Objective:

To assess the association between preterm birth and neurodevelopmental disorders (NDDs) in children born in Pakistan, aged 2–6 years.

Approach:

• Study Design: Retrospective cross-sectional study analyzing medical and developmental records of 2634 Pakistani children aged 2–6 years, born between 2015 and 2020.
• Assessment Tools: Neurodevelopmental outcomes were assessed using Ages and Stages Questionnaire-3, Modified Checklist for Autism in Toddlers, Revised, and Bayley-III.
• Statistical Analysis: Multivariable logistic regression examined factors associated with NDDs, adjusting for various demographic factors.

Key Findings:

• 27.7% of children studied were preterm.
• NDD prevalence was higher in preterm children (25.8%) compared to full-term children (13.4%).
• Prevalence of specific disorders: ASD (5.8% vs 2.0%), ADHD (7.9% vs 4.7%), CP (2.6% vs 0.6%), developmental delay (15.2% vs 9.6%).
• Prevalence increased with severity of prematurity: extremely (55.6%), very (32.1%), late preterm (23.9%).
• Independent associations with NDDs included preterm birth (aOR=1.91), low maternal education (aOR=1.44), male sex (aOR=1.34), low income (aOR=1.29), and NICU admission (aOR=1.52).
• Children who were preterm and from low SES households had the highest odds of NDDs (aOR=9.43).

Interpretation:

Preterm birth and low socioeconomic status were associated with a greater burden of neurodevelopmental disorders in Pakistani children aged 2–6 years.

Limitations:

• Retrospective design may limit causality inference.
• Data may not be representative of all regions in Pakistan due to selection from specific healthcare facilities.

Conclusion:

The study highlights the increased risk of neurodevelopmental disorders in preterm children, particularly those from low socioeconomic status backgrounds.