Article

Comparison of Enrollment in Interventional Therapies Between Late-Preterm and Very Preterm Infants at 12 Months' Corrected Age

New York Medical College, Maria Fareri Children's Hospital at Westchester Medical Center, Department of Pediatrics, Division of Newborn Medicine, 95 Grasslands Rd, Valhalla, NY 10595, USA.
PEDIATRICS (Impact Factor: 5.47). 04/2009; 123(3):804-9. DOI: 10.1542/peds.2008-0928
Source: PubMed

ABSTRACT

To determine the requirement for therapeutic services of late-preterm infants (34 to 36 weeks' gestation) and morbidities associated with their developmental delays compared with their very preterm (<32 weeks' gestation) counterparts.
We used a retrospective cohort study of former preterm children admitted to the neonatal unit who were evaluated at the Regional Neonatal Follow-up Program of Westchester Medical Center in New York at 12 +/- 2 months' corrected age from January 2005 through October 2006. Logistic regression was used to compare odds ratios between late-preterm and very preterm children who qualified for early intervention services. Antenatal, demographic, and neonatal factors were compared between subgroups.
Of the 497 preterm infants evaluated at the Regional Neonatal Follow-up Program, 127 met inclusion criteria (77 very preterm and 50 late-preterm infants). Of the late-preterm infants, 30% qualified for and received early intervention services, 28% physical therapy, 16% occupational therapy, 10% speech therapy, and 6% special education. In the very preterm subgroup, 70% qualified for and received early intervention services, 66% physical therapy, 32% occupational therapy, 32% speech therapy, and 21% special education. Very preterm children were more likely to be enrolled in therapies than their late-preterm counterparts. However, when adjusting for neonatal comorbidities of prematurity, there was no difference in enrollment in early intervention services between the very preterm and late-preterm infants.
After controlling for comorbidities of prematurity, we found that late-preterm infants requiring admission to the neonatal unit have the same risk as very preterm infants of requiring interventional therapies. This would indicate that it is not only the degree of prematurity but also the morbidities experienced in the neonatal period in conjunction with the period of rapid brain growth that have a profound influence on neurodevelopmental outcomes. This should be considered when planning their hospital discharge and follow-up.

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    • "However the majority of these studies do not consider the early neonatal factors or admission status of LPIs [15]. Indeed, a recent study by Kalia and colleagues [16] proposes that LPIs should be considered on the basis of their neonatal outcomes and admission status, whilst Boyle and Boyle [17] suggest that the consequences associated with the place of postnatal care of LPIs warrant further research. Furthermore , not all LPIs require NIC and yet, prior to the current study, a comparison group of infants born within the same gestational age range has Early Human Development 90 (2014) 201–205 Abbreviations: LPI, late preterm infant; NIC, neonatal intensive care; HSQ, Health Status Questionnaire; GP, general practitioner. "
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    Preview · Article · Jan 2014 · Early human development
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    • "Before consultation for this study 30% of the preterm and/or SGA infants were seen by a speech and language therapist. This is, however, comparable with other studies in which 32% of the very preterm infants received speech therapy at a corrected age of 12 (±2) months [6] "
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