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Biological and Environmental Factors as Predictors of Language Skills in Very Preterm Children at 5 Years of Age

Howard, Kelly PhD*†; Roberts, Gehan PhD*‡§; Lim, Jeremy BHlthSc (Hons) (Psych)*†; Lee, Katherine J. PhD*‡; Barre, Natalie BSc (Hons)*†; Treyvaud, Karli DPsych*; Cheong, Jeanie MD*‡§; Hunt, Rod W. PhD; Inder, Terri E. PhD*∥; Doyle, Lex W. MD*‡§; Anderson, Peter J. PhD*†

Journal of Developmental & Behavioral Pediatrics: April 2011 - Volume 32 - Issue 3 - p 239-249
doi: 10.1097/DBP.0b013e31820b7882
Original Article

Objective: Language problems are thought to occur more frequently in very preterm children compared with healthy term born children. The primary aim of this study was to examine the contributions of biological and environmental risk factors to language outcomes in very preterm children at 5 years of age.

Methods: A cohort of 227 very preterm infants (birth weight <1250 g or gestational age <30 weeks) were recruited at birth and followed up at 2 and 5 years of age (corrected for prematurity) in a prospective, longitudinal study in Melbourne, Australia. Outcomes at 5 years of age were the Expressive and Receptive Language Scales from the Kaufman Survey of Early Academic and Language Skills. A range of hypothesized biological and environmental factors identified from past research were examined as predictors of language outcomes at 5 years of age using linear regression models.

Results: Lower maternal education and poorer communication skills in the child at 2 years of age were predictive of poorer expressive and poorer receptive language outcomes at 5 years of age. Lower expressive language scores were also associated with the presence of moderate-severe white matter abnormalities on neonatal magnetic resonance imaging.

Conclusions: Results support the role of both biological and environmental factors in the evolution of language difficulties and highlight the need to consider these factors in the follow-up of preterm infants.

From the *Critical Care and Neurosciences, Murdoch Childrens Research Institute, Royal Children's Hospital; †Department of Psychological Sciences, University of Melbourne; ‡Department of Pediatrics, University of Melbourne; §Department of Obstetrics and Gynecology, The Royal Women's Hospital, Parkville, Victoria, Australia; ∥School of Medicine, Washington University, St Louis, MO.

Received June 2010; accepted December 2010.

This work was supported by the National Health and Medical Research Council, project grant 237117; training fellowship 284568 (to P.J.A.); senior research fellowship 628371 (to P.J.A.); The Royal Women's Hospital Research Foundation; the Brockhoff Foundation; and the Murdoch Childrens Research Institute.

Address for reprints: Peter Anderson, PhD, Victorian Infant Brain Studies (VIBeS), The Royal Children's Hospital, Flemington Road, Parkville, VIC, 3052, Australia; e-mail:

© 2011 Lippincott Williams & Wilkins, Inc.