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Early developmental intervention and neurodevelopmental trajectories in preterm infants without severe brain injury

Pediatric Research (2026)Cite this article

Abstract

Background

Early developmental intervention seeks to enhance functional outcomes in preterm infants by leveraging neuroplasticity. We investigated the relationship between early intervention and neurodevelopmental outcomes in early childhood among preterm infants without severe brain injury.

Methods

This prospective cohort study enrolled very-low-birth-weight infants (23+0–32+6 weeks’ gestation) registered in the Korean Neonatal Network. Neurodevelopment was evaluated at corrected ages 18-24 months and chronological ages 33-45 months using the Bayley Scales of Infant and Toddler Development (Second or Third Edition), the Korean Developmental Screening Test, or both. Infants who began motor-based or language therapy prior to 18–24 months of corrected age were defined as the early intervention group.

Results

Of the 1797 infants who completed follow-up, 518 (28.8%) received early intervention. Compared to infants without early intervention, those with early intervention had lower gestational age and higher rates of prematurity-related complications and post-discharge rehospitalizations. The interaction between the intervention group and assessment time was statistically significant, indicating that early intervention was associated with a reduced risk of motor developmental delays over time (adjusted odds ratio 0.669, 95% confidence interval 0.472–0.949).

Conclusion

Early intervention was associated with more favorable motor outcomes, highlighting the importance of timely support for high-risk preterm infants.

Impact

  • Preterm infants with greater medical complexity more commonly received early intervention.

  • Early intervention mitigated the progression of motor developmental delays over time.

  • An enriched early environment may help offset the negative developmental impact of preterm complications.

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Fig. 1: Flow chart of study cohort.
Fig. 2: Flow diagram depicting the distribution of neurodevelopmental assessment tools by intervention group and assessment time point.

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Data availability

The Korean Neonatal Network (KNN) Publication Ethics Policy conforms to the following guidelines for managing and accessing research data: All information regarding patients and participating NICUs is confidential. Access to the data is limited to individuals with approved research purposes. Institutions or individuals not affiliated with the KNN must submit an official request to the KNN publication-Ethics Committee and obtain network approval to access the data.

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Acknowledgements

This research was supported by the National Institute of Health (NIH) research project (2025-ER0601-00#).

Funding

This study was supported by the Soonchunhyang University Research Fund (grant number 2025-0026), which covered publication costs. The funder did not participate in (1) the study design, (2) the data collection, analysis, or interpretation, (3) the manuscript preparation, or (4) the decision to submit the manuscript for publication.

Author information

Authors and Affiliations

  1. Department of Pediatrics, The Catholic University of Korea Eunpyeong St. Mary’s Hospital, Seoul, Republic of Korea

    Jungha Yun

  2. Department of Pediatrics, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea

    Seong Phil Bae, Do Hyun Kim & Woo Ryoung Lee

  3. Department of Pediatrics, Soonchunhyang University College of Medicine, Cheonan, Republic of Korea

    Seong Phil Bae, Do Hyun Kim & Woo Ryoung Lee

  4. Department of Biostatistics, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea

    Suyeon Park

  5. Department of Applied Statistics, Chung-Ang University, Seoul, Republic of Korea

    Suyeon Park

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  1. Jungha Yun
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  2. Seong Phil Bae
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  4. Woo Ryoung Lee
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Contributions

JY and SPB conceptualized and designed the study. SPB and SYP were responsible for data acquisition and analysis. JY and SPB drafted the manuscript. DHK and WRL critically revised the manuscript. All authors approved the final version before submission.

Corresponding author

Correspondence to Seong Phil Bae.

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Competing interests

The authors declare no competing interests.

Consent statement

Participation of the infant in the registration of data in the KNN was approved by the Institutional Review Board (IRB) of each participating center. Written informed consent was obtained from the parents of each participant in the study.

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Yun, J., Bae, S.P., Kim, D.H. et al. Early developmental intervention and neurodevelopmental trajectories in preterm infants without severe brain injury. Pediatr Res (2026). https://doi.org/10.1038/s41390-026-04825-8

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