Risk profiles of motor deficits in preterm infants: a cluster analysis approach.

Abstract

Preterm infants face increased risks of developmental impairments. Maternal pregnancy complications, neonatal morbidity, and social adversity may additively increase these risks. This study aimed to identify intersecting maternal, neonatal, and social risk factors clustering within mother and preterm infant dyads, and to examine their prospective associations with infants' cognitive and motor outcomes. Data from 222 mother and preterm infant dyads were analyzed using two-step cluster analysis based on maternal, neonatal, and social risk factors. Mixed-effects linear regression models assessed differences in outcomes at 3 months (MOS-R) and 12 months (Bayley III) corrected age according to identified risk profiles. Four risk profiles emerged. The low-risk profile (A) represented minimal maternal, neonatal, and social adversity. At 3 months, infants in the high social (C) and high neonatal risk (D) profile had lower MOS-R scores compared with profile A (C: coefficient = -2.27, 95% CI [-3.46, -1.07], p < 0.01; D: -3.75 [-5.40, -2.08], p < 0.01). No difference was observed for the high maternal risk profile (B). These findings emphasize an intersectional approach to understanding developmental vulnerability in preterm infants. Simultaneous consideration of maternal, neonatal, and social risks is crucial for early identification and targeted follow-up of at-risk families. This study demonstrates that maternal, neonatal, and social risk factors occur in distinct clusters among preterm infant-mother dyads. Person-centered risk profiles reflect different etiological pathways Findings emphasize the need for intersectional risk screening to guide individualized multidisciplinary follow-up care for preterm infants.