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Multi-domain cognitive impairments at school age in very preterm-born children compared to term-born peers

Elise Roze1,2, Sijmen A Reijneveld3, Roy E Stewart3

  • 1Division of Neonatology, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, Netherlands. e.roze@umcutrecht.nl.

BMC Pediatrics
|April 14, 2021
PubMed

Insights

Very preterm children often experience multiple cognitive impairments by school age, a higher rate than term-born peers. These deficits appear to be a general increase rather than a specific pattern of cognitive dysfunction.

Area of Science:

  • Developmental neuroscience
  • Pediatric neurology
  • Cognitive psychology

Background:

  • Preterm infants face risks for lasting motor, cognitive, and behavioral deficits.
  • Cognitive impairments may persist into childhood, impacting development.
  • Understanding these long-term effects is crucial for early intervention.

Purpose of the Study:

  • To investigate the co-occurrence of cognitive impairments across multiple domains at school age in very preterm children.
  • To compare the patterns of cognitive deficits in very preterm children versus term-born controls.

Main Methods:

  • A comparative study included 60 very preterm children (≤32 weeks gestation) and 120 term-born controls.
  • Cognitive functions assessed at school age included intelligence (WISC-III), visuomotor integration (NEPSY-II), verbal memory (AVLT), attention (TEA-ch), and executive functioning (BRIEF).
  • Co-occurrence of abnormal (<5th percentile) and suspect-abnormal (<15th percentile) cognitive functions was analyzed.

Main Results:

  • 15% of preterm children had abnormal outcomes in multiple cognitive functions (≥2), compared to 3% of controls (OR 4.65).
  • Rates of multiple suspect-abnormal cognitive outcomes were 55% in preterms versus 25% in controls (OR 3.02).
  • Low performance IQ was more frequently associated with additional cognitive impairments in preterm children (OR 5.43).

Conclusions:

  • A majority of very preterm children exhibit co-occurring impairments in multiple cognitive domains.
  • The increased occurrence of multi-domain cognitive impairments in preterms suggests a general developmental impact, not a specific impairment pattern.
  • While preterm birth is linked to broader cognitive challenges, specific patterns of co-occurrence do not differ significantly from controls, except for low performance IQ.
Abstract

Keywords:
Co-occurrenceCognitionLong-term outcomeNeurodevelopmental outcomePrematurity

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