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Preterm Birth: Research, Intervention and Developmental Outcomes

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: closed (31 October 2020) | Viewed by 49944

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Special Issue Editors

Prof. Dr. Annalisa Guarini

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Guest Editor

Department of Psychology, University of Bologna, 40127 Bologna, Italy
Interests: preterm birth; language development; academic achievement; bullying and cyberbullying
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Miguel Pérez Pereira

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Guest Editor

Departamento de Psicología Evolutiva y de la Educación, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
Interests: language development; preterm children; blind children

Prof. Dr. Anneloes van Baar

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Guest Editor

Child and Adolescent Studies, Utrecht University, 3508 TC Utrecht, The Netherlands
Interests: development of children with perinatal risk factors like preterm birth; diagnostic assessments

Prof. Dr. Alessandra Sansavini

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Guest Editor

Department of Psychology, “Alma Mater Studiorum” Università di Bologna, 40127 Bologna, Italy
Interests: development of communication, language, cognition, learning abilities and modalities of mother-infant interaction in infants and children with atypical (preterm) and typical (full-term) development; instruments of observation and evaluation of communication and language in the first years of life; development of narrative, social, cognitive, and temporal competences at preschool age; relationships between oral and written linguistic abilities at preschool and school age
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We are organizing a Special Issue on “Preterm Birth: Research, Intervention, and Developmental Outcomes” in the International Journal of Environmental Research and Public Health. The venue is a peer-reviewed, scientific journal that publishes articles and communications in the interdisciplinary area of environmental health sciences and public health. For detailed information about the journal, we refer you to https://www.mdpi.com/journal/ijerph.

Preterm birth is defined as a birth occurring before 37 weeks of gestation. As recently suggested by the World Health Organization, preterm birth is recognized as an important public health issue, since prematurity is one of the leading causes of death in children under 5 years of age. The incidence rate has increased in the last ten years, and inequalities in survival rates and negative outcomes are described around the world (March of Dimes, PMNCH, Save the Children, WHO. Born Too Soon: The Global action report on preterm Birth, 2012). Indeed, in low-income countries, the rate of death is around 50% for babies born below 32 weeks of gestation, while in high-income countries, almost all preterm babies survive, though severe and moderate impairments are reported (e.g., cerebral palsy, neurosensory disabilities, cognitive delay, linguistic, academic and behavioral impairments, March of Dimes et al., 2012). Preterm birth is therefore a critical event that not only affects child development but also has an impact on the families and society, with particular reference to care and educational settings.

This Special Issue aims at documenting research on the effects of preterm birth on developmental outcomes from the first years of life, including school age and up to the adolescence. An interdisciplinary approach is appreciated, since the care of preterm children requires a collaboration among different professional areas of expertise, including paediatricians, psychologists, therapists, educators, and teachers. In addition, interventions regarding neonatal care and follow-up programs are welcome. We also welcome contributions comparing different countries across the globe.

Prof. Dr. Annalisa Guarini
Prof. Dr. Miguel Pérez Pereira
Prof. Dr. Anneloes van Baar
Prof. Dr. Alessandra Sansavini
Guest Editors

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

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Keywords

Preterm birth
Interventions
Outcomes
High-income country
Low-income country
Infancy
School age
Adolescence
Neonatal care
Follow-up

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Published Papers (14 papers)

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Editorial

Jump to: Research, Review

4 pages, 284 KiB

Open AccessEditorial

Special Issue: Preterm Birth: Research, Intervention and Developmental Outcomes

by Annalisa Guarini, Miguel Pérez Pereira, Anneloes van Baar and Alessandra Sansavini

Int. J. Environ. Res. Public Health 2021, 18(6), 3169; https://doi.org/10.3390/ijerph18063169 - 19 Mar 2021

Cited by 4 | Viewed by 2416

Abstract

As indicated by the World Health Organization, preterm birth is a relevant public health issue, being one of the leading causes of death in children under five years of age [...] Full article

