Cognitive development in preterm and full term infants

Abstract

Introduction. Compared with full term, premature infants have an increasing risk for developing cognitive delay. Early detection and treatment would decrease risk for developing cognitive delay and learning problems during more advanced ages. Objective. To evaluate cognitive development in preterm and in full term infants and identify neonatal features (gestational age, weight of birth, age, gender) associated with cognitive developmental delay. Population. Preterm infants (29-36 GA), extremely preterm infants (24-28 GA) and full term infants (37-43 GA) from 6 to 24 month old, who attend the Preterm Clinic and Development Program at the Hospital Italiano de Buenos Aires and the Centro Interdisciplinario de Investigaciones en Psicología, Matemáticas y Experimental (CIIPMECONICET). Buenos Aires, Argentina. Methods. The Sensory-motor Intelligence Argentine Scale (EAIS) was administrated. Socio-demographic and neonatal features data was collected from the Neonatology Service’s electronic database and/or parental interview. A multivariate logistic regression was performed to evaluate: gender, age, gestational age - GA (full term [>36 GA], preterm [29-36 GA] and extremely preterm [<28 GA]) and weight of birth (Adequate Birth Weight [ABW] >2500gr., Low Birth Weight [LBW] 2500-1500gr., Very Low Birth Weight [VLBW] <1500gr.) as determinants of cognitive developmental delay. Results. A total of 343 infants from 6 to 24 month old (corrected age in case of prematurity) were evaluated. About gestational age: 214 (62,4%) were full term infants, 116 (33,8%) were preterm infants (from 29 to 36 GA) and 13 (3,8 %) were extremely preterm infants (< 28GA). Preterm and extremely preterm infants showed a higher risk of cognitive developmental delay compared to full term infants. The estimated Odds Ratio (OR) according with the multivariate regression model were: preterm infants group OR: 2.48 (CI 95%: 1.11-5.51) and extremely preterm infants group OR: 10.12 (CI 95%: 2.81-36.40). As regards the weight of birth, 228 infants (66,5%) were ABW, 62 (18%) LBW and 53 (15,5%) were VLBW. Groups of LBW and VLBW infants showed a higher risk of cognitive developmental delay compared with ABW infants. LBW group OR: 3.01 (CI 95%: 1.19-7.56); VLBW group OR: 4.60 (CI 95%: 1.88-11.25). All the results were adjusted by gender and infant age. Conclusions. Our results suggest that preterm and extremely preterm infants; LBW and VLBW infants showed a significant increased risk for cognitive developmental delay compared with full term and ABW infants.