the fine motor domain of development at 18 months (P=0.030). In comparison among the three groups, significant differences were observed in the gross motor (P = 0.005), fine motor (P = 0.030), and communication (P = 0.020) domains. After using logistic regression models, neurodevelopment in all domains at birth and 18 months of age was independent of late preterm birth but related to underlying morbidity and duration of Neonatal Intensive Care Unit (NICU) admission.

Conclusion: Late preterm birth is not effective on neurodevelopment alone, but a history of co-morbidity or NICU admission at birth is an effective factor. Early diagnosis and intervention can improve the neurodevelopmental outcome of late preterm infants.