Neurodevelopmental disorders and behavioral outcomes among late preterms at 4–6 years of age

Abstract Introduction: The objective of this study is to assess the long-term neurodevelopmental and behavioral outcomes in late preterm infants (LPI) at the age of 4–6 years. In addition, the study aims to explore the relationship between neonatal risk stratification and these outcomes. Methods: A cross-sectional study was conducted at child development center (CDC) in Kerala, India. Fifty-six LPI aged 4–6 years were screened using the neurodevelopmental screening tool, Vineland Adaptive Behavior Scale, third edition (VABS-3), and Gessel’s drawing test. Confirmatory diagnoses were made using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition and INCLEN diagnostic tools. Data were analyzed using the Statistical Package for the Social Sciences Version 26. Results: Neurodevelopmental disorders (NDD) were identified in 43% of participants. The most common disorders were attention-deficit hyperactivity disorder (28.6%) and speech-language delay (21.4%). Low adaptive skills were observed in 35.7% of children and significant externalizing behavior was also noted in 35.7%. There was a statistically significant association between lower VABS scores and NDD ( P < 0.001). Children with moderate neonatal risk had higher rates of NDD and poor behavioral outcomes. Conclusion: LPIs are at substantial risk for neurodevelopmental and behavioral challenges by early childhood. Structured long-term follow-up and early intervention strategies are essential to mitigate adverse outcomes.