CHILDREN born moderate to late preterm (MLP, 32–36 weeks’ gestation) exhibit poorer cognitive and academic performance, and more behavioural difficulties at school age compared with peers born early term or later (≥37 weeks). These findings highlight the need for developmental surveillance in this group.
This prospective longitudinal cohort study investigated the neurodevelopmental outcomes of children born MLP compared to those born early term or later, with recruitment at birth from a single tertiary hospital in Melbourne, Australia, between December 2009 and March 2014. The study followed 201 children in each group, assessing 159 born MLP (79.1%) and 137 born early term or later (68.2%) at age 9. Cognitive abilities, academic performance, motor function, behaviour, and social communication skills were evaluated using regression models adjusted for socioeconomic and perinatal factors. Multiple imputation addressed missing data.
At age 9, children born MLP had significantly lower full-scale IQ scores (mean difference −4.4; 95% CI: −7.7-−1.0) and poorer cognitive performance across verbal comprehension, visuospatial, and working memory domains. Academic outcomes were also reduced, with lower scores in pseudoword decoding (mean difference −4.0; 95% CI: −7.0-−1.1) and mathematics (mean difference −5.0; 95% CI: −8.8-−1.2). Behavioural difficulties were more prevalent in the MLP group (31.7% vs 21.5%; adjusted risk ratio: 1.57; 95% CI: 1.06–2.33), though manual dexterity showed no significant difference. Early developmental delays at age 2 were strongly associated with poorer neurodevelopmental outcomes at school age.
The persistence of neurodevelopmental challenges in children born MLP highlights the importance of structured developmental follow-up. Early assessments, particularly at age 2, could identify at-risk children and enable targeted interventions to support learning and behavioural development.
Reference
Cheong JLY et al. Neurodevelopment at age 9 years among children born at 32 to 36 weeks’ gestation. JAMA Netw Open. 2024;7(11):e2445629.
