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Neuropsychological Outcomes at 19 Years of Age Following Extremely Preterm Birth
Helen O'Reilly1,2, Samantha Johnson3, Yanyan Ni4
1Institute for Women's Health, University College London, London, United Kingdom; h.o'reilly@ucl.ac.uk.
Insights
Young adults born extremely preterm (EP) show lasting cognitive and neuropsychological deficits compared to term-born peers. The rate of intellectual impairment in EP individuals increased from childhood into early adulthood.
Area of Science:
- Neuroscience
- Developmental Psychology
- Pediatrics
Background:
- Children born extremely preterm (<26 weeks' gestation) exhibit lower cognitive scores and higher rates of impairment than term-born individuals.
- The long-term neuropsychological outcomes in adulthood for extremely preterm individuals remain under-described.
Purpose of the Study:
- To assess neuropsychological outcomes in early adulthood for individuals born extremely preterm (EP).
- To longitudinally investigate changes in intellectual impairment rates from childhood to adulthood in the 1995 EPICure cohort.
Main Methods:
- A neuropsychological assessment was conducted at 19 years of age on 127 extremely preterm (EP) young adults and 64 term-born controls.
- Evaluated domains included general cognitive abilities (IQ), visuomotor skills, prospective memory, executive functions, and language.
Main Results:
- EP adults demonstrated significantly lower scores than controls across all tested neuropsychological domains (effect sizes 0.7–1.2).
- Sixty percent of EP adults had impairment in at least one domain, with general cognitive functioning and visuomotor abilities most affected.
- The prevalence of intellectual impairment (IQ <70) in EP participants increased by 6.7% between ages 11 and 19 (P=.02).
Conclusions:
- Extremely preterm (EP) born adults exhibit persistent deficits in general cognitive abilities and various neuropsychological functions compared to term-born peers.
- These deficits do not show improvement over time, with intellectual impairment prevalence increasing into adulthood.
Background And Objectives:
Children born extremely preterm (EP) (<26 weeks' gestation) have lower cognitive scores and an increased rate of cognitive impairment compared with their term-born peers. However, the neuropsychological presentation of these EP individuals in adulthood has not been described. The aim of this study was to examine neuropsychological outcomes in early adulthood after EP birth in the 1995 EPICure cohort and to investigate if the rate of intellectual impairment changed longitudinally.
Methods:
A total of 127 young adults born EP and 64 term-born controls had a neuropsychological assessment at 19 years of age examining general cognitive abilities (IQ), visuomotor abilities, prospective memory, and aspects of executive functions and language.
Results:
Adults born EP scored significantly lower than term-born controls across all neuropsychological tests with effect sizes (Cohen's d) of 0.7 to 1.2. Sixty percent of adults born EP had impairment in at least 1 neuropsychological domain; deficits in general cognitive functioning and visuomotor abilities were most frequent. The proportion of EP participants with an intellectual impairment (IQ <70) increased by 6.7% between 11 and 19 years of age (P = .02). Visuospatial functioning in childhood predicted visuomotor functioning at 19 years.
Conclusions:
Adults born EP continue to perform lower than their term-born peers in general cognitive abilities as well as across a range of neuropsychological functions, indicating that these young adults do not show improvement overtime. The prevalence of intellectual impairment increased from 11 years into adulthood.
