Neurodevelopmental disorders such as intellectual disabilities, autism spectrum disorders, attention deficit hyperactivity disorder, speech disorders are common in extremely preterm infants born before 24 weeks of gestation, as shown in a study from Sweden reported in the journal Acta Paediatrica.¹

Researchers retrospectively analysed childhood diagnoses of neurodevelopmental and somatic conditions in 383 extremely preterm infants born before 24 weeks of gestation (21.9-23.9 weeks; median 23.3 weeks). Data was acquired from the national Swedish registries between 2007 and 2018. Their median birth weight ranged from 340 to 874 grams (median 565 gm). Children were followed up until 2 to 13 years of age.

Data analysis showed that 75% had a neurodevelopmental disorder. More than half (52%) had speech disorders, while 40% had intellectual disabilities. Other disorders included attention deficit hyperactivity disorder in 30%, autism spectrum disorders in 24%, visual impairment in 22%, cerebral palsy in 17% and epilepsy in 10%; a small percentage (5%) had hearing impairment.

A gender difference was seen for intellectual disabilities and visual impairment; 45% boys born at 23 weeks had intellectual disabilities compared to 27% girls. Likewise, visual impairment was more frequently seen in boys than in girls; 25% vs 14%, respectively. 55% of children were referred for habilitative therapy.

Eighty-eight percent had some somatic diagnosis most commonly asthma (63%) followed by failure to thrive or short stature (39%). Somatic conditions were more common in infants born at 21 and 22 weeks compared to those born at 23 weeks.

This retrospective registry-based study has characterized the neurodevelopmental disorders and somatic conditions in extremely preterm infants seen in more than 90% of the study population after they were discharged. Clinicians should be mindful of the various disorders affecting these children and “identify their long-term support needs at an early stage”.

Reference

1. Morsing E, et al. Neurodevelopmental disorders and somatic diagnoses in a national cohort of children born before 24 weeks of gestation. Acta Paediatr. 2022 Mar 22. doi: 10.1111/apa.16316.