Comparison of utilization of interventional therapies between moderately preterm and very preterm infants at 12 months corrected age

Background: Moderately preterm infants(MP; 32-36 wks gestation) comprise the majority of preterm infants. Little is known about their developmental outcomes and therapeutic needs. Objective: To determine the requirement for therapeutic services in MP infants compared to very preterm infants(VP; <32 weeks gestation) at 12 months corrected age(CA). Methods: Preterms seen at the Westcher Medical Center Neonatal follow-up clinic at 12 m CA were stratified into MP and VP groups. Logistic regression was used to compare odds ratios(OR) of need for early intervention(EI), physical therapy(PT), occupational therapy(OT), speech therapy(ST) and special education(SE). Adjustments were made for antenatal, demographic, and neonatal factors. Results: 169 infants were evaluated at 12±2m CA . VP(n=77) and MP(n=92) had mean CA of 12.1 ± 1.3m and 12.0± 1.2m. In MP, 36% needed EI, 28% PT, 17% OT, 16% ST, and 8% SE. In VP, 70% needed EI, 66% PT, 32% OT, 32% ST, and 21% SE. VP were more likely to require EI (OR 4.2, 95%CI 2.2-8.0), PT (OR 5.0, 95%CI 2.6-9.6), OT (OR 2.3, 95%CI 1.1-4.7), ST (OR 2.5, 95%CI 1.2-5.1), and SE(OR 3.2, 95%CI 1.2-8.2). RDS and receipt of caffeine for apnea of prematurity were the only confounders of this relationship. Conclusions: VP had a higher rate of EI, PT, OT, and ST use compared to MP. However, 36% of MP required EI and 28% utilized PT. With approximately 70% of preterm births being MP, there is a large population requiring these services. MP infants must be screened and referred for interventional therapies.