背景與目的. 具有妊娠週數小於 37 週、極低出生體重或是腦部病變等危險因子的嬰兒
常被視為未來可能會出現發展障礙的高危險群。檢測不同種類及嚴重度的發展障礙將 有利於早期療育;由於傳統新生兒檢測著重於動作或行為相關的發展，臨床上，新生 兒的認知功能的檢測仍具有挑戰性。認知和動作發展的緊密相關可以從例如在執行認 知任務時小腦的共同活化(co-activation)，和認知發展理論中指出動作探索所扮演的重 要性得知，認知和動作在發展的過程為不斷的正向循環，動作能力並對更高階的認知 發展有決定性的影響。因此，本篇研究將探討以下議題:第一、高風險嬰兒未滿矯正 年齡 5 個月前的動作表現與三歲時的認知發展之間的相關性;第二、周產期的發展遲 緩危險因子，妊娠週數小於 37 週、非常低出生體重、小於妊娠年齡、慢性肺疾病及不 正常腦部超音波影像等因素對認知發展結果的影響。
方法. 本篇研究共從成功大學醫學院附設醫院收錄七十五位符合收案條件的嬰兒，並持 續追蹤至三歲。早期的動作表現是利用整體動作評估和阿爾伯塔嬰兒動作評估量表來 評估。整體動作評估包含三個時期的紀錄:早產期(preterm)、蠕動期(writhing)及不安 運動期(fidgety);蠕動期及不安運動期的粗大動作發展則利用阿爾伯塔嬰兒動作評估量 表來記錄，落於第十百分等級以下則定義為動作發展遲緩。三歲時的追蹤則利用貝利 嬰幼兒發展量表評估其認知發展，並將綜合分數小於 90 分定義為認知發展遲緩。整體 動作評估是依照其動作品質，在早產期和蠕動期分為正常或不正常(包含單調性、同 步痙攣性和混亂性)，在不安運動期分為正常或不正常(包含異常性及不安運動缺 乏);進行統計分析時，再將所有評估結果二分成為正常與不正常兩類以於利於統計 分析。整體動作軌跡由三個時期的整體動作組成，並根據其穩定成為正常整體動作的 時間點分為 T1、T2 及 T3，三種分類。本研究使用預測效度、肯德爾等級相關係數及 克雷莫V相關係數探討早期動作和認知發展結果的相關性、曼-惠特尼U檢定及克拉斯
卡-瓦立斯檢定比較動作表現之不同組間之平均分數差異，討論嬰兒早期動作表現及其 認知發展之關係;並利用羅吉斯迴歸分析探討 5 個周產期危險因子與認知發展結果的 關係。
結果. 整體動作評估用於預測三歲認知發展障礙的特異度(60-91%)及陰性預測率(92- 95%)較佳，敏感度(34-63%)尚可，陽性預測率(7-46%)較差;阿爾伯塔的準確率(91- 92%)較高，但是敏感度(25-37%)仍低。有較差的嬰兒早期動作表現的兒童，例如在不 安運動時期有異常的整體動作，或是經由阿爾伯塔評估爲動作發展遲緩，其認知發展 分數會顯著地低於有較好的嬰兒早期動作表現的兒童。不安運動期之整體動作與認知 發展結果，及嬰兒時期之粗大動作發展與認知發展結果，皆達低至中度相關(r= 0.20- 0.49)。相較於不安運動時期的整體動作之顯著結果，本篇研究並未發現整體動作軌跡 與認知發呈現顯著相關。五個周產期危險因子中，只有慢性肺疾病顯著地影響認知發 展結果，沒有慢性肺疾病的嬰兒發展出認知障礙的機率是有慢性肺疾病的嬰兒的 0.054 倍。
討論與結論. 相較於早產期或蠕動期，不安運動期之整體動作，用於預測三歲的認知發 展有較高的相關性。雖然過小的樣本數可能造成整體動作軌跡的不顯著結果，但是認 知發展之平均分數，由最早出現正常整體動作的組別(T1)遞減的趨勢，仍符合過去研 究的結果。比較同一時期的自發性整體動作及自主性粗大動作發展，後者與認知發展 結果有較佳的預測效度及相關性，呈現中度相關(r=0.47-0.49)。此結果可能與心理學對 於知覺產生的過程之理論互相呼應。而嬰兒尚在發展中、且易受缺氧而產生傷害的中 樞神經系統，則有助於解釋慢性肺疾病與認知發展的顯著關聯。嬰兒早期的動作表現 與認知發展的顯著相關，包含不安運動期的整體動作，或是自主粗大動作發展都有助 於臨床的應用及決策。未來有關於整體動作軌跡與認知發展的研究，則可致力於整體動作軌跡的分類原則或是優化整體動作所需包含的時期長短，並建議將危險因子納入 預測模型中。

Background. Infants with prematurity, very low birth weight or encephalopathy are at higher
risks for developmental disabilities. Detecting disabilities in different varieties of severity and patterns in infancy allows early intervention. Since neonatal examinations focused on motor- or behavior-related development, it remains challenging to identify cognitive function at early infancy. The co-activation or cross-talks of cerebellum during cognitive task and the suggestions of Piaget’s theory of that through an ongoing acting on and receiving information from environment, perception is generated and the cognitive skills develop. Thus, motor development serves as a major factor in the virtuous cycle paving the way for higher order cognitive abilities. Therefore, the purposes of this study are to examine the early motor performance prior to 5 month old of corrected age and cognitive outcomes at 3 years old, and to analyze the contribution of perinatal risk factors, including preterm birth, very low birth weight (VLBW, birth body weight <1500g), small for gestational age (SGA), chronic lung disease (CLD) and abnormal brain ultrasound (AbUS), to cognitive outcomes.
