Neonatal Predictors of Cognitive Ability in Adults Born Very Preterm: A Prospective Cohort Study

Abstract

Aim To identify neonatal predictors to allow a developmental prognosis of very preterm / very-low birthweight (VP/VLBW) survivors' cognitive abilities into adult life. Method The Bavarian Longitudinal Study is a prospective whole population study that followed 260 VP/VLBW infants from birth to adulthood. Regression analyses were performed to examine which neonatal factors predicted adult IQ. Results VP/VLBW infants’ neonatal morbidity, neonatal treatment, and early social environment explained 37.6% of the variance in adult IQ. Seven unique early life predictors of lower adulthood IQ were found: Respiratory distress syndrome, intraventricular hemorrhage, problems with mobility, mechanical ventilation, less parenteral nutrition, low/middle SES, and poor early parent-infant relationships. Specifically, modifiable factors such as mechanical ventilation predicted a drop of 0.43 IQ points for each day of treatment, adjusted for initial respiratory problems. Good early parent-infant relationships predicted an approximately 5-points increase in adult IQ, adjusted for other significant predictors such as SES. Interpretation Mechanical ventilation, parenteral feeding, and early parenting were identified as significant modifiable factors that were strongly related to adulthood IQ. Mechanical ventilation policies have changed but there is scope for early interventions that focus on positive parenting which may reduce the adverse effects of VP/VLBW birth on cognitive abilities.