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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Ten-year follow-up of children born before 29 gestational weeks: health, cognitive development, behaviour and school
K Stjernqvist1, N W Svenningsen
1Department of Psychology, Lund University, Sweden. Karin.Stjernqvist@itp.lu.se
Insights
Extremely preterm infants show significant challenges in cognitive development and school performance by age 10. Early interventions are crucial for these children
Area of Science:
- Pediatrics
- Developmental Psychology
- Public Health
Background:
- Studies since the 1990s indicate poor school performance in extremely preterm infants.
- A comprehensive assessment of extremely preterm children's overall situation is necessary.
- This study focuses on a southern Swedish population born between 1985-1986.
Purpose of the Study:
- To evaluate the school-age status of extremely preterm (EPT) children at 10 years of age.
- To compare EPT children with full-term (FT) control children across multiple domains.
- To assess health, cognitive development, academic achievement, and behavior.
Main Methods:
- A cohort of 121 infants born before 29 weeks of gestation was identified from a population of 32,120 births.
- Sixty-five EPT survivors were compared with full-term controls at age 10.
- Health, cognitive abilities (IQ, Visual-Motor Integration), school performance, and behavior were assessed.
Main Results:
- Most EPT survivors (92%) had no major neurological disability and were generally healthy.
- EPT children scored significantly lower on IQ (90 vs 106) and Visual-Motor Integration (93.3 vs 109.6) tests compared to FT peers (p < 0.001).
- Academic underachievement (38%), behavioral problems (32%), and ADHD (20%) were more prevalent in EPT children than in FT children (10% and 8%, respectively).
Conclusions:
- Despite good general health, EPT children face significant cognitive and academic challenges.
- Higher rates of behavioral issues, including ADHD, are observed in EPT children.
- Interventions are recommended to support the development and address behavioral problems in extremely preterm children.
Abstract:
Since the mid-1990s several studies have reported poor school performance in extremely preterm infants. The necessity to provide a full picture of the child's situation has been indicated. In a southern Swedish population 32,120 infants were born during the 2-y period 1985-1986. In total, 121 infants (0.4%) were reported liveborn before the 29th gestational wk and 12 (0.04%) were reported stillborn. Only 65 infants (50%) survived to the age of 10 y. The aim of this study was to evaluate the situation of extremely preterm (EPT) children at school, compared with that of full-term (FT) control children, at the age of 10 y. Health, cognitive development, school achievement and behaviour were measured. Ninety-two percent of the preterm children had no major neurological disability and most were in good health. The EPT children had an IQ of 90 +/- 15 vs 106 +/- 15 (mean +/- SD) for the FT children (p <0.001), and on the test of Visual-Motor Integration, the EPT children had 93.3 +/- 12.2 vs 109.6 +/- 14.2 for FT peers (p < 0.001). On both tests the differences between the groups corresponded to approximately one standard deviation. Thirty-eight percent of the EPT children performed below grade level at school. Thirty-two percent had general behavioural problems and 20% had attention deficit hyperactivity disorder, compared with 10% and 8%, respectively, in the FT group. EPT children require interventions to support their development and reduce behavioural problems.
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