Psychomotor development in late premature newborns at five years. Comparison with term newborns using the ASQ3®

Abstract

IntroductionLate prematures (LP) belong to a subgroup of many premature babies with a risk of delayed psychomotor development (PMD). Many subtle changes pass unnoticed if adequate assessment tools are not used. The Ages & Stages Questionnaires 3® (ASQ3®) for parents appears simple and useful for the detection of risk of impairment of PMD, and is recommended by scientific societies that study LP. ObjectivesTo evaluate the risk of impaired PMD in LP at 5 years-old, and compare them with term newborns (TNB) using the ASQ3. Patients and methodsData were collected on the LP born in a third level hospital in 2010, as well as 2 TNB of the same gender for each LP. The prenatal and postnatal morbidity variables were compared. At 5 years, their families (excluding those with other neurological risks) were asked to complete the ASQ3. The cut-off point was determined for the total score of the ASQ3 that would discriminate the risk of PMD impairment using ROC analysis. The cut-off point to determine a change in each domain was obtained according to the ASQ3 manual. ResultsThe ASQ3 was completed for 88 (47%) and 131 (35%) TNB. All the overall mean scores and those for domains were lower in LP, with no significant differences found between the two groups. A risk of PMD impairment (≤253 points) was observed in 7 LP compared to 4 TNB, with no significant difference. More maternal, foetal, and neonatal illnesses were observed in 195 LP than in the 390 TNB. In the univariate analysis, male gender and restricted uterine growth (RUG) were factors associated with a risk of PMD impairment and only RUG in the multivariate analysis. ConclusionThe risk of PMD impairment between LP and TNB at 5 years appears not to be shown, with no significant differences between both, and with the values obtained in the ASQ3 being slightly lower in the LP. Male gender and RUG negatively influence this risk.