Premature babies are more likely to survive without severe disabilities but remain at high risk of developmental delays, a new BMJ study has shown.
Around 50% of children born at 24-26 weeks’ gestation had developmental delays detected, with 41% of children born at 27-31 weeks and 36% of children born at 32-34 weeks also suffering from some form of delay.
At the age of two years, these children had reduced scores on the Ages and Stages questionnaire (ASQ) – a tool for screening developmental and social-emotional progress in children aged up to six. Scores were below the threshold for developmental delay risk, especially in regards to communication and personal-social abilities.
The study’s researchers compared rates of survival – and survival without neuromotor and sensory disabilities such as cerebral palsy, blindness and deafness – in 5,567 children born alive in France at 22-26, 27-31, and 32-34 weeks’ gestation in 1997 and 2011. To examine the risk of development delay in preterm children, they used the ASQ.
They found that rates of survival to two years without neuromotor disabilities increased from 1997 to 2011. Significantly, rates of cerebral palsy decreased by 3.3%, at both 24-31 and 32-34 weeks’ gestation, between the two time periods.
However, despite improvements in neuromotor and sensory outcomes, the risk of developmental delay remained high, even in children born moderately preterm.
The researchers noted, however, that assessing neurodevelopment at two years, compared with later school age outcomes, is challenging as a child’s development does not have a fixed trajectory and some children will recover from developmental delay while for others their deficit will become apparent as they grow.
The study showed that parental questionnaires may represent a promising alternative for early identification of children at risk of later difficulties.