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[Formula: see text] The impact of gestational age on executive function in infancy and early-to-middle childhood
Raj Seraya Bhatoa1, Simrit Nijjar2, Joe Bathelt1,3
1Department of Psychology, Royal Holloway University London, Egham, UK.
Insights
Gestational age significantly impacts preterm infant development. This review found limited evidence linking lower gestational age to executive function deficits in early childhood, citing methodological limitations.
Area of Science:
- Neuroscience
- Developmental Psychology
- Pediatrics
Background:
- Lower gestational age (GA) is a known risk factor for cognitive and developmental issues in preterm infants.
- The specific impact of gestational age on executive function (EF) in early childhood remains unclear due to conflicting research.
- Previous reviews have largely excluded children under four years, leaving a gap in understanding early EF development in relation to GA.
Purpose of the Study:
- To systematically review the impact of gestational age on executive function in preterm-born infants and children.
- To investigate executive function domains including inhibition, working memory, and shifting.
- To focus on the early developmental period from infancy through middle childhood (0-10 years).
Main Methods:
- Systematic literature search of PubMed, Web of Science, and PsycInfo databases.
- Inclusion of studies examining the association between gestational age and executive function in preterm (<37 weeks) and term-born children aged 0-10 years.
- Analysis of 18 studies meeting the inclusion criteria.
Main Results:
- Most included studies (10 out of 18) did not find a significant association between gestational age and executive function.
- However, significant limitations were identified across studies, potentially affecting the interpretation of these null findings.
- Key limitations include inconsistent definitions and measurements of EF and GA, recruitment biases, and a lack of infant-specific or longitudinal data.
Conclusions:
- Current evidence is insufficient to definitively conclude the impact of gestational age on executive function in preterm infants and children.
- Methodological inconsistencies and a paucity of early-life and longitudinal studies hinder robust conclusions.
- Future research must address these limitations to clarify the relationship between gestational age and executive function development in this vulnerable population.
Abstract:
Lower gestational age (GA) is a risk factor for cognitive and developmental concerns following preterm birth. However, its impact on executive function (EF) is unclear based on conflicting conclusions across the literature. Moreover, as children below 4 years have largely been neglected from previous reviews, the impact of GA on EF within this early developmental period remains unclear. Hence, this systematic review investigated the impact of GA on EF following preterm birth in infancy and early-to-middle childhood. PubMed, Web of Science, and PsycInfo were searched for articles investigating the impact of GA on EF (inhibition, working memory, shifting) in preterm-born (<37 week gestation) and term-born participants aged 0-10 years. Eighteen studies were included. Most of the studies (n = 10) found no significant association between EF and GA. However, several limitations hindered conclusions to be drawn about the strength of this interpretation. Examples include inconsistencies in the theoretical underpinnings and operationalisations of EF, discrepancies in the reporting and measurement of GA, recruitment biases, and a paucity of infant or longitudinal studies available. Consequently, these issues may have contributed to inconsistent or null findings, and they must be addressed in future research to better clarify the impact of GA on EF in preterm-born infants and children.
