Neurodevelopmental outcomes in adolescents born very and extremely preterm: a prolonged follow-up from a single-center cohort

Introduction: Preterm birth remains a major global health concern, with growing evidence linking it to long-term neurodevelopmental and psychiatric sequelae. Children born very or extremely preterm are at increased risk for cognitive, motor, and emotional difficulties that may persist into adolescence. Materials and methods: We conducted a retrospective and prospective observational study involving 29 adolescents (aged 14–18 years) born very or extremely preterm between 2005 and 2011 at the University Hospital of Parma. Participants underwent in-person neurological examinations, cognitive testing (Raven's Progressive Matrices), and motor assessments (Movement ABC-2 or Brief Motor Scale), alongside retrieval of early developmental scores from the Bayley Scales (administered between 3 and 36 months). Results: Early cognitive assessments showed strong predictive associations with later intellectual functioning: MDI scores at 12 and 18 months correlated significantly with Raven QI equivalent scores in adolescence (ρ = 0.705 and ρ = 0.763, respectively, p < .01), while the association at 3 months was weaker and non-significant (ρ = 0.410, p = .052). In contrast, early motor scores showed inconsistent predictive associations, with only the 18-month PDI reaching significance (ρ = 0.583, p = .022). Psychiatric or neurodevelopmental diagnoses were present in 50% of extremely preterm and 33.3% of very preterm adolescents. Visuomotor coordination showed the strongest negative correlation with gestational age among motor domains (r = –0.57). Conclusions: These findings suggest that the 12–18 month developmental assessment window carries meaningful prognostic value for both cognitive and motor outcomes in preterm survivors, and support the implementation of structured multidisciplinary surveillance extending into adolescence.