Methods. Seventy-five high risk infants met the inclusion criteria were recruited from National Cheng Kung University Hospital. The motor performance of participants was assessed by Qualitative Assessment of General Movements (GMsA) and Alberta Infant Motor Scale (AIMS). General movement were recorded in three periods, preterm, writhing and fidgety; AIMS were assessed and a percentile ranking equal or below 10th were defined as delayed. Cognitive developmental outcomes were measured by Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) at 3 years of age, and a cognitive composite score below 90 was defined as delay. The GMs was assessed by categorical rating, which was classified as normal, poor repertoire (PR), chaotic (Ch), and cramped synchronized (CS) in preterm and writing period, and GMs in fidgety period were classified as normal, abnormal (AF) and absent fidgety(F-) movements. All the assessment results were further dichotomized to normal (N) and abnormal (A) for the purpose of predictive analyses.
GMs trajectory composed of the results of three periods and were categorized as T1 (NNN or ANN), T2 (AAN or NAN), and T3 (NNA, ANA, NAA or AAA) based on the time point when GMs normalized. The predictive validity, Kendall’s tau b and Cramer’s V correlation coefficient were applied for the early motor performance and cognitive outcomes. Mann- Whitney U test and Kruskal-Wallis test were used for between group difference in mean cognitive scores. Logistic regression was used to estimate the association between 5 perinatal risk factors, and cognitive outcomes.
Results. GMsA had a good specificity (60-91%) and negative predictive value (92-95%), poor sensitivity (34-63%) and positive predictive value (7-46%). AIMS had overall good accuracy (91-92%) but poor sensitivity (25-37%). Participants with less favorable early motor performance such as abnormal GMs in fidgety period and delayed motor development by AIMS developed significantly lower cognitive composite scores at 3 years old. Low to moderate correlation was found between GMs in fidgety period and cognitive outcome and between motor development by AIMS and cognitive outcome (r= 0.20-0.49). Comparing to single results of GMs, there were no statistically significant findings between GMs trajectories and cognitive outcomes. Among the 5 perinatal risk factors, only CLD significantly contributed to the cognitive outcomes ( = -2.9).
