What question did this study set out to answer?

To determine the prevalence and risk factors of developmental delay in preterm infants screened with ASQ-3 Thai.

April 12, 2026Open Access

Prevalence and Perinatal Risk Factors of Developmental Problems in Preterm Infants: Real-World Use of the ASQ-3 Thai in a Neonatal Follow-Up Clinic

RKRatima KosanThammasat University SPSariya PrachukthumThammasat University KPKusalinnaphat PhonngamThammasat University Hospital

Key Points

To determine the prevalence and risk factors of developmental delay in preterm infants screened with ASQ-3 Thai.
Conducted a hospital-based cross-sectional study in a neonatal follow-up outpatient clinic.
Caregivers completed the ASQ-3 Thai and a demographic questionnaire.
Perinatal data were retrieved from medical records.
Infants with abnormal screening results were evaluated by developmental-behavioral pediatricians.
22.4% of infants showed suspected developmental delay based on ASQ-3 Thai results.
Fine motor and problem-solving skills were the most affected areas.
Abnormal screening was linked to lower gestational age and birth weight.
Prolonged oxygen therapy and longer hospital stays were associated with abnormal outcomes.
79% positive predictive value for confirmed neurodevelopmental disorders among screen-positive infants.

Abstract

Introduction: Preterm birth is associated with increased risks of long-term neurodevelopmental impairments. Early developmental screening in real-world neonatal follow-up clinics is essential. The ASQ-3 Thai offers a practical, parent-completed tool; however, evidence of its performance in Thai preterm infants in everyday care settings remains limited. Objectives: To determine the prevalence and perinatal risk factors of suspected developmental delay in preterm infants weeks' gestation screened with the ASQ-3 Thai in a neonatal follow-up clinic, and to explore its pragmatic diagnostic value compared with expert assessment in routine clinical practice. Methods: This hospital-based cross-sectional study was conducted in a neonatal follow-up outpatient clinic. Caregivers of eligible preterm infants aged 2–30 months completed the ASQ-3 Thai and a demographic questionnaire. Perinatal data were retrieved from medical records. Infants with abnormal screening results were referred to developmental-behavioral pediatricians for comprehensive clinical evaluation including TEDA4I. Results: Seventy-six infants were enrolled. Suspected developmental delay based on abnormal ASQ-3 Thai screening was found in 22.4% (17/76). Fine motor and problem-solving domains were most frequently affected. Abnormal screening was significantly associated with lower gestational age, lower birth weight, prolonged oxygen therapy, longer hospitalization, and bronchopulmonary dysplasia. Among screen-positive infants, 11 had confirmed neurodevelopmental disorders, yielding a positive predictive value of 79%. Conclusion: In a neonatal follow-up clinic, developmental problems were common among preterm infants weeks, particularly in those with identifiable perinatal risks. The ASQ-3 Thai demonstrated good pragmatic value as a feasible, parent-completed screening tool to prioritize preterm infants for specialist evaluation and early intervention.

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