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Executive functioning challenges of adolescents born extremely and very preterm
Samantha J Lee1, Lianne J Woodward1, Stephanie Moor2
1School of Health Sciences and Canterbury Child Development Research Group, University of Canterbury, Christchurch, New Zealand.
Frontiers in Psychology
|December 26, 2024
Summary
Children born very preterm (VPT) face executive functioning (EF) challenges in adolescence. Neonatal medical complexity and brain abnormalities mediate the link between prematurity and later EF deficits, highlighting the need for ongoing support.
Area of Science:
- Neuroscience
- Developmental Psychology
- Pediatrics
Background:
- Children born very preterm (VPT; <32 weeks gestation) exhibit higher risks for executive functioning (EF) difficulties.
- Limited understanding exists regarding the specific EF profiles and challenges faced by VPT individuals in late adolescence, especially across diverse EF domains and varying task demands.
Purpose of the Study:
- To delineate the executive functioning (EF) profiles of very preterm (VPT) and full-term (FT) adolescents at age 17.
- To investigate the relationship between gestational age (GA) and subsequent EF performance.
- To identify neonatal predictors influencing EF outcomes in VPT individuals.
Main Methods:
- A prospective longitudinal study design was employed.
- Executive functioning (EF) was assessed in 92 very preterm (VPT) and 68 full-term (FT) adolescents at 17 years of age.
- Gestational age (GA) and neonatal factors, including medical complexity and white matter abnormalities, were analyzed in relation to EF outcomes.
Main Results:
- VPT adolescents demonstrated poorer performance in working memory, planning, and cognitive flexibility compared to FT peers.
- The most significant EF deficits were observed in individuals born extremely preterm (<28 weeks GA) and under high cognitive load conditions.
- The impact of gestational age (GA) on EF was fully explained by neonatal medical complexity and white matter abnormalities.
Conclusions:
- Long-term cognitive support is crucial for individuals born very preterm (VPT).
- Neonatal medical and neurological risks are key factors mediating the association between prematurity and executive functioning (EF) deficits.
- Targeted interventions addressing these risks can potentially mitigate long-term cognitive challenges.
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