Discussion and conclusions. The correlation between motor performance based on GMsA and cognitive outcomes reached highest in the fidgety period. Motor performance based on GMs trajectories showed non-significant result might be caused by the small number of participants included in trajectories analysis, nevertheless, the declined mean cognitive scores of T1 over T3 show partially accordance with previous studies. Comparing concurrent spontaneous and volitional movement, movement assessed by GMsA and AIMS, volitional movements prior to 5-month-old of corrected age displayed significant moderate correlation (r=0.47-0.49) against later cognitive outcomes, and it might correspond with the psychological concept of how perception was generated. The significant association between CLD and cognitive developmental outcome could be explained by the vulnerability to hypoxic-ischemic injury reported in young developing nervous system. The significant correlation between fidgety GMs and cognitive development, and between volitional movements based on AIMS and cognitive development helps improving the clinical suggestion and strategies. Further analyses of GMs trajectories against cognition could be emphasized on the principles of classifying GMs trajectories and the length of GMs trajectories, and it was also suggested that taking risk factors into consideration in such prediction models.
Keywords: high risk infants, developmental delay, cognitive development, general movements

Reference
1. Rüegger C, Hegglin M, Adams M, Bucher HU. Population based trends in mortality, morbidity and treatment for very preterm- and very low birth weight infants over 12 years. 2012.
2. Allen MC. The High-Risk Infant. Pediatric Clinics of North America. 1993;40(3):479-490.
3. Schlösser R, Hutchinson M, JoseVer S, et al. Functional magnetic resonance imaging of human brain activity in a verbal fluency task. 1998.
4. Raichle ME, Fiez JA, Videen TO, et al. Practice-related Changes in Human Brain Functional Anatomy during Nonmotor Learning. 1994.
5. Berman KF, Ostrem JL, Randolph C, et al. Physiological activation of a cortical network during performance of the Wisconsin Card Sorting Test- a positron emission tomography study. 1995.
6. Diamond A. Close Interrelation of Motor Development and Cognitive Development and of the Cerebellum and Prefrontal Cortex. 2000.
7. Middleton FA, Strick PL. Anatomical Evidence for Cerebellar and Basal Ganglia Involvement in Higher Cognitive Function. 1994.
8. Steinlin M. The cerebellum in cognitive processes- Supporting studies in children. 2007.
9. Piaget J. Part 1: Cognitive development in children: Piaget development and learning. 1964.
10. Smith L, Gasser M. The Development of Embodied Cognition: Six Lessons from Babies. 2005.
11. Smith L, Thelen E, Titzer R, McLin D. Knowing in the Context of Acting: The Task Dynamics of the A-Not-B Error. 1999.
12. Burns Y, O’Callaghan M, McDonella B, Rogers Y. Movement and motor development in ELBW infants at 1 year is related to cognitive and motor abilities at 4 years. 2004.
13. Piek JP, Dawson L, Smith LM, Gasson N. The role of early fine and gross motor development on later motor and cognitive ability. 2008.
14. Oudgenoeg-Paz O, Mulder H, Jongmans MJ, van der Ham IJM, Van der Stigchel S. The link between motor and cognitive development in children born preterm and/or with low birth weight: A review of current evidence. Neurosci Biobehav Rev. 2017;80:382-393.
15. Einspieler C, Prechtl HFR, Ferrari F, Cioni G, Bos AF. The qualitative assessment of general movements in preterm, term and young infants — review of the methodology. 1997.
16. Piper M, Darrah J. Motor Assessment of the Developing Infant Saunders; 1994.
17. Kodric J, Sustersic B, Paro-Panjan D. Assessment of general movements and 2.5 year
developmental outcomes: pilot results in a diverse preterm group. Eur J Paediatr
Neurol. 2010;14(2):131-137.
