Perinatal, socioenvironmental, and neurological factors to predict motor delay in infants born preterm.

AIM: To determine the best combination of perinatal characteristics, socioenvironmental factors, and neurological examination at term-equivalent age for identifying motor delay at 3 months 2 weeks corrected age in infants born preterm between 29 weeks and 36 weeks of gestation.

METHOD: This prospective observational cohort study included 241 infants born between 29 weeks and 36 weeks of gestation and admitted for more than 48 hours in the neonatal intensive care unit. At term-equivalent age, perinatal and socioenvironmental factors were collected and a standardized neurological examination was performed. At 3 months 2 weeks corrected age, motor development was assessed using the Alberta Infant Motor Scale. Logistic regression was used to create a prediction model.

RESULTS

At 3 months 2 weeks corrected age, 40% of infants had motor delay. Male sex (odds ratio [OR] = 1.95; 95% confidence interval [CI] = 1.07-3.54) and the perinatal risk index (OR = 1.60; 95% CI = 1.07-2.39) were associated with higher odds of motor delay, whereas receiving breast milk at hospital discharge was protective. The addition of the socioenvironmental risk index, substance use during pregnancy, and neurological assessment at term-equivalent age improved the overall model performance for predicting motor delay at 3 months 2 weeks corrected age.

INTERPRETATION: Combining perinatal, socioenvironmental, and neurological factors can be useful in the clinical context to enhance identification of children born preterm between 29 weeks and 36 weeks of gestation with higher probability of motor delay.