Long-term developmental outcomes of very-low-birth-weight infants born to non-Korean mothers: an analysis using the Korean neonatal network (KNN) database.

backgroundPreterm infants born to multicultural families, particularly very-low-birth-weight infants (VLBWIs; <1,500 g), may experience disparities in neurodevelopmental outcomes. This study examined long-term developmental outcomes among VLBWIs born to non-Korean mothers using data from the nationwide Korean Neonatal Network (KNN) database.

methodsA total of 20,582 VLBWIs born between 2013 and 2023 were analysed after excluding infants with major congenital anomalies. Participants were categorized into two cohorts: Period I (2013–2018) and Period II (2019–2023). Developmental outcomes at corrected ages of 18–24 months and 36 months were assessed using the Korean Developmental Screening Test (K-DST) and Bayley Scale (Bayley II/III). Multivariable logistic regression was performed to identify factors associated with developmental delay.

resultsThe proportion of non-Korean mothers increased over time. Infants born to non-Korean mothers showed higher prevalences of respiratory distress syndrome, sepsis, and pulmonary haemorrhage, and mortality compared with those born to Korean mothers. At both 24 and 36 months, these infants were more likely to exhibit developmental concerns in language, cognitive, and social domains. Maternal nationality, sex, birth weight, persistent pulmonary hypertension of newborn, and intraventricular haemorrhage (grade ≥ 3) were independently associated with language delay.

conclusionsIn this nationwide cohort, infants born to non-Korean mothers were more likely to show developmental concerns during early childhood. These findings indicate associations between maternal nationality and developmental outcomes and underscore the importance of continued developmental surveillance and further research to better understand underlying sociocultural and environmental factors.