(This article belongs to the Special Issue Preterm Birth: Research, Intervention and Developmental Outcomes)

Research

Jump to: Editorial, Review

26 pages, 1165 KiB

Open AccessArticle

Parents’ Experiences of the First Year at Home with an Infant Born Extremely Preterm with and without Post-Discharge Intervention: Ambivalence, Loneliness, and Relationship Impact

by Erika Baraldi, Mara Westling Allodi, Ann-Charlotte Smedler, Björn Westrup, Kristina Löwing and Ulrika Ådén

Int. J. Environ. Res. Public Health 2020, 17(24), 9326; https://doi.org/10.3390/ijerph17249326 - 13 Dec 2020

Cited by 29 | Viewed by 5243

Abstract

With increasing survival rates of children born extremely preterm (EPT), before gestational week 28, the post-discharge life of these families has gained significant research interest. Quantitative studies of parental experiences post-discharge have previously reported elevated levels depressive symptoms, posttraumatic stress-disorder and anxiety among the parents. The current investigation aims to qualitatively explore the situation for parents of children born EPT in Sweden during the first year at home. Semi-structured interviews were performed with 17 parents of 14 children born EPT; eight parents were from an early intervention group and nine parents from a group that received treatment as usual, with extended follow-up procedures. Three main themes were identified using a thematic analytic approach: child-related concerns, the inner state of the parent, and changed family dynamics. Parents in the intervention group also expressed themes related to the intervention, as a sense of security and knowledgeable interventionists. The results are discussed in relation to different concepts of health, parent–child interaction and attachment, and models of the recovery processes. In conclusion, parents describe the first year at home as a time of prolonged parental worries for the child as well as concerns regarding the parent’s own emotional state. Full article

(This article belongs to the Special Issue Preterm Birth: Research, Intervention and Developmental Outcomes)

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20 pages, 1328 KiB

Open AccessArticle

A Parent-Implemented Language Intervention for Late Talkers: An Exploratory Study on Low-Risk Preterm and Full-Term Children

by Mariagrazia Zuccarini, Chiara Suttora, Arianna Bello, Arianna Aceti, Luigi Corvaglia, Maria Cristina Caselli, Annalisa Guarini and Alessandra Sansavini

Int. J. Environ. Res. Public Health 2020, 17(23), 9123; https://doi.org/10.3390/ijerph17239123 - 7 Dec 2020

Cited by 11 | Viewed by 4208

Abstract

Parent-implemented language interventions have been used for children with expressive language delays, but no study has yet been carried out using this intervention for low-risk preterm children. The current study examined the effect of a parent-implemented dialogic book reading intervention, determining also whether the intervention differently impacted low-risk preterm and full-term children. Fifty 31-month-old late talkers with their parents participated; 27 late talkers constituted the intervention group, and 23 constituted the control group. The overall results indicated that more children in the intervention group showed partial or full recovery of their lexical expressive delay and acquired the ability to produce complete sentences relative to the control group. Concerning full-term late talkers, those in the intervention group showed a higher daily growth rate of total words, nouns, function words, and complete sentences, and more children began to produce complete sentences relative to those in the control group. Concerning low-risk preterm late talkers, children in the intervention group increased their ability to produce complete sentences more than those in the control group. We conclude that a parent-focused intervention may be an effective, ecological, and cost-effective program for improving expressive lexical and syntactic skills of full-term and low-risk preterm late talkers, calling for further studies in late talkers with biological vulnerabilities. Full article

(This article belongs to the Special Issue Preterm Birth: Research, Intervention and Developmental Outcomes)

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14 pages, 1083 KiB

Open AccessArticle

Parenting Behavior at 18 Months Predicts Internalizing and Externalizing Problems at 6 Years in Moderately Preterm and Full Term Children

by Lisa Oosterom, Lilly Bogičević, Marjolein Verhoeven and Anneloes L. van Baar

Int. J. Environ. Res. Public Health 2020, 17(22), 8679; https://doi.org/10.3390/ijerph17228679 - 23 Nov 2020

