Long-term cognitive outcomes of extremely low-birth-weight infants: the influence of the maternal educational background

Abstract

Aim: The purpose of the present contribution is to analyse the relationships between perinatal risk factors, social parameters and neurodevelopmental outcomes in extremely low-birth-weight (ELBW) children up to the age of 10-13 years.

Methods: Of 200 live-born ELBW infants, 148 were enrolled in the high-risk infant follow-up programme. Each follow-up visit included a neurodevelopmental examination and an interview with the infant's parents. Multivariate analyses using SPSS (version 17.0, Chicago, IL, USA) were conducted, and a p-value of <0.05 indicated a statistically significant result.

Results: The results of the logistic regression analysis of the biological and sociodemographic risk factors illustrated that a low maternal educational background is the most important factor (OR, 21.9) associated with a decreased composite intelligence quotient (IQ) in children between 10 and 13 years old. A Grade III or Grade IV intraventricular haemorrhage (IVH) or periventricular leukomalacia (PVL) were also associated with decreased IQ at the age of 10-13 years (OR, 6.9). These results were confirmed by ANOVAs with repeated measurements.

Conclusion: Maternal educational background is the strongest predictor of long-term neurodevelopment in ELBW children. The findings emphasize the need for special support and follow-up care services for poorly educated parents.