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Predicting School-Aged Cognitive Impairment in Children Born Very Preterm
Carmina Erdei1,2, Nicola C Austin3,4, Sara Cherkerzian5,2
1Brigham and Women's Hospital, Boston, Massachusetts; cerdei@bwh.harvard.edu.
Pediatrics
|March 8, 2020
Summary
Cognitive impairment is common in very preterm children. Assessments at age 6 years best predict later impairment, especially when considering family social factors.
Area of Science:
- Developmental neuroscience
- Pediatric neurology
- Cognitive psychology
Background:
- Children born very preterm (VPT) face significant risks for cognitive impairment.
- This impairment can negatively affect educational and social development.
- Early identification of cognitive deficits is crucial for intervention.
Purpose of the Study:
- To evaluate the predictive accuracy of cognitive assessments in VPT children.
- To determine the optimal age for identifying cognitive impairment by 12 years.
- To explore the influence of family-social circumstances on diagnostic accuracy.
Main Methods:
- Prospective cohort study of 103 VPT and 109 term-born children.
- Cognitive function assessed using standardized measures from age 2 to 12 years.
- Bayley Scales, Wechsler Preschool, and Wechsler Intelligence Scales were utilized.
Main Results:
- VPT children showed higher rates of severe and any cognitive impairment by age 12.
- Early assessments (age 2) with a severe criterion under-identified affected children.
- Cognitive risk prediction improved with age, with age 6 assessments showing high sensitivity and positive predictive value.
- Family-social factors enhanced diagnostic accuracy.
Conclusions:
- Cognitive risk in VPT children is best predicted by age 6 assessments.
- Early identification and intervention, particularly for those in disadvantaged contexts, may improve outcomes.
- Longitudinal cognitive monitoring is essential for VPT populations.
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