Neuromotor and Cognitive Outcomes of Preterm Infants at 3 Months of Corrected Age in a Northeastern Region of Brazil: Longitudinal Feasibility Study.

BACKGROUND: Preterm infants (PTIs) are at increased risk of neurodevelopmental impairment, particularly in socioeconomically vulnerable regions, where access to early intervention services is limited. However, little is known about the feasibility of longitudinal developmental monitoring in such contexts. OBJECTIVE: This study aimed to evaluate the feasibility of recruiting, retaining, and assessing preterm infants in a resource-limited setting in Northeastern Brazil and to generate preliminary data on early neurodevelopmental outcomes. METHODS: This longitudinal feasibility study was conducted at a referral maternity hospital in Northeastern Brazil between October 2023 and March 2024. PTIs born at ≤32 weeks of gestational age were recruited during hospitalization. Feasibility outcomes included recruitment rate, retention rate, and completeness of assessments. Development was assessed at three time points: (1) Neonatal Intensive Care Unit discharge, (2) Kangaroo Neonatal Intermediate Care Unit discharge, and (3) at 3 months of corrected age (CA), using the Motor Optimality Score (MOS), Test of Infant Motor Performance (TIMP), and Bayley Scales of Infant Development III (BAYLEY-III). Caregiver-infant interaction was assessed using the Recorded Interaction Task (RIT). RESULTS: Of 45 eligible infants, 20 (44.4%) were enrolled, and 10 (50%) completed follow-up in 3 months CA. A total of 67 assessments were conducted. Attrition was due to death (n=5), loss of contact (n=2), withdrawal (n=2), and transfer to another service (n=1). Among infants assessed at 3 months CA, 60% (n=6) of infants had MOS <25, indicating increased risk of neurological impairment. At TIMP, 80% (n=8) showed motor performance below expected levels in 3 months. BAYLEY-III assessments (n=8) indicated below-average motor performance in 50% (n=4) of the infants and below-average cognitive performance in 50% (n=4). All caregiver-infant dyads assessed at follow-up (n=10) demonstrated adequate interaction on RIT (mean score 57.9, SD 12.3). CONCLUSIONS: Longitudinal developmental monitoring of PTIs in a resource-limited setting was feasible, although retention remained a major challenge. Preliminary findings indicated frequent motor and cognitive vulnerabilities after hospital discharge, underscoring the importance of structured follow-ups in early infancy. These findings support the need for larger studies to refine follow-up strategies and evaluate early intervention in similar contexts.