title: Social-emotional delays at 2 years in extremely low gestational age survivors: correlates of impaired orientation/engagement and emotional regulation.
abstract: BACKGROUND
  Premature infants are less socially and emotionally competent at school age than infants born at term.
  
  
  OBJECTIVE
  To evaluate the correlates of social and emotional delays at 2 years of age among prematurely born children.
  
  
  METHODS
  This is a prospective cohort study.
  
  
  METHODS
  904 children born at <28 weeks gestation during 2002-2004 and enrolled in the ELGAN study who survived until age 2 years and returned for a developmental assessment.
  
  
  METHODS
  The Bayley Behavior Rating Scale (BRS), a neurological examination, and the Bayley Scales of Infant Development II (BSID-II).
  
  
  RESULTS
  Fully 31% of children had a non-optimal (14%) or questionable (17%) (NO/Q) BRS score for Emotional Regulation (ER), and 27% had a non-optimal (13%) or questionable (14%) score for Orientation/Engagement (O/E). Children with NO/Q scores on ER and O/E were more likely than others to have MDI and PDI scores <70 and be unable to walk. Antecedents of NO/Q OE scores included multi-fetal pregnancy, while antecedents of NO/Q scores for both ER and O/E included indicators of socioeconomic disadvantage, and male sex.
  
  
  CONCLUSIONS
  Over 25% of children born extremely premature exhibit socio-emotional delays during developmental assessment at age 2 years. Antecedents of these delays include sociodemographic characteristics, as well as those common antecedents of other impairments commonly observed among extremely preterm infants.
authors.affiliation: Department of Pediatrics, Loyola University Medical Center and Loyola University of Chicago Stritch School of Medicine, Maywood, IL, United States.
authors.forename: Lauren A C
authors.initials: LA
authors.lastname: Boyd
authors.forename: Michael E
authors.initials: ME
authors.lastname: Msall
authors.forename: T Michael
authors.initials: TM
authors.lastname: O'Shea
authors.forename: Elizabeth N
authors.initials: EN
authors.lastname: Allred
authors.forename: Gail
authors.initials: G
authors.lastname: Hounshell
authors.forename: Alan
authors.initials: A
authors.lastname: Leviton
mesh_terms: D002657:Child Development / Q000502:physiology*; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000453:epidemiology* / Q000473:pathology; D056348:Emotional Intelligence / Q000502:physiology*; D005865:Gestational Age; D006801:Humans; D018730:Infant Behavior / Q000502:physiology*; D062071:Infant, Extremely Premature / Q000254:growth & development*; D007231:Infant, Newborn; D008297:Male; D009460:Neurologic Examination
keywords: BRS; BSID-II; Bayley Scales Infant Development-II; Behavior Rating Scale; Behavioral regulation; Brain injury; ELGAN; ER; Emotional Regulation; Extreme prematurity; Extremely Low Gestational Age Newborn; GMFCS; Gross Motor Function Classification System; IVH; MDI; Mental Development Index; NO/Q; Neurodevelopmental disability; O/E; Orientation Engagement; PDI; Psychomotor Development Index; intraventricular hemorrhage; non-optimal or questionable