Association between gestational age and birth weight on the language development of Brazilian children: a systematic review

Zerbeto, Amanda B.; Cortelo, Fernando M.; C. Filho, Élio B.

doi:10.1016/j.jped.2014.11.003

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Review Articles • J. Pediatr. (Rio J.) 91 (4) • Aug 2015 • https://doi.org/10.1016/j.jped.2014.11.003 copy

Association between gestational age and birth weight on the language development of Brazilian children: a systematic review^☆ ☆ Please cite this article as: Zerbeto AB, Cortelo FM, Filho ÉB. Association between gestational age and birth weight on the language development of Brazilian children: a systematic review. J Pediatr (Rio J). 2015;91:326-32.

Authorship SCIMAGO INSTITUTIONS RANKINGS

OBJECTIVE:

To review the literature that addresses the relationship between prematurity, birth weight, and development of language in Brazilian children.

SOURCES:

A systematic review of studies published between 2003 and 2012 in English and Portuguese and indexed in PubMed, LILACS, and SciELO. The following key words were used in the searches: Prematuro, Prematuridade, Linguagem, Prematurity, Language, Speech-Language Pathology. Fifty-seven articles were retrieved, 13 of which were included in the systematic review.

SUMMARY OF THE FINDINGS:

The results showed an association between prematurity, low birth weight, and language development. In studies that made comparisons between preterm and term infants, there was evidence that preterm infants had poorer performance on indicators of language. It was also observed that children born with lower birth weight had a poorer performance on measures of language when compared to children with higher weight and closer to 37 weeks of gestational age. Regarding the type of language assessed, expression proved to be more impaired than reception. Higher parental education and family income were indicated as protective factors for the development of language. Conversely, lower birth weight and higher degree of prematurity emerged as risk factors.

CONCLUSIONS:

Preterm birth and low birth weight poses risks for the language development of children, especially in the first years of life. Therefore, it is essential that pediatricians are aware of the language development of these children to ensure proper treatment.

Infant prematurity; Low birth weight; Child; Language; Language development disorders; Language development

Author(s), (year)	Study method	Age of participants (months)	Sample size	Main results
Oliveira LN et al. (2003)⁸	Case-control longitudinal	6-18	20	No difference was observed between FTNB/SGA, PTNB/AGA, and the FTNB/AGA infants in the first semester of life. After 9 months delay in babbling was observed, and in the 12th month polysyllabic babbling and production of first words were delayed.
Meio MD et al. (2004)¹²	Cross-sectional with cohort analysis	48-71	129	Premature children showed worse performance in the areas of vocabulary and comprehension when compared with children born at term, with vocabulary more impaired that comprehension.
Pereira MR, Funayama CA (2004)¹³	Case-control longitudinal	2-15	69	Preterm AGA and SGA children with normal neurological assessment and neuromotor development, showed delay, especially in expressive language.
Ishii C et al. (2006)¹⁴	Cross-sectional descriptive	48-59	20	Preterm children showed changes in language development at 4 years of age at the TEPSI test.
Shirmer CR et al. (2006)⁹	Cross-sectional	36	69	Premature children had higher risk of language delay. Mental, psychomotor, and behavioral delay were significantly correlated with language development in infants with birth weight < 1,500 g; with weight > 1,500 g, the significance was associated only with the mental score.
Bühler KE et al. (2009)²	Case-control longitudinal	1-18	32	Expressive language development occurred significantly later in preterm infants with very-low birth weight when compared to full-term infants.
Isotani SM et al. (2009)¹⁵	Case-control retrospective	Not available	118	Preterm infants and those with low birth weight have a higher occurrence of expressive language delay. These children have a significantly smaller vocabulary than children born at term at the same age, in all semantic categories.
Lamônica DA, Picolini MM (2009)¹⁶	Cross-sectional	6 - 24	30	Preterm children showed language delay in two periods: 6-12 and 12-24 months, and at the period of 12-24 months, the delay was more significant.
Lamônica DA et al. (2010)¹⁷	Case-control cross-sectional	12-24	40	Preterm infants and those born with low or very-low birth weight showed higher losses in the expressive language area, when compared to children born at term.
Lima MC et al. (2011)¹⁸	Case-control longitudinal	12-24	44	The differences were not statistically significant. The transient language alterations found in premature infants at 12 months normalized at 24 months, thus demonstrating the importance and the need to educate parents concerning the appropriate intervention, in order to prevent alterations from persisting throughout early childhood.
Eickmann SH et al. (2012)¹⁹	Case-control cross-sectional	6-12	135	Significant difference was observed between preterm and full-term children regarding expressive language, with premature males showing worse performance.
Fernandes LV et al. (2012)²⁰	Cross-sectional	18-24	58	Very low birth weight preterm infants more often showed alterations in language, social-emotional, and adaptive behavior.
Silveira KA, Enumo SR (2012)²¹	Cross-sectional	12-36	40	Preterm and low birth weight infants showed difficulties in cognitive, language, and motor performance, as well as behavioral problems in the first three years of life.

Assessment tools	Type of language assessed	Studies that used the tools
ELM	Receptive and Expressive	Lamônica DA et al.¹⁷; Oliveira LN et al.⁸; Lima MC et al.¹⁸
Bayley III	Receptive and Expressive	Eickmann SH et al.¹⁹; Silveira KA, Enumo SR²¹; Fernandes LV et al.²⁰
LAVE	Expressive	Isotani SM et al.¹⁵
POI	Receptive and Expressive	Lamonica DA, Picolini MM¹⁶
TEPSI	Receptive and Expressive	Ishii C et al.¹⁴
PELCDO	Expressive	Bühler KE et al.²
Denver II; Bayley II; Language Assessment	Receptive and Expressive	Shirmer CR et al.⁹
WPPSI-R	Receptive and Expressive	Meio MD et al.¹²
Language scripts	Receptive and Expressive	Pereira MR et al.¹³

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[1] * Corresponding author. E-mail: amandabrait@gmail.com (A.B. Zerbeto).