Change in cognitive function over time in very low-birth-weight infants
Laura R Ment1, Betty Vohr, Walter Allan
1Department of Pediatrics, Yale University School of Medicine, 333 Cedar St, New Haven, Conn 06520, USA. laura.ment@yale.edu
JAMA
|February 15, 2003
Summary
Most very low-birth-weight (VLBW) children show cognitive improvement, with gains in verbal and IQ scores through childhood. However, those with early intraventricular hemorrhage (IVH) and central nervous system injury experienced declining scores.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Cognitive Psychology
Background:
- Very low-birth-weight (VLBW) infants face high risks of neurodevelopmental disabilities.
- Emerging evidence suggests potential for brain recovery and compensation following early injury.
Purpose of the Study:
- To investigate cognitive development trajectories in children born preterm with VLBW.
- To assess long-term cognitive changes from early to middle childhood.
Main Methods:
- Prospective follow-up of 296 VLBW infants from a randomized controlled trial.
- Serial cognitive assessments at 36, 54, 72, and 96 months corrected age (CA).
- Utilized Peabody Picture Vocabulary Test-Revised (PPVT-R) and intelligence quotient (IQ) measures.
Main Results:
- Median PPVT-R scores improved from 88 at 36 months CA to 99 at 96 months CA.
- 45% of children gained ≥10 points on PPVT-R; 12.5% gained 5-9 points.
- Higher maternal education and two-parent households correlated with better PPVT-R scores. Early intervention benefited children of less educated mothers.
- Children with early intraventricular hemorrhage (IVH) and central nervous system injury showed initial low scores and subsequent decline.
Conclusions:
- The majority of VLBW children demonstrate cognitive improvements over time.
- Cognitive decline was primarily observed in VLBW infants with early-onset IVH and significant central nervous system injury.
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