18. Spittle AJ, Spencer-Smith MM, Cheong JL, et al. General movements in very preterm
children and neurodevelopment at 2 and 4 years. Pediatrics. 2013;132(2):e452-458.
19. Butcher PR, van Braeckel K, Bouma A, Einspieler C, Stremmelaar EF, Bos AF. The quality of preterm infants' spontaneous movements: an early indicator of intelligence
and behaviour at school age. J Child Psychol Psychiatry. 2009;50(8):920-930.
20. Fjørtoft T, Grunewaldt KH, Lohaugen GC, Morkved S, Skranes J, Evensen KA.
Assessment of motor behaviour in high-risk-infants at 3 months predicts motor and cognitive outcomes in 10 years old children. Early Hum Dev. 2013;89(10):787-793.21. Lefebvre F, Gagnon MM, Luu TM, Lupien G, Dorval V. In extremely preterm infants, do the Movement Assessment of Infants and the Alberta Infant Motor Scale predict 18-month outcomes using the Bayley-III? Early Hum Dev. 2016;94:13-17.
22. Hadders-Algra M. Putative neural substrate of normal and abnormal general movements. Neurosci Biobehav Rev. 2007;31(8):1181-1190.
23. Khazipov R, Luhmann HJ. Early patterns of electrical activity in the developing cerebral cortex of humans and rodents. Trends Neurosci. 2006;29(7):414-418.
24. Mutlu A, Livanelioglu A, Korkmaz A. Assessment of “general movements” in high risk infants by Prechtl analysis during early intervention period in the first year of life. 2010.
25. Maas YG, Mirmiran M, Hart AA, Koppe JG, Ariagno RL, Spekreijse H. Predictive value of neonatal neurological tests for developmental outcome of preterm infants. J Pediatr. 2000;137(1):100-106.
26. Ivanov IS, Shukerski KG, Chepisheva EV. Spontaneous motor activity three months after birth in comparison with clinical and ultrasound studies. 2005.
27. Heineman KR, Schendelaar P, Van den Heuvel ER, Hadders-Algra M. Motor development in infancy is related to cognitive function at 4 years of age. Developmental Medicine & Child Neurology. 2018;60(11):1149-1155.
28. Hadders-Algra M. Variation and variability- key words in human motor development. 2010.
29. Ferrari F, Cionib G, F.R.Prechtl. Qualitative changes of general movements in preterm infants with brain lesions. 1990.
30. Geerdink JJ, Hopkins B. Qualitative changes in general movements and their prognostic value in preterm infants. European Journal of Pediatrics. 1993;152(4):362-367.
31. Einspiele C, Prechtl HFR. Prechtl's assessment of general movements: a diagnostic tool for the functional assessment of the young nervous system. Ment Retard Dev Disabil Res Rev. 2005;11(1):61-67.
32. Bos AF, Loon AJv, Hadders-Algra M, Martijn A, Okken A, Prechtl HFR. spontaneous motility in preterm, small-for-gestational age infants II. Qualitative aspects. 1997.
33. Ploegstra WM, Bos AF, Vries NKSd. General movements in healthy full term infants during the first week after birth. Early Hum Dev. 2014;90(1):55-60.
34. Prechtl HFR. Qualitative changes of spontaneous movements in fetus and preterm infant are a marker of neurological dysfunction. 1990.
35. Grunewaldt KH, Fjortoft T, Bjuland KJ, et al. Follow-up at age 10 years in ELBW children - functional outcome, brain morphology and results from motor assessments in infancy. Early Hum Dev. 2014;90(10):571-578.
36. Prechtl HF, Einspieler C, Cioni G, Bos AF, Ferrari F, Sontheimer D. An early marker for neurological deficits after perinatal brain lesions. Lancet. 1997;349(9062):1361- 1363.
37. Prechtl HFR. General movement assessment as a method of developmental neurology new paradigms and their consequences. 2001.
38. Ferrari F, Cioni G, Einspieler C, et al. Cramped Synchronized General Movements in Preterm Infants as an Early Marker for Cerebral Palsy. 2002.
