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Association of Gestational Age With Verbal Ability and Spatial Working Memory at Age 11
Alyssa Fitzpatrick1, Jennifer Carter2, Maria A Quigley3
1Nuffield Department of Population Health, University of Oxford, United Kingdom.
Insights
Children born very preterm show working memory deficits at 11 years old. However, moderate preterm birth and later term births do not significantly impact cognitive outcomes, suggesting potential catch-up effects for verbal skills.
Area of Science:
- Developmental neuroscience
- Pediatric cognitive assessment
- Perinatal health outcomes
Background:
- Children born very preterm (<32 weeks gestation) face higher risks of cognitive impairment than full-term infants.
- Cognitive risks for moderate preterm (32-33 weeks), late preterm (34-36 weeks), and early term (37-38 weeks) births remain less understood.
- This study investigates the link between gestational age and cognitive function at 11 years, tracking verbal ability development from age 3.
Purpose of the Study:
- To determine the relationship between gestational age and cognitive outcomes at 11 years.
- To analyze the trajectory of verbal ability deficits from age 3 to 11 years.
- To compare cognitive performance across different preterm and early term birth categories with full-term births.
Main Methods:
- Utilized the UK Millennium Cohort Study data (n > 11,000).
- Assessed cognitive abilities using Spatial Working Memory (Cambridge Neuropsychological Test Automated Working Battery) and Verbal Similarities (British Ability Scales).
- Compared gestational age groups to full-term controls using z scores and odds ratios for developmental delay (≥1 SD below the mean).
Main Results:
- Very preterm and moderately preterm children had significantly lower working memory scores compared to full-term children (adjusted differences -0.2 to -0.6).
- These preterm groups also showed a higher likelihood of working memory delay.
- No significant associations were found between late preterm/early term birth and working memory, nor between gestational age and verbal ability at 11 years.
Conclusions:
- Working memory deficits persist at 11 years for very preterm children.
- Earlier verbal delays in preterm children may resolve by age 11, indicating potential "catch-up" effects.
- Gestational age appears to have a diminishing impact on cognitive outcomes as children age.
Background:
Although children born very preterm (gestation <32 weeks) have an increased risk of cognitive impairment compared with full-term children (39-41 weeks), the risk for children born moderately (32-33 weeks) to late preterm (34-36 weeks) and early term (37-38 weeks) is unclear. This study describes the relationship between gestational age and cognitive outcomes at 11 years and the trajectory of deficits in verbal ability from age 3 to 11 years.
Methods:
Cognitive ability was assessed by using the Spatial Working Memory test from the Cambridge Neuropsychological Test Automated Working Battery (n = 11 395) and British Ability Scale Verbal Similarities test (n = 11 889) in the UK Millennium Cohort Study. Each gestational group was compared with the full-term group by using differences in z scores and odds ratios for delay (scoring ≥1 SD below the mean).
Results:
Very and moderately preterm children demonstrated significantly lower working memory scores compared with full-term children (adjusted difference -0.2 to -0.6) and were more likely to be delayed. There was no significant relationship between late-preterm or early-term birth and working memory (adjusted differences < -0.1), or between gestational age and verbal ability at 11 years. There appears to be a general attenuation in odds ratios as the child ages.
Conclusions:
Very preterm children exhibited working memory deficits at 11 years. However, the absence of delayed verbal skills at 11 years despite earlier delays could indicate "catch-up" effects.
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