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Executive function deficits mediate the association between very preterm birth and behavioral problems at school-age

Barbara Schnider1, Vera Disselhoff1, Ulrike Held2

  • 1University Children's Hospital Zurich, Department of Neonatology and Pediatric Intensive Care, Zurich, Switzerland; University Children's Hospital Zurich, Children's Research Center, Zurich, Switzerland.

Early Human Development
|May 30, 2020
PubMed

Insights

Children born very preterm often have executive function deficits, leading to behavioral problems. These executive function deficits partially explain the increased behavioral issues seen in very preterm children at school age.

Area of Science:

  • Neuroscience
  • Developmental Psychology
  • Pediatrics

Background:

  • Children born very preterm face higher risks for executive function deficits.
  • These deficits are associated with social, emotional, and attentional challenges.
  • This study examines the link between executive function and behavioral problems in school-aged children born very preterm.

Purpose of the Study:

  • To investigate if executive function deficits contribute to behavioral problems in very preterm children.
  • To quantify the mediating role of executive function in the relationship between preterm birth and behavioral issues.

Main Methods:

  • Compared 38 very preterm children/adolescents with 41 term-born peers at mean age 12.9 years.
  • Assessed executive functions (working memory, planning, flexibility, fluency) and behavioral problems (SDQ).
  • Used mediation analysis to determine the effect of preterm birth on behavior, with executive function as a mediator.

Main Results:

  • Very preterm children showed poorer executive function abilities (d=0.62, p=0.005).
  • Parents reported more behavioral problems in very preterm children (SDQ Total Difficulties Score, d=0.54, p=0.01).
  • Executive function abilities significantly mediated the effect of preterm birth on behavioral problems (F(2, 76)=6.42, p=0.002).

Conclusions:

  • Executive function deficits may partly explain increased behavioral symptoms in school-aged very preterm children.
  • Highlights the need for ongoing monitoring of executive function development in very preterm children.
  • Emphasizes the importance of early intervention and tailored support for optimal development.
Abstract

Keywords:
Behavioral problemsExecutive functionsPrematurityPreterm birthSchool-age

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