39. Groen SE, Blécourt ACEd, Postema K, Hadders-Algra M. General movements in early infancy predict neuromotor development at 9 to 12 years of age. 2005.
40. Hadders-Algra M. General movements a window for early identification of children at high risk for developmental disorders. 2004.
41. Burger M, Louw QA. The predictive validity of general movements--a systematic review. Eur J Paediatr Neurol. 2009;13(5):408-420.
42. Crowle C, Walker K, Galea C, Novak I, Badawi N. General movement trajectories and neurodevelopment at 3months of age following neonatal surgery. Early Hum Dev. 2017;111:42-48.
43. Bruggink JL, Van Braeckel KN, Bos AF. The early motor repertoire of children born preterm is associated with intelligence at school age. Pediatrics. 2010;125(6):e1356- 1363.
44. Selton D, Andre M, Debruille C, Deforge H, Hascoet JM. Cognitive outcome at 5 years in very premature children without severe early cerebral abnormalities. Relationships with EEG at 6 weeks after birth. Neurophysiol Clin. 2013;43(5-6):289- 297.
45. Ullman H, Spencer-Smith M, Thompson DK, et al. Neonatal MRI is associated with future cognition and academic achievement in preterm children. Brain. 2015;138(Pt 11):3251-3262.
46. Young JM, Powell TL, Morgan BR, et al. Deep grey matter growth predicts neurodevelopmental outcomes in very preterm children. NeuroImage. 2015;111:360- 368.
47. Arsalidou M, Duerden EG, Taylor MJ. The centre of the brain: topographical model of motor, cognitive, affective, and somatosensory functions of the basal ganglia. Hum Brain Mapp. 2013;34(11):3031-3054.
48. Bjuland KJ, Rimol LM, Lohaugen GC, Skranes J. Brain volumes and cognitive function in very-low-birth-weight (VLBW) young adults. Eur J Paediatr Neurol. 2014;18(5):578-590.
49. Chau V, Synnes A, Grunau RE, Poskitt KJ, Brant R, Miller SP. Abnormal brain maturation in preterm neonates associated with adverse developmental outcomes. Neurology. 2013;81(24):2082-2089.
50. Abernethy LJ, Cooke RW, Foulder-Hughes L. Caudate and Hippocampal Volumes, Intelligence, and Motor Impairment in 7-Year-Old Children Who Were Born Preterm. 2004.
51. Fattal-Valevski A, Toledano-Alhadef H, Leitner Y, Geva R, Eshel R, Harel S. Growth Patterns in Children With Intrauterine Growth Retardation and Their Correlation to Neurocognitive Development. 2009.
52. Linsell L, Malouf R, Morris J, Kurinczuk JJ, Marlow N. Prognostic Factors for Poor Cognitive Development in Children Born Very Preterm or With Very Low Birth Weight: A Systematic Review. JAMA Pediatr. 2015;169(12):1162-1172.
53. Nancy B. Bayley scales of infant and toddler development: Bayley-III. San Antonio, TX.: Harcourt Assessment; 2006.
54. Milne S, McDonald J, Comino EJ. The Use of the Bayley Scales of Infant and Toddler Development III with Clinical Populations: A Preliminary Exploration. Physical & Occupational Therapy In Pediatrics. 2011;32(1):24-33.
55. Anderson PJ, Luca CRD, Hutchinson E, Roberts G, Doyle LW. Underestimation of Developmental Delay by the New Bayley-III Scale. 2010.
56. Vohr BR, Stephens BE, Higgins RD, et al. Are outcomes of extremely preterm infants improving? Impact of Bayley assessment on outcomes. J Pediatr. 2012;161(2):222- 228 e223.
57. Spencer-Smith MM, Spittle AJ, Lee KJ, Doyle LW, Anderson PJ. Bayley-III Cognitive and Language Scales in Preterm Children. Pediatrics. 2015;135(5):e1258- 1265.
