Prevalence and Perinatal Risk Factors of Developmental Problems in Preterm Infants: Real-World Use of the ASQ-3 Thai in a Neonatal Follow-Up Clinic

Introduction: Preterm birth is associated with increased risks of long-term neurodevelopmental impairments. Early developmental screening in real-world neonatal follow-up clinics is essential. The ASQ-3 Thai offers a practical, parent-completed tool; however, evidence of its performance in Thai preterm infants in everyday care settings remains limited. Objectives: To determine the prevalence and perinatal risk factors of suspected developmental delay in preterm infants <34>weeks' gestation screened with the ASQ-3 Thai in a neonatal follow-up clinic, and to explore its pragmatic diagnostic value compared with expert assessment in routine clinical practice. Methods: This hospital-based cross-sectional study was conducted in a neonatal follow-up outpatient clinic. Caregivers of eligible preterm infants aged 2–30 months completed the ASQ-3 Thai and a demographic questionnaire. Perinatal data were retrieved from medical records. Infants with abnormal screening results were referred to developmental-behavioral pediatricians for comprehensive clinical evaluation including TEDA4I. Results: Seventy-six infants were enrolled. Suspected developmental delay based on abnormal ASQ-3 Thai screening was found in 22.4% (17/76). Fine motor and problem-solving domains were most frequently affected. Abnormal screening was significantly associated with lower gestational age, lower birth weight, prolonged oxygen therapy, longer hospitalization, and bronchopulmonary dysplasia. Among screen-positive infants, 11 had confirmed neurodevelopmental disorders, yielding a positive predictive value of 79%. Conclusion: In a neonatal follow-up clinic, developmental problems were common among preterm infants <34>weeks, particularly in those with identifiable perinatal risks. The ASQ-3 Thai demonstrated good pragmatic value as a feasible, parent-completed screening tool to prioritize preterm infants for specialist evaluation and early intervention.