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

Most children born preterm are born between 29 and 36 weeks of pregnancy. Although many develop typically, some experience developmental difficulties, and most are not routinely followed in specialized neonatal follow-up programs. Identifying which infants may need closer developmental monitoring is therefore important. We followed infants born between 29 and 36 weeks of pregnancy who required admission to a neonatal intensive care unit. We examined whether information available around the time they would normally have been born—including pregnancy and newborn health factors, family and social circumstances, and a neurological examination—could help identify infants more likely to show early motor difficulties. Motor development was assessed at approximately 3.5 months corrected age. Forty percent of the infants showed early motor delay. Rather than pointing to one factor alone, our findings suggest that considering several aspects of an infant's health and environment together provides more useful information about their likelihood of motor delay. Male infants and infants with multiple medical risk factors around birth were more likely to have motor delay. Not receiving breast milk at hospital discharge was also associated with greater likelihood of motor delay. Family and social factors and the neurological examination contributed additional information to the overall prediction model. These findings could eventually help healthcare professionals identify which infants born between 29 and 36 weeks may benefit from closer developmental monitoring after leaving the hospital. Because the information required is readily available and requires few additional resources, this approach could be particularly useful for children who do not routinely have access to specialized neonatal follow-up. The model requires validation in another group of infants before being used to guide clinical care.