58. Acton BV, Biggs WSG, Creighton DE, et al. Overestimating Neurodevelopment Using the Bayley-III After Early Complex Cardiac Surgery. Pediatrics. 2011;128(4):e794-e800.
59. Reuner G, Fields AC, Wittke A, Löpprich M, Pietz J. Comparison of the developmental tests Bayley-III and Bayley-II in 7-month-old infants born preterm. European Journal of Pediatrics. 2012;172(3):393-400.
60. Yi YG, Sung IY, Yuk JS. Comparison of Second and Third Editions of the Bayley Scales in Children With Suspected Developmental Delay. Annals of Rehabilitation Medicine. 2018;42(2):313.
61. Jary S, Whitelaw A, Walløe L, Thoresen M. Comparison of Bayley-2 and Bayley-3 scores at 18 months in term infants following neonatal encephalopathy and therapeutic hypothermia. Developmental Medicine & Child Neurology. 2013;55(11):1053-1059.
62. Moore T, Johnson S, Haider S, Hennessy E, Marlow N. Relationship between Test Scores Using the Second and Third Editions of the Bayley Scales in Extremely Preterm Children. The Journal of Pediatrics. 2012;160(4):553-558.
63. Johnson S, Moore T, Marlow N. Using the Bayley-III to assess neurodevelopmental delay: which cut-off should be used? Pediatr Res. 2014;75(5):670-674.
64. Lowe JR, Erickson SJ, Schrader R, Duncan AF. Comparison of the Bayley II Mental Developmental Index and the Bayley III Cognitive Scale: are we measuring the same thing? Acta Paediatr. 2012;101(2):e55-58.
65. Johnson S, Marlow N. Developmental screen or developmental testing? Early Human Development. 2006;82(3):173-183.
66. Yu Y-T, Hsieh W-S, Hsu C-H, et al. A psychometric study of the Bayley Scales of Infant and Toddler Development - 3rd Edition for term and preterm Taiwanese infants. Res Dev Disabil. 2013;34(11):3875-3883.
67. Einspieler C, Prechtl HFR, Bos A, Ferrari F, Cioni G. Prechtl's Method on the Qualitative Assessment of General Movements in Preterm, Term and Young Infants. Mac Keith Press; 2004.
68. Spittle AJ, Boyd RN, Inder TE, Doyle LW. Predicting Motor Development in Very Preterm Infants at 12 Months’ Corrected Age: The Role of Qualitative Magnetic Resonance Imaging and General Movements Assessments. Pediatrics. 2009;123(2):512-517.
69. Jeng S-F, Yau K-IT, Chen L-C, Hsiao S-F. Alberta Infant Motor Scale- Reliability and Validity When Used on Preterm Infants in Taiwan. 2000.
70. Darrah J, Piper M, Watt M. Assessment of gross motor skills of at‐risk infants: predictive validity of the Alberta Infant Motor Scale. 1998.
71. Ratner B. The correlation coefficient: Its values range between +1/−1, or do they? Journal of Targeting, Measurement and Analysis for Marketing. 2009;17(2):139-142.
72. Garcia JM, Gherpelli JLD, Leone CR. The role of spontaneous general movement assessment in the neurological outcome of cerebral lesions in preterm infants. 2004.
73. Constantinou JC, Adamson-Macedo EN, Mirmiran M, Fleisher BE. Movement, imaging and neurobehavioral assessment as predictors of cerebral palsy in preterm infants. J Perinatol. 2007;27(4):225-229.
74. de Vries NK, Bos AF. The quality of general movements in the first ten days of life in preterm infants. Early Hum Dev. 2010;86(4):225-229.
75. de Vries NK, Erwich JJ, Bos AF. General movements in the first fourteen days of life in extremely low birth weight (ELBW) infants. Early Hum Dev. 2008;84(11):763- 768.
