Neonatal Complication Count Predicts Long-Term Health and Cognitive Outcomes in Extremely Preterm Infants: Study Shows

Led by Dr. Ruben Vaidya and colleagues from the University of Massachusetts Chan Medical School – Baystate, the research assessed whether a straightforward count of five common neonatal morbidities could serve as a reliable indicator of long-term neurodevelopmental and health challenges. The conditions included in the analysis were bronchopulmonary dysplasia (BPD), severe brain injury identified by ultrasound, severe retinopathy of prematurity (ROP), surgical necrotizing enterocolitis (NEC), and neonatal sepsis.

The study drew data from the long-term Extremely Low Gestational Age Newborns (ELGANs) study, a multicenter, prospective cohort project. A total of 1,198 children born extremely preterm were followed into adolescence, with 889 evaluated at age 10 and 694 assessed again at age 15.

Children were categorized based on the number of the five neonatal morbidities they had experienced: none, one, two, or three or more. Researchers found a clear linear association between the count of these early complications and the likelihood of adverse outcomes later in life.

The following were the key findings of the study:

• Infants with a greater number of neonatal complications had a significantly higher risk of moderate to severe neurocognitive impairment at ages 10 and 15.
• These impairments included challenges with intelligence and executive functioning, identified through standardized cognitive assessments.
• A higher count of neonatal morbidities was also linked to an increased risk of motor impairments.
• These children faced a greater likelihood of legal blindness and severe hearing loss.
• They also had a higher number of chronic medical conditions by age 10.
• Children with three or more neonatal complications were particularly at risk for multiple health disorders.
• These children also reported a lower overall quality of life.

The findings suggest that a simple count of five specific neonatal morbidities may provide clinicians and caregivers with valuable early insight into the long-term needs and prognosis of extremely preterm infants. The study emphasizes the cumulative effect of these complications, rather than focusing on any single condition in isolation.

According to the authors, these insights could aid in the early identification of high-risk children and inform decisions around follow-up care, educational support, and family counseling.

The authors concluded, "The study demonstrates that the burden of early neonatal illnesses in extremely preterm infants has lasting consequences. A basic count of these complications offers a practical tool for predicting neurodevelopmental outcomes and overall health well into adolescence, reinforcing the need for comprehensive neonatal care and long-term follow-up in this vulnerable population."

Reference: https://www.jpeds.com/article/S0022-3476(25)00250-1/abstract