Early medical risks to language development in extremely preterm infants.

Objective: To study the mechanistic role of neonatal morbidities on language performance in extremely preterm (EP) infants.

Study design: We conducted secondary analyses on EP infants born at a single tertiary care center, investigating whether neonatal morbidities mediated associations between gestational age and language performance at 18-26 months corrected age.

Results: Infants born at 25-26 weeks (n = 298) outperformed those born at 22-24 weeks (n = 177) in expressive communication, receptive communication, composite language, and cognition. Retinopathy of prematurity (ROP), grade 2/3 bronchopulmonary dysplasia (BPD), and cognition partially explained gestational age effects on expressive and receptive communication. In the final sequential path models, infants born 22-24 weeks gestation were more likely to be diagnosed with grade 2/3 BPD, which was linked to diminished cognitive skills, and reduced language skills.

Conclusion: Families of EP infants born under 25 weeks or with ROP and/or grade 2/3 BPD should be counseled about higher language impairment risk and receive proactive intervention.