Early medical risks to language development in extremely preterm infants

To study the mechanistic role of neonatal morbidities on language performance in extremely preterm (EP) infants.

We conducted secondary analyses on EP infants born at a single tertiary care center, investigating whether neonatal morbidities mediated associations between gestational age and language performance at 18–26 months corrected age.

Infants born at 25–26 weeks (n = 298) outperformed those born at 22–24 weeks (n = 177) in expressive communication, receptive communication, composite language, and cognition. Retinopathy of prematurity (ROP), grade 2/3 bronchopulmonary dysplasia (BPD), and cognition partially explained gestational age effects on expressive and receptive communication. In the final sequential path models, infants born 22–24 weeks gestation were more likely to be diagnosed with grade 2/3 BPD, which was linked to diminished cognitive skills, and reduced language skills.

Families of EP infants born under 25 weeks or with ROP and/or grade 2/3 BPD should be counseled about higher language impairment risk and receive proactive intervention.