Developmental Profile of an Italian Cohort of ELBW Preterm Infants Born in the 2000s: Is Emerging Language a Weak Point in Early Development?

Objectives: The aim of the study is to describe the neurodevelopmental profile at 24 months of corrected age (CA) measured by Griffiths’ Developmental Scale of a cohort of extremely low birth weight preterm infants born and admitted to an Italian single tertiary care center from 2005 to 2015.

Content: Methods: All consecutive infants born with a birth weight of <1,000 g and admitted within 6 hours from birth to the neonatal intensive care unit (NICU) of the “Fondazione IRCCS Policlinico San Matteo” hospital in Pavia from January 1, 2005, to December 31, 2015, were enrolled. All patients with congenital malformations and/or genetic disorders were excluded. Obstetric and neonatological data were collected. Ultrasound scans’ findings at 40 weeks of gestational age were summarized and classified according to Rademaker. Each patient was examined at term age by a child neuropsychiatrist unaware of the U.S. findings and neonatal neurological examination according to the Amiel-Tison was performed. At 24 months of CA, every patient underwent neurological examination and Griffiths’ Developmental Scale obtaining scores for general quotient (GQ) and for five subscales (locomotor, personal–social, hearing and speech, eye and hand coordination, and performance).

Results: Griffiths’ Developmental Scale scores were available for 174 of 176 patients enrolled. The median GQ was 95.98 (25th: 88, 75th: 106). The median scores obtained on the subscales were the following: locomotor, 98.05 (25th: 88, 75th: 108); personal–social, 99.28 (25th: 90, 75th: 111); hearing speech, 89.65 (25th: 77, 75th: 103); eye–hand coordination, 97.37 (25th: 92, 75th: 105); and performance 97.13 (25th: 85, 75th: 107). A statistically significant difference between the median score obtained on the hearing-speech subscale and on all the other subscales emerged (p < 0.001). Statistical significance persisted after restriction of the analysis to the children with GQ within the normal range, to children with a birth weight of ≤500 g and to children with a gestational age of ≤24 weeks of gestation.

Conclusion: Preterm infants performed significantly lower on language assessment compared with term peers but also scored lower on measures of general cognitive functions. This study confirmed a peculiar developmental profile in preterm infants characterized by a selective deficit in language domain that is maintained regardless GQ, birth weight, and gestational age. Further investigations are needed to understand the pathophysiological mechanisms leading to this selective developmental vulnerability to create early intervention program able to sustain language development in preterm infants.

Publication History

Article published online:
16 March 2022