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Cognitive and Behavioral Outcomes of School-aged Children Born Extremely Preterm: a Korean Single-center Study with

Eun Sun Kim1, Ee-Kyung Kim2, Sae Yun Kim3

  • 1Department of Pediatrics, Kangwon National University School of Medicine, Chuncheon, Korea.

Journal of Korean Medical Science
|October 12, 2021
PubMed

Insights

Extremely preterm (EP) children show lower cognitive function and executive function (EF) than full-term peers. Severe retinopathy of prematurity (ROP) and low discharge weight Z-score are risk factors for cognitive deficits in EP children.

Area of Science:

  • Neuroscience
  • Pediatrics
  • Developmental Psychology

Background:

  • Children born very preterm often experience poorer cognitive and behavioral outcomes.
  • Executive function (EF) is crucial for academic success.
  • Evaluating cognitive and behavioral development in extremely preterm (EP) children is essential.

Purpose of the Study:

  • To assess cognitive (including EF) and behavioral outcomes in Korean extremely preterm (EP) children.
  • To identify biological and socioeconomic risk factors for poor cognitive outcomes in EP children.

Main Methods:

  • Compared 71 extremely preterm infants (EP group) with 40 full-term controls.
  • Utilized cognitive tests (e.g., K-WISC-IV, ATA, Stroop, CCTT, WCST) and behavioral questionnaires (K-CBCL, K-ARS).
  • Collected and analyzed perinatal and demographic data.

Main Results:

  • EP children had significantly lower full-scale intelligence quotient (FSIQ) scores (89.1 vs. 107.1) and poorer EF than controls.
  • 37% of EP children had FSIQ scores below 85, versus 3% in controls.
  • Severe retinopathy of prematurity (ROP) increased low FSIQ risk 8.8-fold; higher discharge weight Z-score reduced risk by half.

Conclusions:

  • EP children demonstrate significantly lower FSIQ and EF compared to full-term peers.
  • Cognitive problems were identified in 37% of EP children, with no significant behavioral differences except social immaturity.
  • Severe ROP and low discharge weight Z-score are independent risk factors for low FSIQ in EP children.
Abstract

Keywords:
BehaviorChildrenCognitiveExecutive FunctionOutcomesPrematurity

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