School performance and behaviour in extremely preterm growth-retarded infants

Area of Science:

• Neonatalogy
• Developmental Pediatrics
• Educational Psychology

Background:

• Infants born extremely preterm with fetal growth restriction present unique developmental considerations.
• Placental insufficiency is a key factor in fetal growth restriction, impacting neurodevelopmental outcomes.
• Understanding school performance and behavior in this cohort is crucial for targeted interventions.

Purpose of the Study:

• To evaluate the school performance and behavioral outcomes of extremely preterm infants with fetal growth restriction.
• To identify factors associated with special education placement and behavioral disturbances in this population.
• To compare outcomes with broader preterm populations.

Main Methods:

• A cohort study included 127 surviving singleton infants born between 26-32 weeks gestation with fetal growth restriction due to placental insufficiency.
• School performance (special education, delayed mainstream placement) and behavior (attention-deficit hyperactivity criteria) were assessed at 4.5-10.5 years.
• Logistic regression analyzed the relationship between obstetric/neonatal factors and school/behavioral outcomes.

Main Results:

• 14% of children required special education, with higher rates in older children (20% vs 10%).
• 39% of children in mainstream education exhibited behavioral problems.
• Special education correlated with bronchopulmonary dysplasia; behavioral problems correlated with absence of a parent.

Conclusions:

• Extremely preterm, growth-retarded infants are at a disadvantage in school performance.
• Incidence of special education and behavioral problems was similar to other preterm infants.
• Obstetric factors like gestational age and birth weight did not predict special education or behavioral issues.