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Executive Functions and Academic Outcomes of Low Birthweight Infants: A Prospective Longitudinal U.S. Cohort

Sarah E Miller1, Mark D DeBoer2, Rebecca J Scharf3

  • 1Division of Neonatology, Department of Pediatrics, University of Virginia Children's Hospital, Charlottesville, Virginia.

American Journal of Perinatology
|December 31, 2019
PubMed

Insights

Children born with low birthweight (LBW) face lasting cognitive challenges, impacting academic success. Early executive function deficits in LBW infants heighten the risk for later academic difficulties.

Area of Science:

  • Developmental Psychology
  • Pediatrics
  • Cognitive Neuroscience

Background:

  • Executive functions, including working memory and cognitive flexibility, are crucial for lifelong learning and academic achievement.
  • Low birthweight (LBW), defined as weight < 2,500 grams, is a potential risk factor for developmental and cognitive outcomes.
  • Children with impaired executive functioning are at higher risk for poor academic performance.

Purpose of the Study:

  • To investigate the long-term cognitive outcomes of children born with low birthweight (LBW).
  • To examine the relationship between LBW and executive functions (working memory, cognitive flexibility) from kindergarten through second grade.
  • To assess the risk of poor academic outcomes associated with early executive functioning deficits in LBW children.

Main Methods:

  • Analysis of prospective data from 12,656 children in the Early Childhood Longitudinal Study (Kindergarten Class 2010-2011).
  • Assessment of academic and executive function outcomes at kindergarten, first, and second grade.
  • Application of multivariable linear and logistic regression models to evaluate birthweight and executive function associations with academic performance.

Main Results:

  • Children born LBW exhibited significantly lower mean z-scores for academic and executive functions compared to normal birthweight peers.
  • LBW children had an increased risk of scoring in the lowest 20% for second-grade reading (OR=1.60), math (OR=1.49), and science (OR=1.41).
  • LBW was associated with higher odds of deficits in cognitive flexibility (OR=1.61) and working memory (OR=1.40).

Conclusions:

  • Low birthweight infants are at persistent risk for diminished cognitive outcomes extending into second grade.
  • Early-onset executive functioning difficulties in LBW children predict increased risk for academic underachievement later in childhood.
  • Interventions targeting executive function development in LBW infants may be critical for improving long-term academic trajectories.
Abstract

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