Cited by 3 | Viewed by 2835

Abstract

Moderately preterm born children (MPT) are at increased risk for behavior problems compared to full term born (FT) children. MPT children may receive less optimal parenting, and in response, may develop behavior problems. Our aims were to examine whether parenting behavior and mother–child interaction quality mediate the association between birth status and child behavior problems. Participants were 120 MPT children and 100 FT children. At 18 months of age, mothers reported on their parenting behavior (support and structure), and mother–child interaction (sensitivity and limit-setting) was observed. At 6 years of age, mothers reported on children’s behavior problems. Using structural equation modeling, birth status was found to predict attention problems, but not internalizing and externalizing problems. Mothers of MPT children set less appropriate limits than mothers of FT children at 18 months of age. More maternal structure at 18 months predicted fewer internalizing and externalizing problems, but not attention problems, at 6 years. These associations between parenting behavior, mother–child interaction quality, and child behavior problems were similar for MPT and FT children. Our findings indicate that maternal structure in toddlerhood is an important predictor of later internalizing and externalizing problems for both MPT and FT children. Full article

(This article belongs to the Special Issue Preterm Birth: Research, Intervention and Developmental Outcomes)

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18 pages, 928 KiB

Open AccessArticle

Toddlers’ Language Development: The Gradual Effect of Gestational Age, Attention Capacities, and Maternal Sensitivity

by Vera E. Snijders, Lilly Bogicevic, Marjolein Verhoeven and Anneloes L. van Baar

Int. J. Environ. Res. Public Health 2020, 17(21), 7926; https://doi.org/10.3390/ijerph17217926 - 29 Oct 2020

Cited by 12 | Viewed by 3786

Abstract

Language development in toddlerhood forms the foundation for speech and language comprehension throughout childhood. Children born moderately preterm are at increased risk for problems in receptive and expressive language functioning, and they may need specific support or interventions. To understand the underlying mechanisms of language development, an integrated model of gestational age, attention capacities, and maternal sensitivity was examined in relation to receptive and expressive language functioning in toddlerhood. Our sample included 221 children (gestational age between 32–41 + 6 weeks; 54.7% born moderately preterm; 51.6% boys; 69.1% highly educated mothers). At 18 months (corrected age), attention capacities were measured using an eye-tracking procedure and maternal sensitivity was observed during mother-child interaction. Language was assessed at 24 months (corrected age). Results showed children with a higher gestational age scored higher on receptive language. This association was direct, as well as indirect through the child’s alerting attention. Expressive language was related to maternal sensitivity. Gestational age and alerting attention capacities specifically were related to language comprehension, whereas maternal sensitivity was related to speech. As language comprehension and speech in toddlerhood show different associations with biological, child, contextual, and regulation factors, they should be viewed as separate constructs in research and practice. Full article

(This article belongs to the Special Issue Preterm Birth: Research, Intervention and Developmental Outcomes)

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13 pages, 369 KiB

Open AccessArticle

Mind-Mindedness and Parenting Stress: A Cross-Sectional Study in a Cohort of Mothers of 3-Month-Old Full-Term and Preterm Infants

by Chiara Suttora, Maria Spinelli, Tiziana Aureli, Mirco Fasolo, Francesca Lionetti, Odoardo Picciolini, Maura Ravasi and Nicoletta Salerni

Int. J. Environ. Res. Public Health 2020, 17(21), 7735; https://doi.org/10.3390/ijerph17217735 - 22 Oct 2020

