Social Adversity and Cognitive, Language, and Motor Development of Very Preterm Children from 2 to 5 Years of Age

J Pediatr. 2018 Dec:203:177-184.e1. doi: 10.1016/j.jpeds.2018.07.110. Epub 2018 Sep 21.

Abstract

Objective: To assess the extent to which social and family factors explain variability in cognitive, language, and motor development among very preterm (<30 weeks of gestation) children from 2 to 5 years of age.

Study design: As part of a longitudinal study, very preterm children recruited as neonates were assessed at 2 (n = 87) and 5 (n = 83) years of age using standardized tests of cognitive, language, and motor ability alongside demographically matched full term (FT) children (n = 63). For very preterm children, developmental change scores were calculated for each domain to assess within-individual variability to 5 years of age. Multivariate regression and mixed-effect models examined social risk index, parenting stress, family functioning, and maternal intellectual ability as predictors of developmental variation among very preterm children.

Results: Very preterm children demonstrated poorer cognitive, language, and motor abilities than FT children at 2 (P ≤ .001) and 5 (P < .002) years of age. Social adversity was associated with cognitive (P < .001) and language (P < .001) outcomes at both ages, with parenting stress also related to cognitive outcomes (P = .03). Infant medical risk was associated with motor outcome at 5 years (P=.01). Very preterm children showed considerable within-individual variation between assessments. Among very preterm children, neonatal white matter abnormalities predicted worsening cognitive (P=.04) and motor development (P = .01). Social risk index predicted worsening language development (P = .04), but this association was subsequently explained by dysfunctional maternal affective involvement (P = .01) and lower maternal intellectual ability (P = .05).

Conclusions: Both clinical and socioenvironmental factors are associated with cognitive, language, and motor developmental variation among very preterm children from infancy to early school age.

Keywords: cognition; development; follow-up; language; motor; social adversity; very preterm.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Child, Preschool
  • Cognition Disorders / diagnosis*
  • Cognition Disorders / epidemiology
  • Developmental Disabilities / diagnosis
  • Developmental Disabilities / epidemiology
  • Female
  • Gestational Age
  • Humans
  • Infant
  • Infant, Extremely Premature / growth & development*
  • Infant, Newborn
  • Language Development*
  • Longitudinal Studies
  • Male
  • Motor Skills / physiology
  • Movement Disorders / diagnosis*
  • Movement Disorders / epidemiology
  • Multivariate Analysis
  • Predictive Value of Tests
  • Regression Analysis
  • Risk Assessment
  • Social Environment
  • United States