Visuospatial and verbal fluency relative deficits in 'complicated' late-preterm preschool children
Ida Sue Baron1, Kristine Erickson, Margot D Ahronovich
1Department of Pediatrics, Inova Fairfax Hospital for Children, 3300 Gallows Road, Falls Church, Virginia 22042, USA. ida@isbaron.com
Insights
Late-preterm birth is linked to subtle neuropsychological deficits in preschoolers, particularly in visuospatial skills and executive function. Early evaluation is recommended for these children to identify potential developmental delays.
Area of Science:
- Neuroscience
- Developmental Psychology
- Pediatrics
Background:
- Late-preterm (LPT) birth (34-36 weeks gestation) accounts for the majority of preterm deliveries.
- Immature brain development in LPT infants is associated with increased morbidity risks.
- Limited data exist on LPT children's neuropsychological outcomes in preschool years.
Purpose of the Study:
- To assess general cognition, attention, memory, language, motor skills, and executive functions in preschoolers born late-preterm (LPT) who required NICU admission.
- To compare these outcomes with those of healthy, term-born children.
Main Methods:
- A single-center retrospective cohort study involved 95 three-year-old children.
- The study compared 60 LPT children admitted to the NICU with 35 healthy term-born controls.
- Participants were born between 2004-2005.
Main Results:
- LPT birth was associated with significant deficits in visuospatial function (p=.005) and visuomotor skills (p=.012).
- Executive functions, specifically noun (p=.018) and action-verb (p=.026) fluency, also showed relative deficits.
- No significant differences were found in attention/working memory, language, nonverbal reasoning, or manual coordination.
Conclusions:
- Late-preterm birth is associated with subtle, selective negative neuropsychological sequelae.
- Visuospatial function appears particularly vulnerable in LPT children by preschool age.
- Verbal fluency may serve as an early predictor of executive dysfunction, supporting routine neuropsychological screening for LPT children.
Background:
Late-preterm children constitute a majority of all preterm deliveries (75%). Their immature brain development at birth has been associated with an increased risk for morbidities. Data have been sparse regarding neuropsychological outcomes in the preschool years.
Aim:
To examine general cognition, attention/working memory, language, manual coordination/motor dexterity, visuomotor, visuospatial, and executive functions in preschoolers born late-preterm (LPT; 34-36 gestational weeks) who required NICU admission compared to term-born participants.
Design:
Single-center retrospective cohort study of 95 three-year-old children; 60 born LPT in 2004-2005 and admitted to the NICU compared to 35 healthy term-born participants born > or =37 gestational weeks and > or =2500 g.
Results:
LPT birth was associated with visuospatial (p=.005), visuomotor (p=.012), and executive function (noun [p=.018] and action-verb [p=.026] fluency) relative deficits, but not attention/working memory, receptive or expressive language, nonverbal reasoning, or manual coordination/dexterity deficit.
Conclusions:
Late-preterm birth is likely to be associated with negative neuropsychological sequelae, although subtle and selective compared to effects reported for children born at an earlier gestational age. Visuospatial function appears to be especially vulnerable to disruption even at preschool age, and verbal fluency may be useful as an early predictor of executive dysfunction in childhood. Routine preschool neuropsychological evaluation is recommended to identify delay or deficit in LPT children preparing for school entry, and may highlight underlying vulnerable neural networks in LPT children.
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