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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
[Pre-school cognitive development of very low birth weight preterm children]
Maria Dalva B B Meio1, Claudia S Lopes, Denise S Morsch
1Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ. mdmeio@centroin.com.br
Insights
Children born preterm with very low birthweight showed significantly lower cognitive scores. These results suggest potential learning difficulties, highlighting the need for early family and school support.
Area of Science:
- Developmental Psychology
- Neonatal Medicine
- Pediatric Neurology
Context:
- Premature birth and very low birthweight (VLBW) are associated with increased risks for neurodevelopmental challenges.
- Early cognitive assessment is crucial for identifying children who may require additional support.
- Understanding long-term cognitive outcomes informs interventions for at-risk populations.
Purpose:
- To investigate the cognitive development of school-aged children born preterm with VLBW.
- To compare cognitive performance between VLBW children and a term-born control group.
- To identify potential learning difficulties in this vulnerable population.
Summary:
- A cohort of 79 children born preterm with VLBW (mean birthweight 1,219.6 g) were assessed using the WPPSI-R Test.
- Significant differences in total, verbal, and performance scores were observed compared to a term-born control group.
- The VLBW group exhibited borderline intellectual functioning, indicating potential academic challenges.
Impact:
- Findings underscore the need for targeted educational and familial support for preterm VLBW children.
- Early identification of cognitive deficits can guide the development of tailored intervention strategies.
- This research contributes to understanding the long-term neurodevelopmental sequelae of extreme prematurity and low birthweight.
Objective:
To examine the cognitive development of school-aged children born preterm and with very low birthweight.
Methods:
A cohort of premature infants born between January, 1991, and September, 1993 was examined at pre-school age. All of them were born in a public Neonatal Intensive Care Unit, with birth weight less than 1,500 g. The WPPSI-R Test was used for cognitive evaluation and applied by psychologists. Babies with malformations, genetic syndromes, congenital infections, transferred from other institutions or born at home, and those with conditions which precluded the application of the test were excluded. A group of pre-school children in the same city, born at term, were tested for comparison.
Results:
79 children were studied, with mean birthweight 1,219.6 g (+/-168.9); of these, 44 (72.1%) attended school. No significant statistical difference was found between the groups (study and loss). The WPPSI-R Test mean scores were: 75.6+/-11.9 (total); 77+/-12.9 (performance) and 78.6+/-11.1 (verbal) for the study group, and 85.1+/-13.2 (total); 85.3+/-13.8 (performance) and 87.7+/-13.9 (verbal) for the comparison group. This difference was significant for total (p < 0.0001), verbal (p < 0.0001) and performance scores (p = 0.002), as well as for the subtests of the WPPSI-R Test.
Conclusions:
The children who entered this study had borderline intellectual functioning at the moment of the evaluation. Results indicate that they may face learning difficulties at school, thus requiring adequate stimuli that should be provided by the family and the school.
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