Language Disorders in Preterm Toddlers with Ventricular Hemorrhage

Introduction: Prematurity is a risk factor for neurodevelopment outcome. Ventricular hemorrhage (VH) affects especially preterm infants with low birth weight and low gestational age. Language delay is closely associated with future academic disability. Objective: Investigate the effect of VH on language development in children born prematurely. Methods: Fifty-four toddlers (37 weeks of gestation; < 2000g body weight at birth) were assessed when they were 12 or 24 months. They were admitted to a follow-up Program at the Pediatric Department, Universidade Federal de Sγo Paulo – Escola Paulista de Medicina. The children were divided into two groups: 30 (55.55%) with VH at birth and 24 (44.44%) without it. We used a behavior list concerning expressive and receptive language to assess language development. The performance was classified as typical or not according to the percentage of correct responses at a given chronological age. To study the relation between numeric and categorical variables we used t test and ANOVA. Likelihood ratio tests were used to analyze the association between categorical variables. Finally, the logistic regression model was used to explore the relation between VH, sex, and language delay. Results: Low birth weight (p=0.104), asphyxia (p=0.055), bronchopulmonary dysplasia (p=0.687), and mechanic ventilating therapy (p=0.509) were not associated with VH occurrence. However, the lower the gestational age the more severe the VH (p=0.035). Twenty-six (86%) children with VH at birth showed language delay; this was statistically significant when compared to children without VH at birth (p=0.000). The odds ratio for a child with VH to show language delay was eight times greater than that of a child without VH, being three times greater in boys. Conclusions: VH preterm infants, especially boys, are at a high risk of language development delay. Follow-up programs should pay attention to these children, because language development is linked to the most important levels of functioning of a human being. Moreover, psychological diagnoses at risk conditions should assess children at different ages to verify how these conditions affect the different phases of development.