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Reaction times, learning, and executive functioning in adults born preterm
Julia Suikkanen1,2, Satu Miettola3, Kati Heinonen4
1Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki and Oulu, Finland. julia.suikkanen@helsinki.fi.
Insights
Adults born preterm generally show similar cognitive abilities to full-term peers. However, those born very preterm or small for gestational age (SGA) may experience lasting cognitive challenges into adulthood.
Area of Science:
- Neuroscience
- Developmental Psychology
- Public Health
Background:
- Preterm birth is a significant risk factor for brain development.
- Cognitive outcomes in adults born preterm vary depending on gestational age and birth weight.
- Understanding long-term cognitive function in preterm populations is crucial for targeted interventions.
Purpose of the Study:
- To compare cognitive functioning in adults born at different ranges of prematurity (early, late) and with varying birth weights (appropriate for gestational age, small for gestational age [SGA]) against full-term controls.
- To identify specific subgroups of preterm-born individuals who may experience persistent cognitive deficits into adulthood.
Main Methods:
- Utilized data from the ESTER Preterm Birth Study, including 133 early preterm, 241 late preterm, and 348 full-term participants without severe disabilities.
- Administered the Cogstate® test battery to assess various cognitive domains including learning, memory, executive function, attention, and emotional cognition.
- Employed linear regression models, adjusting for prenatal and postnatal factors and socioeconomic status, to analyze cognitive performance differences.
Main Results:
- Overall, early preterm, late preterm, and full-term participants demonstrated comparable cognitive abilities across most subtests.
- A notable exception was the Groton Maze Learning Test, where early preterm participants showed weaker spatial memory efficiency (0.6 fewer moves/10s).
- Late preterm and SGA participants exhibited significantly weaker spatial memory efficiency compared to full-term controls (1.3 fewer moves/10s).
Conclusions:
- Adults born across the spectrum of prematurity, on average, do not exhibit major cognitive deficits.
- Cognitive impairments in adulthood appear primarily associated with being born very preterm or preterm with SGA.
- These findings suggest that while preterm birth poses risks, many individuals can achieve comparable cognitive function to term-born peers, particularly with supportive environments.
Background:
This study examines cognitive functioning in adults born across the range of prematurity with appropriate or small for gestational age (SGA) birth weight compared with full-term controls.
Methods:
ESTER Preterm Birth Study participants without severe disabilities, comprising 133 early preterm (<34 weeks, 17% SGA), 241 late preterm (34 + 0-36 + 6 weeks, 13% SGA), and 348 full-term subjects, performed the Cogstate® test at a mean age of 23.3 (SD = 1.2) years. Subtests measured paired associate learning, psychomotor function, executive function, spatial memory efficiency, visual memory, attention, working memory, visual learning, and emotional cognition. Data were analyzed with linear regression, full models adjusted for prenatal and postnatal factors and socioeconomic position.
Results:
Early preterm, late preterm, and full-term participants showed similar abilities in almost all subtests. Early preterm participants had 0.6 fewer moves/10 s (95% CI: -1.0; -0.2, full model) and late preterm and SGA participants had 1.3 fewer moves/10 s (95% CI: -2.1; -0.4) than full-term controls in the Groton Maze Learning Test, indicating weaker spatial memory efficiency.
Conclusions:
Adults born across the range of prematurity on average lack major defects in cognitive abilities. Cognitive problems may persist to adulthood only among those born the smallest: very preterm or preterm and SGA.
Impact:
Although preterm birth is a risk for the developing brain, adults born preterm as a group showed similar cognitive performance to their full-term peers. Children born preterm across gestational ages show defects in cognitive domains. With a supportive environment, many of them have the potential to catch up with those born at term. The unfavorable effect of late preterm birth on cognitive functions in childhood may not persist to adulthood; in this study, adults born late preterm showed similar cognitive functioning to adults born full-term. The deficits in cognitive function in adults born preterm detected by earlier studies mainly concern those born the smallest, i.e., very preterm or preterm and small for gestational age.
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