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Executive Function Outcomes at School Age in Children Born Moderate-to-Late Preterm

Lauren Rossetti1, Leona Pascoe2, Rheanna M Mainzer3

  • 1School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia; Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia.

The Journal of Pediatrics
|May 9, 2025
PubMed

Insights

Children born moderate-to-late preterm (MLP) show poorer executive function (EF) at school age, particularly in goal setting. These EF difficulties may impact academic and social development.

Area of Science:

  • Developmental Psychology
  • Neuroscience
  • Pediatrics

Background:

  • Moderate-to-late preterm (MLP) birth (32-36 weeks' gestation) is associated with various developmental challenges.
  • Executive functions (EF) are crucial for academic and social success.
  • Understanding EF outcomes in MLP children is vital for early intervention and support.

Purpose of the Study:

  • To compare school-age executive function (EF) outcomes between moderate-to-late preterm (MLP) and term-born children.
  • To investigate differences across EF subdomains: attentional control, cognitive flexibility, goal setting, and everyday executive behaviors.

Main Methods:

  • A cohort study comparing 201 MLP children and 201 term-born children.
  • EF measures administered at 9 years of corrected age.
  • Statistical analyses included linear/quantile regression and generalized linear models, adjusted for covariates.

Main Results:

  • MLP children performed significantly poorer in goal setting and cognitive flexibility compared to term-born peers.
  • MLP children had an increased risk of executive dysfunction, cognitive flexibility, and goal-setting impairments.
  • Behavioral executive dysfunction was also more prevalent in the MLP group.

Conclusions:

  • Children born moderate-to-late preterm exhibit a pattern of increased executive function difficulties at school age.
  • These difficulties are most pronounced in goal setting and may affect academic performance and social skills.
  • Early identification and targeted interventions are crucial for supporting MLP children's development.
Abstract

Keywords:
attentional controlbehaviorcognitioncognitive flexibilityexecutive functiongoal settingpreterm birth

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