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Cognitive outcomes for extremely preterm/extremely low birth weight children in kindergarten

Leah J Orchinik1, H Gerry Taylor, Kimberly Andrews Espy

  • 1Department of Psychology, Case Western Reserve University, Cleveland, Ohio, USA.

Journal of the International Neuropsychological Society : JINS
|September 20, 2011
PubMed

Insights

Extremely preterm/extremely low birth weight (EPT/ELBW) children show significant cognitive deficits at school entry. These deficits are linked to early risk factors, neurodevelopmental issues, and socioeconomic status, highlighting the need for early intervention.

Area of Science:

  • Neonatal and Developmental Pediatrics
  • Cognitive Neuroscience
  • Public Health

Background:

  • Extremely preterm/extremely low birth weight (EPT/ELBW) infants face increased risks for developmental challenges.
  • Cognitive outcomes at school age for this vulnerable population require further investigation.
  • Understanding associations with neonatal factors and socioeconomic status (SES) is crucial for targeted support.

Purpose of the Study:

  • To assess cognitive outcomes in kindergarten-aged EPT/ELBW children.
  • To explore the relationship between cognitive deficits and neonatal factors, early neurodevelopmental impairment, and SES.
  • To identify specific areas of cognitive vulnerability in EPT/ELBW survivors.

Main Methods:

  • A hospital-based birth cohort study comparing 148 EPT/ELBW children (gestational age <28 weeks and/or birth weight <1000 g) with 111 term-born normal birth weight (NBW) controls.
  • Comprehensive cognitive testing in kindergarten, including measures of response inhibition, executive function, and motor/perceptual-motor abilities.
  • Statistical analysis controlling for background factors, neonatal risks, early neurodevelopmental impairment, and SES.

Main Results:

  • EPT/ELBW children exhibited pervasive cognitive deficits compared to NBW controls, with 3-6 times higher rates of deficits.
  • Significant impairments in response inhibition (48% vs. 10%), executive function, and motor skills were observed, even after accounting for verbal knowledge.
  • Neonatal risk factors, early neurodevelopmental impairment, and lower SES were associated with increased cognitive deficits within the EPT/ELBW group.

Conclusions:

  • EPT/ELBW children experience global and selective cognitive deficits upon school entry.
  • Early identification and intervention are warranted to mitigate the long-term impact of these deficits.
  • The findings underscore the importance of considering neonatal history, developmental trajectory, and socioeconomic context in managing EPT/ELBW children.

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