Gestational Age and Cognitive Development in Childhood.

Area of Science:

• Neuroscience
• Developmental Psychology
• Genetics

Background:

• Preterm and early-term births are recognized risk factors for cognitive impairment.
• Comprehensive studies integrating genetics, prenatal risks, and child-specific factors in high-risk populations are limited.

Purpose of the Study:

• To investigate the long-term cognitive outcomes in children across various gestational ages (very preterm, moderately preterm, late preterm, early term) compared to full-term births.
• To account for genetic and other significant risk factors in the analysis of cognitive development.

Main Methods:

• Prospective, multicenter, longitudinal cross-sectional study of 5946 children aged 9-10 years.
• Cognitive assessments included the NIH Toolbox, Little Man Task, and Rey Auditory Verbal Learning Test.
• Polygenic scores for cognitive performance (cogPGS) were generated; hierarchical regression models adjusted for SES, cogPGS, and prenatal/child-specific factors.

Main Results:

• Moderately preterm birth (32-33 weeks) was associated with significantly lower composite cognitive scores and deficits in vocabulary, working memory, and episodic memory compared to full-term birth.
• These associations remained significant and independent of SES, cogPGS, and other risk factors.
• Children born at 32 weeks or earlier showed the lowest cognitive scores, while late preterm and early term births had outcomes similar to full-term peers.

Conclusions:

• Moderately preterm birth is independently associated with long-term cognitive challenges in children.
• The findings highlight the importance of continued monitoring for all preterm infants, especially those born before 34 weeks' gestation.
• Early identification and intervention may be crucial for mitigating developmental challenges in vulnerable preterm populations.