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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Neuro-cognitive performance of very preterm or very low birth weight adults at 26 years
Suna Eryigit Madzwamuse1, Nicole Baumann1, Julia Jaekel1,2
1Department of Psychology, University of Warwick, Coventry, UK.
Insights
Adults born very preterm or with very low birth weight (VP/VLBW) experience persistent cognitive deficits, including lower IQ and executive functioning (EF). Family socioeconomic status (SES) significantly impacts cognitive performance in both VP/VLBW and term-born individuals.
Area of Science:
- Developmental Neuroscience
- Cognitive Psychology
- Longitudinal Cohort Studies
Background:
- Children born very preterm (VP <32 weeks gestation) and/or with very low birth weight (VBLW <1500 g), termed VP/VLBW, are at higher risk for cognitive impairment.
- Previous research indicated executive functioning (EF) problems in childhood, but persistence into adulthood remained unclear.
- The study investigated the long-term cognitive outcomes of VP/VLBW individuals, considering factors like smallness for gestational age (SGA) and socioeconomic status (SES).
Purpose of the Study:
- To assess general intelligence (IQ) and executive functioning (EF) in adults born VP/VLBW compared to term-born controls.
- To examine the influence of smallness for gestational age (SGA) on cognitive outcomes.
- To investigate the impact of family socioeconomic status (SES) at birth on adult cognitive performance.
Main Methods:
- Utilized data from the Bavarian Longitudinal Study, a prospective cohort of neonatal at-risk children born in 1985/86.
- Assessed 217 VP/VLBW individuals and 197 controls using a comprehensive battery of IQ and EF tests at 26 years of age.
- Analyzed the effects of SGA and family SES on cognitive performance.
Main Results:
- VP/VLBW adults demonstrated significantly lower scores in IQ and EF compared to controls, with a 1.16 standard deviation (SD) difference in Full-Scale IQ.
- Cognitive deficits in VP/VLBW adults were characterized as general and multiple, rather than specific to EF.
- Family SES significantly impacted general intelligence in both VP/VLBW and control groups, showing a 1.13 SD difference between high and low SES.
Conclusions:
- Cognitive deficits observed in childhood among VP/VLBW individuals persist into adulthood, with no evidence of narrowing the gap compared to term controls.
- VP/VLBW adults do not overcome their cognitive challenges, even with childhood special educational support.
- Low family SES at birth has a similar, additive adverse effect on cognitive performance for both VP/VLBW and term-born offspring.
Background:
Children born very preterm (VP <32 weeks gestation) and/or with very low birth weight (VBLW <1500 g; subsequently VP/VLBW) have been previously reported to have more cognitive impairment and specific executive functioning problems than term children; however, it remains unclear whether these problems persist into adulthood. This study aimed to examine general intelligence (IQ) and executive functioning (EF) of adults born VP/VLBW in comparison to term controls. Additionally, the effects of smallness for gestational age (SGA) and family socioeconomic status (SES) at birth were investigated.
Methods:
The Bavarian Longitudinal Study is a geographically defined prospective cohort study of neonatal at-risk children born in 1985/86 in Southern Germany. A total of 217 VP/VLBW and 197 controls completed the battery of IQ and EF tests at 26 years of age.
Results:
VP/VLBW adults scored significantly lower than controls in IQ and EF. There was a 1.16 standard deviation (SD) unit difference between the VP/VLBW and controls in Full-Scale IQ. VP/VLBW adults were found to have general and multiple cognitive problems rather than specific deficits in EF. SGA was not a significant predictor of cognitive impairment. Family SES had a significant impact on general intelligence in both VP/VLBW and term controls. The SES effects amounted to 1.13 SD units between individuals born into high versus low SES.
Conclusions:
No narrowing of cognitive deficits between VP/VLBW and term control adults to previous childhood assessments at 6 years of age was found. VP/VLBW adults do not outgrow their cognitive problems despite many receiving special educational support in childhood. Low family SES at birth has similar additive adverse effects on cognitive performance in VP/VLBW and term offspring.