76. Manacero SA, Marschik PB, Nunes ML, Einspieler C. Is it possible to predict the infant's neurodevelopmental outcome at 14 months of age by means of a single preterm assessment of General Movements? Early Hum Dev. 2012;88(1):39-43.
77. Schie PEV, Rep A, Ganzevoort W, et al. General movements in infants born from mothers with early-onset hypertensive disorders of pregnancy in relation to one year's neurodevelopmental outcome. 2008.
78. Hofsten CV. Action, the foundation for cognitive development. 2009.
79. Howe TH, Sheu CF, Hsu YW, Wang TN, Wang LW. Predicting neurodevelopmental
outcomes at preschool age for children with very low birth weight. Res Dev Disabil.
2016;48:231-241.
80. SR H, MW S, MS A, et al. Predictive validity of the "Movement Assessment of
Infants.". 1984.
81. Coolman RB, Bennett FC, Sells CJ, Swanson MW, Andrews MS, Robinson NM.
Neuromotor development of graduates of the neonatal intensive care unit- patterns
encountered in the first two years of life. 1985.
82. Coryell J, Provost B, Wilhelm IJ, Campbell SK. Stability of Bayley Motor Scale
scores in the first year of life. 1989.
83. Palisano R. Concurrent and predictive validities of the Bayley Motor Scale and the
Peabody Developmental Motor Scales. 1986.
84. Doyle LW, Davis PG, Schmidt B, Anderson PJ. Cognitive outcome at 24 months is
more predictive than at 18 months for IQ at 8-9 years in extremely low birth weight
children. Early Hum Dev. 2012;88(2):95-98.
85. Luttikhuizen dos Santos ES, de Kieviet JF, Konigs M, van Elburg RM, Oosterlaan J.
Predictive value of the Bayley scales of infant development on development of very preterm/very low birth weight children: a meta-analysis. Early Hum Dev. 2013;89(7):487-496.
86. Niccols A, Latchman A. Stability of the Bayley Mental Scale of Infant Development with High Risk Infants. The British Journal of Development Disabilities. 2002;48(94):3-13.
87. McQuillen PS, Ferriero DM. Perinatal Subplate Neuron Injury: Implications for Cortical Development and Plasticity. 2005.
88. Adams-Chapman I, Bann CM, Vaucher YE, Stoll BJ, Eunice Kennedy Shriver National Institute of Child H, Human Development Neonatal Research N. Association between feeding difficulties and language delay in preterm infants using Bayley Scales of Infant Development-Third Edition. J Pediatr. 2013;163(3):680-685 e681- 683.
89. Wood NS, Costeloe K, Gibson AT, et al. The EPICure study: associations and antecedents of neurological and developmental disability at 30 months of age following extremely preterm birth. Arch Dis Child Fetal Neonatal Ed. 2005;90(2):F134-140.
90. Franz AR, Pohlandt F, Bode H, et al. Intrauterine, early neonatal, and postdischarge growth and neurodevelopmental outcome at 5.4 years in extremely preterm infants after intensive neonatal nutritional support. Pediatrics. 2009;123(1):e101-109.
91. Hansen BM, x000F, lholm, B H, P U, G G. Perinatal risk factors of adverse outcome in very preterm children: a role of initial treatment of respiratory insufficiency? Acta Paediatrica. 2004;93(2):185-189.
92. Vohr BR, Wright LL, Poole WK, McDonald SA. Neurodevelopmental outcomes of extremely low birth weight infants <32 weeks' gestation between 1993 and 1998. Pediatrics. 2005;116(3):635-643.
93. Helderman JB, O'Shea TM, Kuban KC, et al. Antenatal antecedents of cognitive impairment at 24 months in extremely low gestational age newborns. Pediatrics. 2012;129(3):494-502.
94. Stoelhorst GMSJ, Rijken M, Martens SE, et al. Developmental outcome at 18 and 24 months of age in very preterm children: a cohort study from 1996 to 1997. Early Human Development. 2003;72(2):83-95.