Family social risks on neurodevelopmental outcomes in preterm infants without severe brain injury.

BACKGROUND

To assess family-social risks on neurodevelopmental impairment (NDI) outcomes in preterm infants without severe brain injury (SBI).

METHOD: Infants born <29 weeks' gestation without high-grade intraventricular hemorrhage, periventricular leukomalacia, or cerebellar hemorrhage in the population were assessed using the Bayley Scales of Infant Development. NDI included cognitive/motor delay, cerebral palsy, and bilateral blindness/deafness. Family-social risks included young maternal age, low maternal educational level, minority ethnicity, low family socioeconomic status, and single-parent family. Ordered logistic and linear regression models analyzed family-social and clinical risks for NDI severity outcomes at 24 months.

RESULTS

Among 459 infants, 82% had no/mild NDI, 14% moderate NDI, and 4% severe NDI. Each additional family-social risk increased severe NDI odds by 1.6 times (95% CI: 1.2-2.0), with each extra day of oxygen therapy raising NDI risk by 3% (2-4%). Family-social risks lowered cognitive (-3.3), language (-3.2), and motor (-2.2) scores at 24 months. Males had lower cognitive (-2.7), language (-4.0), and motor (-1.8) scores than females. Each oxygen therapy day reduced all developmental domain scores by 0.1.

CONCLUSIONS

Family social risks, male sex, and oxygen exposure are associated with NDI outcomes in preterm infants without SBI. Additional support for high-risk infants may improve outcomes.

IMPACT: Nearly one-fifth of preterm infants without severe neonatal brain injury (SBI) have moderate/severe neurodevelopmental impairment (NDI), showing developmental deviations from those with no/mild NDI since age 12 months. Family social risks increase the odds of more severe NDI, complicated by additional days of oxygen therapy. Family social risks and male sex are associated with lower developmental scores at 24 months in cognition, language, and motor abilities. Prolonged oxygen therapy contributes to poorer neurodevelopmental performance in all domains. Preterm infants without SBI but with identifiable demographic and clinical risk factors may benefit from surveillance and early intervention services.