Cognitive Development in Preschool-Aged Very Preterm Infants with Normal MRI Results

Overview

This study evaluates cognitive outcomes in very preterm infants with normal MRI findings at term-equivalent age. It identifies associations between cognitive outcomes and factors such as male sex, preterm premature rupture of membranes, early-onset sepsis, low maternal education, and a non-German native language.

Background

Very preterm infants are at heightened risk for neurodevelopmental challenges, even with normal MRI results. Understanding cognitive outcomes in this population is crucial for identifying risk factors.

Data Highlights

Key Findings

• 18.9% of children had an IQ < 85, indicating below-average cognitive performance.
• Male sex was associated with increased risk of adverse cognitive outcomes (OR 2.0–2.9, p<0.05).
• Preterm premature rupture of membranes was linked to poorer cognitive outcomes.
• Early-onset sepsis was identified as a risk factor for adverse cognitive outcomes.
• Low maternal education significantly correlated with lower cognitive performance (OR 7.2).
• A native language other than German was associated with lower cognitive performance (OR 4.0).

Clinical Implications

Healthcare providers should consider individual risk factors when assessing cognitive development in very preterm infants with normal MRI findings. Continuous developmental surveillance and early intervention strategies are recommended to support at-risk children.

Conclusion

Most very preterm infants with normal MRI findings achieve age-appropriate cognitive outcomes, but a subgroup remains at risk for cognitive difficulties.

Related Resources & Content

1. European Radiology, 2024 -- Prevalence of Cerebral Injuries in a Large Population of Very and Extremely Preterm Infants at Term-Equivalent Age: Findings from a Decade of a Single Tertiary Neonatal Care Facility
2. European Radiology, 2025 -- Impact of Cerebellar Hemorrhage in Extremely Preterm Infants: Correlation of Dentate Nucleus Involvement and Cerebellar Hypoplasia with Negative Cognitive Outcomes
3. European Radiology, 2023 -- Graph Convolutional Neural Network-Based Prediction of Brain Age Reveals Neurodevelopmental Patterns in Preterm Infants
4. Frontiers in Pediatrics, 2026 -- Neurodevelopmental outcomes in adolescents born very and extremely preterm: a prolonged follow-up from a single-center cohort
5. Developmental follow-up, surveillance and support at the age of 4 years: a best practice guide from the British Association for Neonatal Neurodevelopmental Follow-Up - PubMed
6. Associations between neonatal brain structure and neurodevelopmental outcomes following very preterm birth | Journal of Perinatology
7. Developmental follow-up, surveillance and support at the age of 4 years: a best practice guide from the British Association for Neonatal Neurodevelopmental Follow-Up - PubMed
8. Associations between neonatal brain structure and neurodevelopmental outcomes following very preterm birth | Journal of Perinatology