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Published on: May 23, 2011
Neurocognitive function of 10-year-old multiples born less than 28 weeks of gestational age
J Wells Logan1, Elizabeth N Allred2,3, Michael E Msall4
1Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, USA. JWells.Logan@NationwideChildrens.org.
Insights
Children born from multiple births (twins, triplets, etc.) showed similar neurocognitive and academic performance compared to singletons when born extremely preterm. No evidence suggests poorer outcomes for these children in early development.
Area of Science:
- Neonatal Medicine
- Developmental Psychology
- Pediatric Neurology
Background:
- Extremely preterm birth (before 28 weeks gestation) poses risks to neurocognitive development.
- The impact of birth plurality (twins, triplets, etc.) on neurocognitive outcomes in extremely preterm children is not well-understood.
Purpose of the Study:
- To compare neurocognitive and academic function at age 10 years between children born from multifetal pregnancies and singleton controls, all born extremely preterm.
- To investigate potential differences in specific domains of neurocognitive function, including executive function, intelligence, language, and academic achievement.
Main Methods:
- A cohort study evaluated 874 children born before 28 weeks gestation at age 10 years.
- Neurocognitive function and academic achievement were assessed using 18 standardized tests.
- Statistical analyses adjusted for potential confounding factors to compare outcomes between children from multifetal pregnancies (twins, triplets, septuplets) and singletons.
Main Results:
- Children from multifetal pregnancies performed significantly better on one executive function subtest compared to singletons.
- No significant differences were observed in intelligence, language, academic achievement, processing speed, visual perception, or fine motor skills between the groups.
- Overall neurocognitive and academic performance was comparable between children born from multifetal pregnancies and singletons.
Conclusions:
- Children born from multifetal pregnancies who were extremely preterm do not exhibit worse neurocognitive or academic function at age 10 compared to their singleton peers.
- These findings suggest that extreme prematurity, rather than birth plurality, is a primary determinant of neurocognitive outcomes in this population.
- Further research may explore the specific factors contributing to executive function differences in multifetal pregnancies.
Introduction:
Few studies have examined the relationship between birth plurality and neurocognitive function among children born extremely preterm.
Study Design:
We compared rates of Z-scores ≤-2 on 18 tests of neurocognitive function and academic achievement at age 10 years in 245 children arising from twin pregnancies, 55 from triplet pregnancies, and 6 from a septuplet pregnancy to that of 568 singletons, all of whom were born before the 28th week of gestation.
Results:
In total, 874 children were evaluated at the age of 10 years. After adjusting for confounders, children of multifetal pregnancies performed significantly better on one of six subtests of executive function than their singleton peers. Performance was similar on all other assessments of intelligence, language, academic achievement, processing speed, visual perception, and fine motor skills.
Conclusion:
We found no evidence that children born of multifetal pregnancies had worse scores than their singleton peers on assessments of neurocognitive and academic function.
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