Cited by 10 | Viewed by 3325

Abstract

The preterm birth of a child is a sudden event that can disturb the overall family system and its functioning. Many studies have been conducted with the aim of exploring how and the degree to which this event affects the early mother–infant dyadic relationship and maternal well-being, with often mixed findings. The present study investigates the combined effect of preterm birth and parenting stress on mind-mindedness, a parenting dimension that captures how parents represent and treat their children as separate individuals with their own mental states and activities. A hundred and ten mothers and their three-month-old infants (preterm = 54; full-term = 56) participated in the study. Mind-mindedness was assessed by coding mothers’ comments about infant’s mental states during dyadic face-to-face interaction. Parenting stress was evaluated with the Parenting Stress Index Short Form questionnaire. Mothers of preterm infants reported similar levels of appropriate and non-attuned mind-related comments to mothers of full-term infants. The reported parenting stress levels were also comparable. Interestingly, only mothers of preterm infants who reported higher stress in parenting showed more non-attuned comments during the interaction. The results underline the need to address preterm birth as a complex event, going beyond group differences and considering its interplay with other risk or protective factors in shaping children’s and parents’ adjustments and well-being. Full article

(This article belongs to the Special Issue Preterm Birth: Research, Intervention and Developmental Outcomes)

22 pages, 372 KiB

Open AccessArticle

Speech and Language Skills of Low-Risk Preterm and Full-Term Late Talkers: The Role of Child Factors and Parent Input

by Chiara Suttora, Annalisa Guarini, Mariagrazia Zuccarini, Arianna Aceti, Luigi Corvaglia and Alessandra Sansavini

Int. J. Environ. Res. Public Health 2020, 17(20), 7684; https://doi.org/10.3390/ijerph17207684 - 21 Oct 2020

Cited by 25 | Viewed by 3836

Abstract

Among children in the third year of life, late talkers comprise from 9% to 20%. This range seems to increase when addressing preterm children. This study examined video-recorded child spontaneous speech during parent–child book sharing as well as linguistic skills reported through the MacArthur Bates Communicative Development Inventories (MB-CDI) Short Form in 61 late talkers aged 30 months old (26 low-risk preterm, 8 females; 35 full-term, 12 females). Differences between low-risk preterm and full-term late talkers in child language measures and parental speech input were tested, as were the roles of child and parent factors on child language. Low-risk preterm and full-term late talkers showed similar speech and language skills. Similarly, no differences were found in measures of parental speech between groups. Child cognitive score, chronological age, and low-risk preterm status were positively associated with lexical diversity, rate, and composition of child speech production, whereas family history for language and/or learning disorders as well as parent measures of lexical diversity, rate, and grammatical complexity were negatively associated with the above child variables. In addition, child cognitive score and low-risk preterm status were positively associated with the MB-CDI measures of word and sentence production. Findings are discussed in terms of the need of good practices when following up on low-risk preterm children and of interventions targeting parents’ input to preterm and full-term late talkers. Full article

(This article belongs to the Special Issue Preterm Birth: Research, Intervention and Developmental Outcomes)

23 pages, 754 KiB

Open AccessArticle

Learning Abilities in a Population of Italian Healthy Preterm Children at the End of Primary School

by Silvia Bucci, Francesca Bevilacqua, Chiara De Marchis, Maria Franca Coletti, Simonetta Gentile and Anna Maria Dall’Oglio

Int. J. Environ. Res. Public Health 2020, 17(20), 7599; https://doi.org/10.3390/ijerph17207599 - 19 Oct 2020

Cited by 3 | Viewed by 2166

Abstract

Background: Delays in learning skills have been extensively reported for very preterm children. However, few studies have examined academic achievement profiles in Italian preterm children as a function of their neonatal immaturity. Methods: A cross-sectional study was performed that included 82 healthy Italian children born very and extremely preterm (without major neurosensory outcomes; IQ ≥85). Children were evaluated for academic and neurocognitive performances at the second cycle of primary school. Results: Healthy preterm children showed on average academic and neurocognitive profiles that did not differ according to gestational age. Impairment was seen to one or more learning domains in 14.6% of the healthy preterm children. Conclusions: Italian children born very and extremely preterm without major neurosensory damage and/or cognitive delay showed on average learning and neurocognitive profiles within the normal range, regardless of gestational age. Nevertheless, they showed higher proportions of learning impairment than a normative Italian population during their final years of primary school. Healthcare providers should be aware of this result, and long-term surveillance should be organized to promptly identify those children who are in need of therapeutic intervention. Full article

