Related Experiment Video
Updated: Jun 25, 2026
Modeling Encephalopathy of Prematurity Using Prenatal Hypoxia-ischemia with Intra-amniotic Lipopolysaccharide in Rats
Published on: November 20, 2015
Lasting effects of preterm birth and neonatal brain hemorrhage at 12 years of age
Thuy Mai Luu1, Laura R Ment, Karen C Schneider
1Women and Infants Hospital, Department of Pediatrics, 101 Dudley St, Providence, RI 02905, USA.
Insights
Preterm children born in the early 1990s show significant neurodevelopmental deficits and require more educational support by age 12. Severe neonatal brain injury is a key predictor of poorer cognitive outcomes in these children.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Child Psychology
Background:
- Preterm birth is associated with increased risks for neurodevelopmental impairments.
- Early 1990s cohort studies provide crucial long-term follow-up data on preterm infants.
- Understanding the impact of neonatal factors on later outcomes is vital for intervention.
Purpose of the Study:
- To compare cognitive, language, behavioral, and educational outcomes of preterm children versus term-born controls at 12 years of age.
- To assess the influence of neonatal brain injury, indomethacin treatment, and environmental factors on intellectual function.
- To identify predictors of neurodevelopmental outcomes in a cohort of very low birth weight preterm infants.
Main Methods:
- Longitudinal study evaluating 375 preterm children (birth weight 600-1250g) from the Indomethacin Intraventricular Hemorrhage Prevention Trial and 111 controls.
- Neuropsychometric testing (Wechsler Scales, Clinical Evaluation of Language Fundamentals) and neurologic examinations were performed at 12 years.
- Severe neonatal brain injury was defined by cranial ultrasound findings (IVH, PVL, ventriculomegaly).
Main Results:
- Preterm children scored 6-14 points lower on IQ tests and exhibited more language and behavior problems than controls.
- Severe neonatal brain injury was the strongest predictor of lower intellectual function.
- Preterm children, particularly those with brain injury, required significantly more school services and academic support.
Conclusions:
- Preterm children born in the early 1990s exhibit significant neurodevelopmental deficits by age 12.
- Severe neonatal brain injury is a critical factor influencing long-term neuropsychological outcomes.
- These deficits lead to increased educational service needs, highlighting the importance of early intervention and support.
Objectives:
Our goals were to compare cognitive, language, behavioral, and educational outcomes of preterm children to term controls and to evaluate the impact of neonatal brain injury, indomethacin, and environmental risk factors on intellectual function at 12 years of age.
Methods:
A total of 375 children born in 1989-1992 with birth weights of 600 to 1250 g enrolled in the Indomethacin Intraventricular Hemorrhage Prevention Trial and 111 controls were evaluated. Neuropsychometric testing, neurologic examination, and interviews on educational needs were completed. Severe brain injury was defined as the presence of grade 3 to 4 indomethacin intraventricular hemorrhage, periventricular leukomalacia, or severe ventriculomegaly on cranial ultrasound.
Results:
On the Wechsler Scales of Intelligence for Children, the preterm cohort obtained a full-scale IQ of 87.9 +/- 18.3, verbal IQ of 90.8 +/- 18.9, and performance IQ of 86.8 +/- 17.9. Preterm children obtained scores 6 to 14 points lower than term controls on all psychometric tests after adjustment for sociodemographic factors. On the Clinical Evaluation of Language Fundamentals (test of basic language skills), 22% to 24% of preterm children scored in the abnormal ranges (<70) as opposed to 2% to 4% of controls. Preterm children with and without brain injury required more school services (76% and 44% vs 16%), and support in reading (44% and 28% vs 9%), writing (44% and 20% vs 4%), and mathematics (47% and 30% vs 6%) compared with controls. Preterm children also displayed more behavior problems than their term counterparts. Severe neonatal brain injury was the strongest predictor of poor intelligence. Antenatal steroids, higher maternal education, and 2-parent family were associated with better cognition, whereas minority status incurred a disadvantage. Indomethacin did not affect intellectual function among preterm children.
Conclusions:
Preterm children born in the early 1990s, especially those with severe brain injury, demonstrate serious deficits in their neuropsychological profile, which translates into increased use of school services at 12 years.
