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Neurodevelopmental outcome in preterm infants
1Division of Neonatology, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. a.f.bos@bkk.umcg.nl
Insights
Preterm children show cognitive and motor score distributions shifted leftward compared to norms, indicating developmental delays. Brain lesions and gestational age did not influence these outcomes in this cohort.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Child Psychology
Background:
- Preterm birth is associated with increased risks for neurodevelopmental impairments.
- Understanding the specific cognitive and motor deficits in very preterm children is crucial for early intervention.
Purpose of the Study:
- To determine the distribution of cognitive and motor scores in very preterm children at school age.
- To investigate the influence of brain lesions and decreasing gestational age on these outcomes.
Main Methods:
- One hundred and six very preterm children (gestational age 24.0-31.6 wk) were assessed between 6 to 12 years.
- Cognitive function was evaluated using the Wechsler Intelligence Scale for Children (IQ).
- Motor outcome was assessed with the Movement Assessment Battery for Children (Movement ABC).
Main Results:
- Cognitive and motor scores were normally distributed but shifted leftward, indicating lower-than-average performance.
- Mean total IQ was 0.60 SD below norm, with verbal and performance IQs also significantly lower.
- Movement ABC z-scores were -1.27 SD below norm, indicating motor impairments.
Conclusions:
- Very preterm children exhibit a leftward shift in cognitive and motor outcome distributions at school age.
- The observed effect sizes suggest significant developmental disadvantages for preterm individuals.
- No correlation was found between brain lesions or gestational age and the cognitive/motor scores in this study group.
Aim:
To determine the distribution of cognitive and motor scores in preterm children, and to establish the influence of brain lesions and decreasing gestational age thereon.
Method:
One hundred and six very preterm children (63 males, 43 females; gestational age 24.0-31.6 wk; birthweight 480-2275 g) were assessed for cognition and motor outcome at 6 to 12 years. We assessed total, verbal, and performance IQ using the Wechsler Intelligence Scale for Children, and motor outcome using the Movement Assessment Battery for Children (Movement ABC).
Results:
The IQs and Movement ABC z-scores were normally distributed, but shifted to the left. Mean total IQ (SD) was 91 (12), performance IQ 89 (13), and verbal IQ 93 (15), being 0.60, 0.73, and 0.47 SD lower than the norm respectively. Movement ABC z-scores were -1.27 SD lower (SD 1.01). IQ and Movement ABC z-scores did not correlate with brain lesions or gestational age.
Interpretation:
The distribution curve for cognition and motor outcome at school age is shifted to the left in preterm children, with an effect size of 0.60 SD for IQ (nine IQ points) and 1.27 SD for motor outcome. These findings are restricted to the current group. Developmental disruptions, affecting cerebral white matter, cortex, cerebellum, and thalamus might be involved, although the exact pathogenetic mechanism is unclear.
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