(This article belongs to the Special Issue Preterm Birth: Research, Intervention and Developmental Outcomes)

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14 pages, 2352 KiB

Open AccessArticle

Neurodevelopmental Trajectories of Preterm Infants of Italian Native-Born and Migrant Mothers and Role of Neonatal Feeding

by Dino Gibertoni, Alessandra Sansavini, Silvia Savini, Chiara Locatelli, Gina Ancora, Enrica Perrone, Magda Ialonardi, Paola Rucci, Maria Pia Fantini, Giacomo Faldella and Luigi Corvaglia

Int. J. Environ. Res. Public Health 2020, 17(12), 4588; https://doi.org/10.3390/ijerph17124588 - 25 Jun 2020

Cited by 7 | Viewed by 3061

Abstract

There is evidence that preterm infants of migrant mothers are at a higher risk of adverse perinatal outcomes than those of native-born mothers, and that human milk feeding is beneficial to infants’ neurodevelopment. Using the United Nations Human Development Index (HDI) to classify mother’s country of origin, we investigated whether type of neonatal feeding (human milk vs. mixed milk vs. exclusive formula milk) affected preterm newborn neurodevelopment varying across different HDI categories (Italian native-born vs. high HDI migrant vs. low HDI migrant) up to 2 years of age. Neurodevelopment of 530 infants born in Italy at ≤32 weeks of gestational age and/or weighing <1500 g was measured at 3-, 6-, 9-, 12-, 18-, and 24-months corrected age (CA) using the revised Griffiths Mental Development Scale 0–2 years. The trajectories of the general developmental quotient and its five subscales were estimated using mixed models. At 24-months CA only preterm infants of low HDI migrant mothers and fed exclusive formula milk showed moderate neurodevelopment impairment, with lower developmental trajectories of eye-hand coordination, performance, and personal-social abilities. Migrant mothers from low HDI countries and their preterm infants should be targeted by specific programs supporting maternal environment, infant development, and human or mixed milk neonatal feeding. Future research should focus on a deeper understanding of the mechanisms through which type of feeding and mother migrant conditions interact in influencing preterm infants’ neurodevelopment. Full article

(This article belongs to the Special Issue Preterm Birth: Research, Intervention and Developmental Outcomes)

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14 pages, 835 KiB

Open AccessArticle

Early Motor Trajectories Predict Motor but not Cognitive Function in Preterm- and Term-Born Adults without Pre-existing Neurological Conditions

by Nicole Baumann, James Tresilian, Peter Bartmann and Dieter Wolke

Int. J. Environ. Res. Public Health 2020, 17(9), 3258; https://doi.org/10.3390/ijerph17093258 - 7 May 2020

Cited by 5 | Viewed by 2993

Abstract

Very preterm (VP; <32 weeks gestation) and/or very low birth weight (VLBW; <1500 g) birth has been associated with an increased risk of adverse motor and cognitive outcomes that may persist into adulthood. The aim of this study was to determine whether motor development in the first five years of life is associated with motor and cognitive outcomes in adulthood. A prospective observational study in Germany followed 260 VP/VLBW and 229 term-born individuals from birth into adulthood. Early motor trajectories (i.e., high and low degree of motor difficulties) were determined from neurological examinations from birth to 56 months. Adult motor and cognitive outcomes were determined from information from multiple instruments and IQ tests, respectively. Associations of VP/VLBW birth and early motor difficulties on adult outcomes were assessed using regression analyses. VP/VLBW individuals had an increased risk for early motor difficulties (Relative Risk: 11.77, 95% confidence interval (CI): 4.28, 32.35). Early motor difficulties were associated with poorer motor competence in adulthood (β = 0.22, p < 0.001), independent of VP/VLBW birth. Adult IQ was predicted by VP/VLBW (β = −0.12, p < 0.05) and child IQ (β = 0.51, p < 0.001), while early motor difficulties ceased to be associated with adult IQ once participants with a neurological impairment were excluded (β = 0.02, p > 0.05). Motor problems in childhood were homotypically associated with poorer motor competence in adulthood. Similarly, early cognitive problems were homotypically associated with adult cognitive outcomes. Thus, both motor and cognitive function should be assessed in routine follow-up during childhood. Full article

