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Trends in Executive Functioning in Extremely Preterm Children Across 3 Birth Eras
Alice C Burnett1,2,3,4, Peter J Anderson5,2,6, Katherine J Lee2,7
1Premature Infant Follow-Up Program and alice.burnett@mcri.edu.au.
Pediatrics
|December 3, 2017
Summary
Extremely preterm or low birth weight children show worsening executive dysfunction over time. This trend, particularly in working memory and planning, may impact academic and social development.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Child Psychology
Background:
- Extremely preterm (EP) and extremely low birth weight (ELBW) children face risks for neurodevelopmental challenges.
- Executive functioning is crucial for academic and social success.
- Previous studies suggest executive dysfunction in EP/ELBW survivors, but trends over time require investigation.
Purpose of the Study:
- To compare executive functioning outcomes at school age between extremely preterm/extremely low birth weight children and term-born peers across different birth eras (1991-1992, 1997, 2005).
- To identify trends in executive dysfunction among EP/ELBW survivors over time.
Main Methods:
- Population-based cohorts of EP/ELBW survivors and matched term-born controls from Victoria, Australia, were studied.
- Parents rated executive functioning using the Behavior Rating Inventory of Executive Function (BRIEF) when children were 7-8 years old.
- Logistic regression analyzed differences in elevated BRIEF scores between groups and eras, with sensitivity analyses excluding intellectual impairment.
Main Results:
- EP/ELBW children consistently demonstrated higher rates of executive dysfunction across most BRIEF domains compared to controls.
- A significant increase in executive dysfunction was observed in the 2005 EP/ELBW cohort, particularly affecting working memory and planning/organization.
- This trend persisted after controlling for demographic factors and remained evident even when excluding children with intellectual impairment.
Conclusions:
- A concerning trend of increasing executive dysfunction is evident in more recently born extremely preterm/extremely low birth weight children.
- This escalating executive dysfunction may negatively impact academic achievement and social-emotional well-being.
- Longitudinal monitoring and targeted interventions are crucial for this vulnerable population.
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