A prospective follow-up of very low birth weight (VLBW) infants with and without bronchopulmonary dysplasia (BPD) and term control infants was conducted. The effects of BPD and VLBW on speech-language development and specific language impairment at 3 years of age were investigated, controlling for the effects of sociodemographic and other medical risk factors. Groups were compared on cognitive and speech-language outcomes using the Battelle Language and Bayley Mental Scales of Infant Development. Children with a history of BPD had lower receptive language skills than VLBW children without BPD, who in turn had lower receptive skills than term children. Children with a history of BPD also had lower expressive skills than the two comparison groups, whereas VLBW children without BPD did not differ in expressive language from term children. When IQ score was controlled, children with BPD demonstrated specific language impairment in receptive language. The presence of patent ductus arteriosis (PDA) was the best predictor of language deficits and the combined occurrence of PDA and BPD resulted in differentially lower language scores. Neurologic complications, low socioeconomic status, and minority race were also significant predictors of language delay. The findings emphasize the importance of considering both medical and sociodemographic factors in evaluating the risk of VLBW infants for poorer speech-language outcomes.
Department of Pediatrics, Divisions of Behavioral Pediatrics and Psychology, Case Western Reserve University School of Medicine (SINGER, SIEGEL, LEWIS, HAWKINS)
Department of Critical Care, Case Western Reserve University School of Medicine (YAMASHITA)
Department of Neonatology, Case Western Reserve University School of Medicine, Cleveland, Ohio (BALEY)
Address for reprints: Lynn T. Singer, Ph.D., The Triangle Building, 11400 Euclid Avenue, Suite 250-A, Cleveland, Ohio 44106; e-mail: email@example.com.
Acknowledgments. This work was supported by Grants MCJ 390592 and MCJ 39017 from the Maternal and Child Health Bureau (Title V, Social Security Act) Health Resources and Services Administration and the NIH Heart, Lung, and Blood Institute (HL38193). Thanks are extended to the participating families and to Sarah Fulton, Marilyn Davillier, Peggy Bruening, Karen Sofranko, and Jie Huang for research assistance.