Change in cognitive abilities over time during preschool age in low risk preterm children
Barbara Caravale1, Nadia Mirante, Cristina Vagnoni
1Department of Medical and Surgical Neonatology, Children's Hospital Bambino Gesù, Research Hospital, Piazza Sant'Onofrio 4, 00165, Rome, Italy. bcaravale@libero.it
Insights
Low-risk preterm infants show lasting deficits in visual-motor and perceptual skills by age five. These children, even without neurological impairment, benefit from extended follow-up programs.
Area of Science:
- Developmental Pediatrics
- Neuropsychology
- Perinatal Medicine
Background:
- Neurological outcomes for 'low-risk' preterm infants require further investigation.
- Understanding long-term development is crucial for including these infants in follow-up programs until school age.
Purpose of the Study:
- To assess the neuropsychological development of low-risk, low birth weight (LBW) children without neurological impairment from birth to five years.
- To identify specific areas of cognitive and motor function that may be affected in this cohort.
Main Methods:
- A cohort of 26 preterm infants (30-34 weeks gestation) without major neurological disabilities was compared to 23 term-born controls.
- Neuropsychological assessments were conducted at 3 and 5 years of age, evaluating visual-motor integration, visual perception, language, and attention.
Main Results:
- At 5 years, preterm children scored significantly lower in visual motor integration (p=0.01) and visual perception (p=0.002) compared to controls.
- A trend toward lower scores was observed in a picture vocabulary test (p=0.07).
- Preterm children required more time (5 years) to reach performance levels achieved by term-born children at 3 years in some skills.
Conclusions:
- Even 'low-risk' preterm infants demonstrate persistent deficits in visual-motor, perceptual, and some language skills up to age five.
- These findings support the need for regular, long-term follow-up programs for all preterm infants, regardless of initial risk status.
Background:
More information is needed on 'low-risk' preterm infants' neurological outcome so that they can be included in follow-up programs at least until school age.
Objective:
To examine the neuropsychological outcome in a group of low-risk low birth weight (LBW) children without neurological impairment followed from birth to 5 years of age.
Patients:
26 intellectually normal children born preterm (30-34 weeks gestation) without major neurological disabilities and 23 control children born at term and matched for age, sex, and parental educational and occupational status.
Methods:
Subjects already evaluated at 3 years of age underwent assessment again at 5 years using as neuropsychological outcome measures a wide range of tests including perceptual and visual-motor function, language comprehension and expression, and attention skills.
Results:
When tested at 5 years, children born preterm still obtained significantly lower mean scores than controls on visual motor integration test (57 vs 64, p=0.01), visual perception test (41 vs 43, p=0.002) and a trend toward a lower score in the picture vocabulary test (81 vs 85.5, p=0.07). The group of premature infants and controls improved their performance over time in the neuropsychological abilities investigated and, in some skills such as visual perception. Children born preterm took longer than those born at term to reach similar performance levels, 5 versus 3 years.
Conclusion:
Ex low-risk children born preterm achieve lower scores over time in visual-motor and perceptual ability scales and in some language tests than children born at term. Like high-risk premature infants even those at low risk deserve regular follow-up with long-term programs.
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