Neonatal predictors of cognitive ability in adults born very preterm: a prospective cohort study

Aim To identify neonatal predictors to allow a developmental prognosis of the cognitive abilities of survivors born very preterm/very low birthweight (VLBW) into adult life. Method The Bavarian Longitudinal Study is a prospective whole‐population study that followed 260 infants born very preterm/ VLBW from birth to adulthood. Regression analyses examined which neonatal factors predicted adult IQ. Results Neonatal morbidity, neonatal treatment, and early social environment of infants born very preterm/ VLBW explained 37.6% of the variance in adult IQ . Seven unique early‐life predictors of lower adulthood IQ were found: respiratory distress syndrome, intraventricular haemorrhage, problems with mobility, mechanical ventilation, less parenteral nutrition, low/middle socioeconomic status, and poor early parent–infant relationships. Specifically, modifiable factors such as mechanical ventilation predicted a drop of 0.43 IQ points for each day of treatment, adjusted for initial respiratory problems. Good early parent–infant relationships predicted an approximately 5‐point increase in adult IQ , adjusted for other significant predictors such as socioeconomic status. Interpretation Mechanical ventilation, parenteral feeding, and early parenting were identified as significant modifiable factors that were strongly related to adult IQ . Mechanical ventilation policies have changed but there is scope for early interventions that focus on positive parenting, which may reduce the adverse effects of very preterm/ VLBW birth on cognitive abilities.