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Stability of neurodevelopmental trajectories in moderately late and early preterm children born 15 years apart

Pediatric Research (2024)Cite this article

Abstract

Background

Neurodevelopmental trajectories of preterm children may have changed due to changes in care and in society. We aimed to compare neurodevelopmental trajectories in early and moderately late preterm children, measured using the Developmental (D)-score, in two cohorts born 15 years apart.

Methods

We included early preterm and moderately late preterm children from two Dutch cohorts (LOLLIPOP, 2002–2003 and ePREM, 2016–2017). ePREM counterparts were matched to LOLLIPOP participants by gestational age and sex. D-score trajectories were summarized by a multilevel model with random intercepts and random slopes, and multigroup analyses were used to test if the intercepts and slopes differed across cohorts.

Results

We included 1686 preterm children (1071 moderately late preterm, 615 early preterm) from LOLLIPOP, and matched these with 1686 ePREM counterparts. The neurodevelopmental trajectories of the two cohorts were mostly similar. For early preterm children, we found no statistically significant differences. For moderately late preterm children, both the intercept (43.0 vs. 42.3, p < 0.001) and slope (23.5 vs. 23.9, p = 0.002) showed some, but only clinically minor, differences.

Conclusion

Developmental trajectories, measured using the D-score, in the first four years of life are comparable and stable across a period of 15 years for both early and moderately late preterm children.

Impact

  • Neurodevelopmental trajectories are similar for early and moderately late preterm children born 15 years apart and thus seem quite stable in time.

  • The validated Developmental score visualizes these trajectories based on developmental milestone attainment

  • Because of its stability over time, the Developmental score trajectory may aid clinicians in neurodevelopmental assessment of preterm children as this simplifies monitoring and interpretation, similar to a growth chart.

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Fig. 1: Distribution of calendar-age-based D-scores.
Fig. 2

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Acknowledgements

This study was part of a larger study on the growth and development of preterm children. We wish to thank the participating preventive child healthcare PCHC physicians for their contribution to the fieldwork. In particular, we thank Drs. E.M.J. ten Vergert, M. Broer van Dijk, and B. van der Hulst for coordinating the project. We are grateful to the ePREM research group for their contribution to this cohort study. Finally, we thank Dr. J. Almansa for his assistance in the statistical analyses.

Funding

LOLLIPOP was supported by grants from the research foundation of Beatrix Children’s Hospital, the Cornelia Foundation for the Handicapped Child, and the research fund of A. Bulk-Child Preventive Child Health Care, Dutch Brain Foundation, and unrestricted investigator-initiated research grants from FrieslandCampina, Friso Infant Nutrition, and Pfizer Europe. The financiers had no role at any stage of the project, including the decision to submit the manuscript. ePREM was supported by a grant from ZonMw (grant 70-73600-98-519).

Author information

Authors and Affiliations

  1. Department of Pediatrics, Division of Neonatology, Beatrix Children’s Hospital, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen, 9713, GZ, the Netherlands

    Nienke H. van Dokkum

  2. Department of Health Sciences, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen, 9713, GZ, the Netherlands

    Nienke H. van Dokkum, Alexander Lepe, Sijmen A. Reijneveld & Marlou L. A. de Kroon

  3. Netherlands Organization for Applied Scientific Research TNO, Schipholweg 77, Leiden, 2316, ZL, The Netherlands

    Stef van Buuren

  4. Department of Methodology and Statistics, Utrecht University, Padualaan 14, Utrecht, 3584, CH, The Netherlands

    Stef van Buuren

  5. Department of Public Health and Primary Care, Environment and Health, Youth Health Care, University of Leuven, KU Leuven, Leuven, Belgium

    Marlou L. A. de Kroon

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  1. Nienke H. van Dokkum
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  2. Alexander Lepe
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Contributions

Ms. van Dokkum N.H. assisted in the data handling and statistical analyses and drafted the initial manuscript. Mr. Lepe A. performed the data handling, data visualizations, and statistical analyses. Prof van Buuren S. conceptualized and designed the D-score and performed part of the statistical analyses. Prof Reijneveld S.A. conceptualized and designed the LOLLIPOP study and data handling. Prof de Kroon M.L.A. conceptualized and designed the ePREM study and data handling and supervised the execution of the LOLLIPOP and ePREM studies. All authors critically reviewed and revised the manuscript and approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Nienke H. van Dokkum.

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Competing interests

The authors declare no competing interests.

Consent statement

The LOLLIPOP study was approved by the Institutional Review Board of the University Medical Center Groningen (METc 2005/130), and written informed consent was provided by all parents.

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van Dokkum, N.H., Lepe, A., van Buuren, S. et al. Stability of neurodevelopmental trajectories in moderately late and early preterm children born 15 years apart. Pediatr Res (2024). https://doi.org/10.1038/s41390-024-03188-2

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