Developmental Outcomes of Premature and Low Birth Weight Infants

Document Type : Original Article


1 Associate Professor of Neonatology, Neonatal Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

2 General physician, Patient safety research center, Mashhad University of Medical Sciences, Mashhad, Iran

3 Professor of Neonatology, Neonatal Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

4 Assistant Professor of Neonatology, Neonatal Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

5 BSc in Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran

6 Assistant Professor of pediatrics, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran


Background: Prematurity is the most common cause of death and disability And Preterm infants, are prone to developmental complications. For this reason this study was designed for follow up of these babies until 2 years by modified DDST-2.
Methods: This study was a prospective longitudinal descriptive study from March 2009 to March 2011 in clinic of sheikh and Imam Reza Hospitals, mashhad, Iran. Sample size with Confidence coefficient of 95% and power 80%, was determined 100 hundred babies. Infants were seen by a pediatrician at a follow up clinic at 1, 3, 6, 9,12,15,18, 24, months.The developmental assessment was done using Denver-2 Developmental Screening Test.
Results: mean age for smiling was 4/6 ± 2/1  months which significantly differed with appropriate age (p = 0.000), mean age for telling two syllables words 11/7±  1/9 months, without significant difference of appropriate age.(p = 0.139). Average age for understanding NO was 10/4±  2/0 months that significantly differed with appropriate age(p = 0.000). The average age for telling 6 word was 17/8±  3/0, without significant difference with appropriate age (p = 0.510).
Conclusion: Children with history of prematurity and low birth weight have more disability and developmental delay so they need to developmental screening tests. 


  1. [homepage on the website]. Preterm Labor and Birth: Condition Information. [Retrieved 7 March 2015; 03/11/2014 ].
  2. [homepage on the website]. What are the symptoms of preterm labor? [Retrieved 7 March 2015; 11/06/2013.]. .
  3. [homepage on the website]. Preterm birth Fact sheet N°363. [Retrieved 6 Mar 2015].
  4. [homepage on the website]. What are the risk factors for preterm labor and birth?. [Retrieved 7 March 2015.  03/11/2014. Cloherty, John P. (2012)].
  5. Wilkins. P. Care of the Extremely Low Birth Weight Infant. Manual of neonatal care (7th ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & 146. ISBN 9781608317776.
  6. theis "Reducing Perinatal and Neonatal Mortality" Check |url= value (PDF). Child Health Research Project Special Report. 1999. 
  7. Mathews TJ, MacDorman MF. Infant mortality statistics from the 2003 period linked birth/ infant death data set. Natl Vital Stat Rep. 2006 May 3;54(16):1-29.
  8. Aizenman E, White WF, Loring RH, Rosenberg PA. A 3,4-dihydroxyphenylalanine oxidation product is a non-N-methyl-D-aspartate glutamatergic agonist in rat cortical neurons. Neurosci Lett. 1990 Aug 14;116(1-2):168-71.
  9. Frye RE, Landry SH, Swank PR, Smith KE. Executive dysfunction in poor readers born prematurely at high risk. Dev Neuropsychol. 2009;34(3):254-71. doi: 10.1080/87565640902805727.

10. Marlow N, Wolke D, Bracewell MA, Samara M. Neurologic and Developmental Disability at Six Years of Age after Extremely Preterm Birth. N Engl J Med. 2005 Jan 6;352(1):9-19. CS1 maint: Date and year (

  1. 11.  Bell EF, Acarregui MJ. Restricted versus liberal water intake for preventing morbidity and mortality in preterm infants. Cochrane Database Syst Rev. 2014;12:CD000503. doi: 10.1002/14651858.CD000503.pub3. Epub 2014 Dec 4. 

12. Saigal S, Doyle LW. An overview of mortality and sequelae of preterm birth from infancy to adulthood. Lancet. 2008 Jan 19;371(9608):261-9. doi: 10.1016/S0140-6736(08)60136-1.

13. Gilbert WM, Nesbitt TS, Danielsen B. The Cost of Prematurity: Quantification by Gestational Age and Birth Weight. Obstet Gynecol. 2003 Sep;102(3):488-92.

14. Spencer E. Ante. Million-Dollar Babies. BusinessWeek. June 12, 2008. Retrieved 2010-1-24.

  1. 15.  Frankenburg, William K.; Dobbs, J.B. The Denver Developmental Screening Test. J Pediatr. 1967 Aug;71(2):181-91.

16. "Denver Developmental Materials". Denver Developmental Materials. Denver Developmental Materials. Retrieved 15 July 2015.

  1. 17.  Atkinson S A. Randall, Simpson J. Factors influencing body composition of premature infants at term- adjusted age. Ann N Y Acad Sci. 2000 May;904:393-9.

18. Chatelaine P. Children born with intrauterine growth retardation or small forgestational age: long term growth and metabolic consequences. Endocr Regul. 2000 Mar;34(1):33-6.

19. Saigal S, Hoult LA, Streiner DL, Stoskopf BL, Rosenbaum PL.. School difficulties at adolescence in a regional cohort of  children who wewe extremely Low Birth Weight. Pediatrics. 2000 Feb;105(2):325-31.

20. Hunt JV, Cooper BAB Tooley WH. Very low birthweight infants at 8 and 11 years of age: role of neonatal illness and family status. Pediatrics. 1988 Oct;82(4):596-603.

21. Halasey CL, Collin MF, Anderson CL. Extremely low birth weight children and their peers: a comparison of preschool performance. Pediatrics. 1993;91(4):807-11.

22. Ford GW, Doyle LW, Davis NM, Callanan C. Very low birth weight and growth into adolescence. Arch Pediatr Adolesc Med. 2000 Aug;154(8):778-84.

23. Aylward GP, Hatcher RP, Leavitt LA, Rao V, Bauer CR, Brennan MJ, et al. Factors affecting neurobehavioral responses of preterm infants at term conceptional age. Child Dev. 1994;55(4):1155-65.

24. Moster D, Lie RT, Markestad T. Long-Term Medical and Social Consequences of Preterm Birth. N Engl J Med. 2008 Jul 17;359(3):262-73. doi: 10.1056/NEJMoa0706475. 

25. "Depression linked to premature birth". The Age (Melbourne). 2004-05-04. Retrieved 2008-12-16. 

26. Böhm B, Katz-Salamon M, Institute K, Smedler AC, Lagercrantz H, Forssberg H. Developmental Risks and Protective Factors for Influencing cognitive outcome at 5,5 years of age in very-low-birthweight children. Dev Med Child Neurol. 2002 Aug;44(8):508-16. 

27. Spencer MD, Moorhead TW, Gibson RJ, McIntosh AM, Sussmann JE, Owens DG, et al. Low birthweight and preterm birth in young people with special educational needs: a magnetic resonance imaging analysis. BMC Med. 2008 Jan 30;6:1. doi: 10.1186/1741-7015-6-1.