Neonatal Adverse Outcomes, Neonatal Birth Risks, and Socioeconomic Status: Combined Influence on Preterm Infants’ Cognitive, Language, and Motor Development in Brazil
Carolina Panceri, Nádia Cristina Valentini, Rita C. Silveira, Beth A. Smith, Renato S. Procianoy
Abstract
Background: This study extended previous research by investigating the combined effects of neonatal birth risks, neonatal adverse outcomes, and socioeconomic status on preterm neurodevelopment. Method: A total of 184 preterm infants were assessed using the Bayley Scales of Infant Development III in a follow-up clinic in southern Brazil. Structural equation modeling was conducted with 3 latent variables (neonatal birth risks, neonatal adverse outcomes, and socioeconomic status) and 3 outcomes (cognitive, language, and motor development). Results: The analyses showed that neonatal adverse outcomes were associated with infants’ cognitive (b = –0.45, P < .001), language (b = –0.23, P = .001), and motor (b = –0.51, P < .001) development. Socioeconomic status also explained the variances (cognitive: b = 0.20, P = .006; language: b = 0.28, P = .001; and motor: b = 0.21, P = .004), whereas neonatal birth risks remained significant only in the motor development (b = 0.15, P = .040). Conclusion: This study suggests that the most evident contributors to poor neurodevelopment were adverse outcomes and socioeconomic risk factors.