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[Medical, cognitive and affective status of four-year-old very premature babies without severe disability. A
M H Blond1, B Castello-Herbreteau, E Ajam
1Unité d'information médicale et d'économie de la santé, hôpital Bretonneau, CHU de Tours, 37044 Tours cedex 1, France. mh.blond@chu-tours.fr
Insights
Very premature babies show significant cognitive and affective deficits by age 4. Early intervention is crucial to prevent long-term neurodevelopmental and social challenges in these vulnerable children.
Area of Science:
- Neonatal care
- Developmental pediatrics
- Neuroscience
Context:
- Premature infants (<33 weeks gestation) face developmental risks.
- Longitudinal studies are essential for tracking long-term outcomes.
- Early childhood development requires comprehensive assessment.
Purpose:
- To assess cognitive functions and affective development in very premature infants at 4 years of age.
- To compare outcomes of premature infants with full-term controls.
- To identify specific areas of neurodevelopmental delay.
Summary:
- Premature infants exhibited lower height, socioeconomic status, and nursery school levels compared to controls.
- Cognitive assessments (K-ABC) and affective evaluations (PSA, Conners' tests) revealed significant deficits in the preterm group.
- Multivariate analysis confirmed lower K-ABC scores and social competence, indicating persistent neurodevelopmental challenges.
Impact:
- Highlights the critical need for ongoing follow-up of premature infants.
- Emphasizes the necessity of implementing preventive measures for cognitive and social disabilities.
- Informs clinical practice and policy regarding support for high-risk neonates.
Aim:
To determine cognitive performances and affective development of a cohort of very premature babies at the age of 4 years.
Population And Methods:
Longitudinal case-control study. Newborns less than 33 weeks gestation were included from 1992 to 1994 and were matched with two full-term newborns. At 4 years of age, they have been evaluated for medical status, cognitive functions with the K-ABC test and affective condition with the PSA and Conners' tests.
Results:
The preterm group was significantly different from the controls for: a smaller height, (P < 0.01), a lower socioeconomic level (P = 0.027), a lower nursery school level (44% versus 27,6%, P = 0.05), the incapacity to draw "a bonhomme" (55,3% versus 93%, P < 0.001), lower performances for the K-ABC and PSA tests, a pathologic Conners score (20.4% versus 2.4%, P < 0.001). Multivariate analysis by logistic regression showed a similar neuropsychological results: a lower score of K-ABC (< 80, P = 0.0006, odds-ratio = 33.2), and a lower social competence score of PSA (< 45, P = 0.004, odds-ratio = 35.9).
Conclusion:
Follow-up of premature babies is required, and measures to prevent or minimize cognitive and social disabilities are mandatory.