(This article belongs to the Special Issue Preterm Birth: Research, Intervention and Developmental Outcomes)

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13 pages, 397 KiB

Open AccessArticle

A Follow-Up Study of Cognitive Development in Low Risk Preterm Children

by Miguel Pérez-Pereira, María Pilar Fernández, María Luisa Gómez-Taibo, Zeltia Martínez-López and Constantino Arce

Int. J. Environ. Res. Public Health 2020, 17(7), 2380; https://doi.org/10.3390/ijerph17072380 - 31 Mar 2020

Cited by 12 | Viewed by 2762

Abstract

The results of a longitudinal study on the cognitive development of one group of full-term and three groups of low risk preterm children with different gestational ages (GA) are presented. The 181 participants were divided into four GA groups of similar size. The aims were: 1) To check if there are differences in cognitive development (measured through the Batelle scale) among the GA groups. 2) To establish the predictive factors of cognitive development at 22 and 60 months of age, taking into account biomedical, environmental and individual factors. The results of the repeated measures ANOVA performed at 22 and 60 months of age indicated that the cognitive trajectories of the four GA groups were similar. Linear regression analyses showed that the effect of the different predictors changed in relation to the time of measurement of cognitive development. Biological factors and the quality of home environment had a moderate effect on the cognitive development at 22 months of age. Cognitive results obtained at 22 months of age, and, to a lesser extent, working memory had the greatest effect on cognitive development at 60 months. GA does not predict cognitive development. Preterm children do not show cognitive delay if they are healthy. Full article

(This article belongs to the Special Issue Preterm Birth: Research, Intervention and Developmental Outcomes)

8 pages, 285 KiB

Open AccessArticle

Maternal Mental Illness Is Associated with Adverse Neonate Outcomes: An Analysis of Inpatient Data

by Abigail Lopez, Monideepa B. Becerra and Benjamin J. Becerra

Int. J. Environ. Res. Public Health 2019, 16(21), 4135; https://doi.org/10.3390/ijerph16214135 - 27 Oct 2019

Cited by 3 | Viewed by 2597

Abstract

Objective: Addressing mental illness and associated outcomes is a major public health priority in the United States. In this study, our goal was to assess the role of maternal mental illness and its association to poor fetal growth and preterm delivery in one of the most socioeconomically disadvantaged areas of California. Methods: Data were obtained from the public database of California inpatient data from the Office of Statewide Health Planning and Development (OSHPD). OSHPD provides de-identified data on all inpatient department visits within California, to ensure confidentially of patients. Each variable was dichotomized into a binary variable of presence or absence of diagnosis status. The primary independent variable was clinical diagnosis of any mental illness. The dependent variables were pregnancy birth outcomes defined as poor fetal growth and preterm delivery. We specifically focused on inland Southern California due to its higher socioeconomic burden and poor maternal–child outcomes. Results: In the inland Southern California area, which is generally a geographic location with high poverty, maternal mental illness was associated with 79% higher odds of poor fetal growth and 64% higher odds of preterm delivery. Increasing numbers of co-morbidities were also associated with poor fetal growth. On the other hand, being older, being on Medicaid or other insurance status, being non-Hispanic Black, as well as increasing co-morbidities were associated with increased odds of preterm delivery. Conclusions: The purpose of the study was to evaluate the immediate birth outcomes associated with maternal mental illness. Given the empirical evidence of the study, addressing maternal mental health status is a key public health issue, especially in socioeconomically disadvantaged areas. Full article

