Risk Factors of Growth Retardation and Developmental Deficits in Very Preterm Infants in a German Tertiary Neonatal Unit

Over the last two decades, improvements in perinatology have led to increased survival rates of preterm infants. A large number of studies and meta-analyses have investigated of preterm infants and/or the influence of developmental care. However, the combined influence of the most frequent risk factors and developmental care on the long-term somatic, motor, and cognitive outcome of preterm infants remains unclear. This retrospective, single-center cohort study includes 256 children treated in a tertiary neonatal intensive care unit in Rostock, Germany, between 2008 and 2013. Follow-up examinations (somatic, psychomotor, and mental development) were performed at (corrected) 24 months using Bayley Scales of Infant Development II (BSID-II). Developmental care was carried out according to the legal framework and national guidelines (physiotherapy and/or early education). Bronchopulmonary dysplasia (BPD) and an exclusive formula feeding showed a 2.8-4.6-fold higher risk (95% Confidence Interval: Mental Developmental Index 1.73-7.58; Psychomotor Developmental Index 1.44-14.54; body length 1.20-6.41) for developmental deficits (mental and psychomotor developmental index; body length). Developmental care after discharge according to national guidelines did not prevent this. Since this is a retrospective pilot study, no recommendations can be made based on this analysis. Therefore, future research should evaluate whether standard developmental care should be extended by tailored measures depending on individual risk factors.

Automated summary

This study investigates the combined influence of common risk factors and developmental care on the long-term outcome of preterm infants. It found that bronchopulmonary dysplasia and exclusive formula feeding were associated with a higher risk of developmental deficits in terms of mental, psychomotor development, and body length. National guidelines for developmental care did not fully prevent these outcomes. Future research may explore tailored measures based on individual risk factors.