Social–emotional delays at 2 years in extremely low gestational age survivors: Correlates of impaired orientation/engagement and emotional regulation

• Published in: Early human development Vol. 89; no. 12; pp. 925 - 930
• Main Authors: Boyd, Lauren A.C, Msall, Michael E, O'Shea, T. Michael, Allred, Elizabeth N, Hounshell, Gail, Leviton, Alan
• Format: Journal Article
• Language: English
• Published: Ireland 01-12-2013
• Subjects: Advanced Basic Science; Child Development - physiology; Child, Preschool; Developmental Disabilities - epidemiology; Developmental Disabilities - pathology; Emotional Intelligence - physiology; Gestational Age; Humans; Infant Behavior - physiology; Infant, Extremely Premature - growth & development; Infant, Newborn; Male; Neonatal and Perinatal Medicine; Neurologic Examination; Extremely Low Gestational Age Newborn; BSID-II; Behavior Rating Scale; Psychomotor Development Index; ELGAN; Emotional Regulation; BRS; Mental Development Index; Gross Motor Function Classification System; O/E; NO/Q; ER; Bayley Scales Infant Development-II; non-optimal or questionable; MDI; PDI; intraventricular hemorrhage; Neurodevelopmental disability; Behavioral regulation; Extreme prematurity; Orientation Engagement; IVH; GMFCS; Brain injury
• ISSN: 0378-3782; 1872-6232
• DOI: 10.1016/j.earlhumdev.2013.09.019

Abstract Background Premature infants are less socially and emotionally competent at school age than infants born at term. Aims To evaluate the correlates of social and emotional delays at 2 years of age among prematurely born children. Study design This is a prospective cohort study. Subjects 904 children born at < 28 weeks gestation during 2002–2004 and enrolled in the ELGAN study who survived until age 2 years and returned for a developmental assessment. Outcome measures The Bayley Behavior Rating Scale (BRS), a neurological examination, and the Bayley Scales of Infant Development II (BSID-II). Results Fully 31% of children had a non-optimal (14%) or questionable (17%) (NO/Q) BRS score for Emotional Regulation (ER), and 27% had a non-optimal (13%) or questionable (14%) score for Orientation/Engagement (O/E). Children with NO/Q scores on ER and O/E were more likely than others to have MDI and PDI scores < 70 and be unable to walk. Antecedents of NO/Q OE scores included multi-fetal pregnancy, while antecedents of NO/Q scores for both ER and O/E included indicators of socioeconomic disadvantage, and male sex. Conclusions Over 25% of children born extremely premature exhibit socio-emotional delays during developmental assessment at age 2 years. Antecedents of these delays include sociodemographic characteristics, as well as those common antecedents of other impairments commonly observed among extremely preterm infants.