(This article belongs to the Special Issue Preterm Birth: Research, Intervention and Developmental Outcomes)

12 pages, 827 KiB

Open AccessArticle

Shorter Time to Full Preterm Feeding Using Intact Protein Formula: A Randomized Controlled Trial

by Maria Elisabetta Baldassarre, Antonio Di Mauro, Margherita Fanelli, Manuela Capozza, Jennifer L. Wampler, Timothy Cooper and Nicola Laforgia

Int. J. Environ. Res. Public Health 2019, 16(16), 2911; https://doi.org/10.3390/ijerph16162911 - 14 Aug 2019

Cited by 9 | Viewed by 3862

Abstract

Background: This study was carried out to evaluate enteral feeding advancement and tolerance in preterm infants receiving one of two marketed formulas: intact protein preterm formula (IPF) or extensively hydrolyzed formula (EHF) for the first 14 feeding days. Methods: Primary outcome was days to full enteral feeding (≥140 mL/kg/day). Per protocol analyses included the following: all participants who met study entrance criteria and completed study feeding (primary) and those who received ≥75% enteral intake from study formula (subset). Mothers were encouraged to provide their breast milk. Results: Of the 65 enrolled (IPF: n = 32; EHF: n = 33), 60 completed study feeding per protocol (IPF: n = 30; EHF: n = 30), 37 (62%) received predominantly breast milk, and 23 (38%) received ≥75% study formula intake (IPF: n = 11; EHF: n = 12). No group differences were detected in tolerance measures. No necrotizing enterocolitis (NEC) was reported. Median time to achievement of full enteral feeding was significantly shorter for the IPF vs. EHF group (day 10 vs. 14, p < 0.05) (subset analysis). Mean enteral intake significantly increased by day 14 for the IPF group (p < 0.05), reflecting group divergence as achieved feeding volumes increased. Conclusions: Results suggest shorter time to full enteral feeding and higher feeding volume achieved by study end in preterm infants receiving intact protein preterm formula versus extensively hydrolyzed formula. Full article

(This article belongs to the Special Issue Preterm Birth: Research, Intervention and Developmental Outcomes)

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Review

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24 pages, 863 KiB

Open AccessReview

Cognitive and Learning Outcomes in Late Preterm Infants at School Age: A Systematic Review

by Sílvia Martínez-Nadal and Laura Bosch

Int. J. Environ. Res. Public Health 2021, 18(1), 74; https://doi.org/10.3390/ijerph18010074 - 24 Dec 2020

Cited by 32 | Viewed by 4933

Abstract

Late preterm children born between 34^0/7 and 36^6/7 weeks’ gestation account for ≈70% of prematurely born infants. There is growing concern about this population at risk of mild neurodevelopmental problems, learning disabilities and lower academic performance. Following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement, this paper analyzes recent published evidence from 16selected studies involving late preterm children and control group assessments at preschool and/or school age, mainly focusing on cognitive functioning, language learning and academic achievement. The review identifies the assessment tools used in these studies (standardized tests, parental questionnaires and laboratory tasks) and the areas being evaluated from preschool (age 3 years) to primary school levels. Results reveal the presence of mild difficulties, pointing to suboptimal outcomes in areas such as executive function, short term verbal memory, literacy skills, attention and processing speed. Some difficulties are transient, but others persist, possibly compromising academic achievement, as suggested by the few studies reporting on higher risk for poor school performance. Given the increasing number of late preterm children in our society the review highlights the need to implement screening strategies to facilitate early risk detection and minimize the negative effects of this morbidity in childhood. Full article

(This article belongs to the Special Issue Preterm Birth: Research, Intervention and Developmental Outcomes)

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