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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Do healthy preterm children need neuropsychological follow-up? Preschool outcomes compared with term peers
Anna M Dall'oglio1, Barbara Rossiello, Maria F Coletti
1Unit of Clinical Psychology, Department of Neurosciences, Bambino Gesù Paediatric Hospital, Rome, Italy. amdalloglio@opbg.net
Insights
Healthy preterm children show lower cognitive and neuropsychological scores compared to term-born peers. Early follow-up is crucial for identifying challenges and planning interventions to support academic success.
Area of Science:
- Developmental Psychology
- Neuroscience
- Pediatrics
Background:
- Preterm birth (<33 weeks gestational age) can impact cognitive and neuropsychological development.
- Early identification of developmental differences is crucial for timely intervention.
- Maternal education is a known factor influencing child development.
Purpose of the Study:
- To assess neuropsychological performance in preschool-aged preterm children.
- To examine the relationship between neuropsychological outcomes, cognitive development, and maternal education.
- To identify potential academic difficulties in healthy very preterm children.
Main Methods:
- A cohort of 35 very preterm children and 50 term-born controls were assessed at 4 years of age.
- Cognitive development was measured using the Griffiths Mental Development Scales.
- Neuropsychological functions (language, memory, visuospatial skills) were evaluated using standardized tests, with analyses adjusted for cognitive level and maternal education.
Main Results:
- Preterm children had significantly lower overall cognitive scores (Griffiths scale) than term-born children.
- Preterm children exhibited lower performance in most neuropsychological tests, including verbal fluency, comprehension, short-term memory, and spatial abilities, even after adjustments.
- Maternal university education was associated with higher cognitive scores.
Conclusions:
- Healthy very preterm children demonstrate specific neuropsychological deficits compared to term-born peers.
- Neuropsychological follow-up is recommended for very preterm children before school entry.
- Interventions should be planned to address identified strengths and challenges, aiming to optimize academic outcomes.
Aim:
the aim of this study was to determine neuropsychological performance (possibly predictive of academic difficulties) and its relationship with cognitive development and maternal education in healthy preterm children of preschool age and age-matched comparison children born at term.
Method:
a total of 35 infants who were born at less than 33 weeks' gestational age and who were free from major neurosensory disability (16 males, 19 females; mean gestational age 29.4wk, SD 2.2wk; mean birthweight 1257g, SD 327g) and 50 term-born comparison children (25 males, 25 females; mean birthweight 3459g, SD 585g) were assessed at 4 years of age. Cognition was measured using the Griffiths Mental Development scales while neuropsychological abilities (language, short-term memory, visual-motor and constructive spatial abilities, and visual processing) were assessed using standardized tests. Multivariable regression analysis was used to explore the effects of preterm birth and sociodemographic factors on cognition, and to adjust neuropsychological scores for cognitive level and maternal education.
Results:
the mean total Griffiths score was significantly lower in preterm than in term children (97.4 vs 103.4; p<0.001). Factors associated with higher Griffiths score were maternal university education (β=6.2; 95% confidence interval [CI] 0.7-11.7) and having older siblings or a twin (β=4.0; 95% CI 0.5-7.6). At neuropsychological assessment, preterm children scored significantly lower than term comparison children in all tests except lexical production (Boston Naming Test) and visual-processing accuracy. After adjustment for cognitive level and maternal education, differences remained statistically significant for verbal fluency (p<0.05) and comprehension, short-term memory, and spatial abilities (p<0.01).
Interpretation:
neuropsychological follow-up is also recommended for healthy very preterm children to identify strengths and challenges before school entry, and to plan interventions aimed at maximizing academic success.
