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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Long-term cognitive, executive, and behavioral outcomes of moderate and late preterm at school age
Ju Hyun Jin1, Shin Won Yoon1, Jungeun Song2
1Department of Pediatrics, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
Insights
Moderate to late preterm infants show higher risks of borderline intelligence and attention deficits, impacting school performance. Continuous monitoring of cognitive and executive functions is crucial for these children.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Child Psychology
Background:
- Moderate preterm (32-33 weeks) and late preterm (34-36 weeks) birth are increasingly linked to neurodevelopmental issues.
- Concerns exist regarding potential impacts on school performance in these populations.
Purpose of the Study:
- To investigate cognitive function, visual-cognitive skills, executive function, and behavioral issues in school-aged moderate to late preterm infants.
- To identify potential neurodevelopmental challenges in this cohort.
Main Methods:
- A cohort of 37 children aged 7-10 years, born between 32 and 36 weeks gestation, were assessed.
- Exclusion criteria included severe neurological impairments, congenital malformations, or chromosomal abnormalities.
- Neuropsychological assessments involved 5 tests and 3 questionnaires to evaluate cognitive and behavioral outcomes.
Main Results:
- 65% of children exhibited attention deficit hyperactivity disorder (ADHD) related issues.
- 32.4% and 24.3% of children had below-borderline executive and memory quotients, respectively.
- No significant associations were found between perinatal factors or socioeconomic status and the assessed neurodevelopmental outcomes.
Conclusions:
- Moderate to late preterm infants are at elevated risk for borderline intelligence and attention problems during early school years.
- Cognitive and executive functions, vital for academic success, require careful monitoring and follow-up in preterm infants.
- Early identification and intervention are key to supporting the academic trajectory of preterm children.
Background:
There is increasing concern that moderate preterm (32-33 weeks' gestation) and late preterm (34-36 weeks' gestation) birth may be associated with minor neurodevelopmental problems affecting poor school performance.
Purpose:
We explored the cognitive function, cognitive visual function, executive function, and behavioral problems at school age in moderate to late preterm infants.
Methods:
Children aged 7-10 years who were born at 32+0 to 36+6 weeks of gestation and admitted to the neonatal intensive care unit from August 2006 to July 2011 at the National Health Insurance Service Ilsan Hospital were included. We excluded children with severe neurologic impairments, congenital malformations, or chromosomal abnormalities. Neuropsychological assessments consisted of 5 neuropsychological tests and 3 questionnaires.
Results:
A total of 37 children (mean age, 9.1±1.2 years) participated. The mean gestational age at birth was 34.6±7.5 weeks, while the mean birth weight was 2,229.2±472.8 g. The mean full-scale intelligence quotient was 92.89±11.90; 24.3% scored between 70 and 85 (borderline intelligence functioning). An abnormal score was noted for at least one of the variables on the attention deficit hyperactivity disorder diagnostic system for 65% of the children. Scores below borderline function for executive quotient and memory quotient were 32.4% and 24.3%, respectively. Borderline or clinically relevant internalizing problems were noted in 13.5% on the Child Behavior Check List. There were no significant associations between perinatal factors or socioeconomic status and cognitive, visual perception, executive function, or behavior outcomes.
Conclusion:
Moderate to late preterm infants are at risk of developing borderline intelligence functioning and attention problems at early school age. Cognitive and executive functions that are important for academic performance must be carefully monitored and continuously followed up in moderate to late preterm infants.
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