Extremely low gestational age and development outcomes in the first two years of life: a longitudinal study.

Background and aims: Extremely low gestational age (ELGA) constitutes a risk factor for early development even in absence of cerebral damages, since an immature central nervous system is exposed in the first months after birth to invasive and often inadequate stimulations (Als et al. 2004). Several studies have pointed out that these children show cognitive and learning difficulties at preschool and school age (Doyle et al., 2001; Marlow et al., 2005; Wood et al., 2000).The aim of this study is to show longitudinally how ELGA affects the developmental outcomes of preterms without major cerebral damage from birth to 24 months, with respect to fullterm (FT) birth. Methods: Twenty-nine ELGA infants (GA ≤ 28 weeks, mean GA 26.9 ± 1 weeks, BW 893 ± 223 gms) without major cerebral damage and 10 healthy FT infants (>37 weeks) were assessed at 6, 12, 18 and 24 months, through the revised Griffiths Mental Development Scales (1996) All infants were of Italian mother tongue. Results: ELGA preterms had developmental outcomes significantly lower than FT infants at all assessments, [RM-ANOVA: F(1,37)= 5.44; p=.025]. Several mild and a few moderate to severe cognitive impairments were found in the ELGA sample, while no impairments emerged in the FT sample. Conclusions: ELGA determined an at risk developmental trajectory and a higher risk of delays in the first two years of life. These results show the importance of monitoring the development of ELGA infants with repeated assessments in order to early identify infants with delays and plan interventions.