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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Cognitive performance in a low birth weight cohort at 5 and 11 years of age
Irene Elgen1, Kristian Sommerfelt, Bjørn Ellertsen
1Department of Pediatrics, University of Bergen, Bergen, Norway.
Insights
Low birth weight children show comparable cognitive functions to peers when parental factors are controlled. However, early motor or verbal issues in these children increase later school problem risks.
Area of Science:
- Neuroscience
- Developmental Psychology
- Pediatrics
Background:
- Low birth weight (LBW) is a significant risk factor for adverse neurodevelopmental outcomes.
- Understanding cognitive trajectories and predictors in LBW children is crucial for early intervention.
Purpose of the Study:
- To evaluate cognitive functions and their changes over time in LBW children.
- To identify prenatal, perinatal, and neonatal predictors of cognitive outcomes and school performance in LBW children.
Main Methods:
- A cohort study comparing 130 LBW children with 131 controls.
- Neuropsychological testing (Wechsler Intelligence Scale for Children-Revised, Illinois Test of Psycholinguistic Abilities, etc.) and school performance assessment (Child Behavior Check List).
Main Results:
- LBW children demonstrated comparable verbal, visuo-spatial, distractibility, and motor tempo functions to controls after accounting for parental factors.
- Breast milk feeding association with intelligence quotient (IQ) became insignificant after controlling for confounding parental factors.
- No significant prenatal, perinatal, or neonatal predictors related to cognitive outcome or school problems at age 11.
- Motor problems and low verbal IQ at age 5 in LBW children doubled the risk of school problems at age 11.
Conclusions:
- LBW children's cognitive outcomes are largely comparable to controls when parental influences are considered.
- Cognitive tests may not reliably predict school problems in LBW children, highlighting the importance of early identified developmental issues.
Abstract:
The objective of this study was to evaluate cognitive functions, changes over time, and prenatal, perinatal, and neonatal predictors in low birth weight children. A cohort of 130 low birth weight children was compared with 131 control children. A neuropsychologic test battery including subtests from the Wechsler Intelligence Scale for Children-Revised and the Illinois Test of Psycholinguistic Abilities, Knox Cube Test, Grooved Pegboard Test, Finger, and Foot Tapping was used. School performance was assessed using the Child Behavior Check List. Low birth weight children were comparable with control children in areas of verbal and visuo-spatial function, distractibility, and motor tempo, when parental factors were controlled for. An apparent association between breast milk feeding and child intelligence quotient was rendered insignificant when confounding parental factors were controlled for. None of the other identifiable prenatal, perinatal, or neonatal predictors were significantly related to cognitive outcome or school problems at 11 years of age. No differences were found in cognitive functions between those weighing less than 1500 g and 1500-2000 g. Motor problems and low verbal intelligence quotient at 5 years of age in the low birth weight children (previously published data) each doubled the risk of presenting a school problem at 11 years of age. Our findings are encouraging for low birth weight children regarding testable cognitive consequences and less encouraging regarding ability of cognitive test to identify school problems.
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