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Prematurity and milestones — DCH MCQ

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ModerateDevelopmentPrematurity and milestonesDCH

A 7-month-old boy who was born at 28 weeks' gestation attends routine developmental follow-up. He smiles responsively, reaches for toys and has good head control. His movements are symmetrical, his muscle tone is normal and he has not lost any acquired skills. He does not yet sit independently. What is the most appropriate advice when interpreting his development?

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Correct answer: B — Assess all developmental domains using corrected age until 2 years

The correct answer is B. A baby born at 28 weeks is approximately 12 weeks preterm, making his corrected age about 4 months. Developmental expectations should therefore be based on corrected age rather than chronological age until 2 years. Independent sitting is not expected at a corrected age of 4 months, while smiling, reaching and good head control are reassuring. Correction applies across developmental domains, not just gross motor skills, so C is incorrect. Using chronological age would risk falsely labelling delay. In the absence of regression, abnormal tone, asymmetry or social-communication concerns, failure to sit at this corrected age neither establishes gross motor delay nor indicates an autism assessment. He should continue routine developmental surveillance appropriate for a very preterm infant.

Reference: National Institute for Health and Care Excellence. Developmental follow-up of children and young people born preterm, NG72, recommendations 1.3.9–1.3.12. 2017. https://www.nice.org.uk/guidance/ng72/chapter/Recommendations