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Cognitive function at school age in children born before 27 weeks' gestation: A single-center retrospective study in

Keiji Takakubo1, Narutaka Mochizuki1, Shinya Hirano1

  • 1Department of Neonatal Medicine, Osaka Women's and Children's Hospital, Japan.

Pediatrics and Neonatology
|May 26, 2026
PubMed

Insights

Extremely preterm infants born before 27 weeks gestation show cognitive impairments at school age. However, cognitive outcomes significantly improve with increased gestational age, highlighting the need for long-term follow-up.

Area of Science:

  • Neonatal Medicine
  • Developmental Pediatrics
  • Neuroscience

Background:

  • Extremely preterm (EP) infants face high risks of neurodevelopmental impairments.
  • School-age outcomes for EP infants are documented globally, but Japanese data, especially for 22-23 weeks gestation, is limited.
  • Increased survival rates for very early preterm infants necessitate better understanding of their long-term cognitive development.

Purpose of the Study:

  • To evaluate school-age cognitive impairments in Japanese infants born before 27 weeks gestation.
  • To identify associations between gestational age and cognitive outcomes at 8 years.
  • To describe longitudinal cognitive development from 3 to 8 years in this cohort.

Main Methods:

  • Retrospective cohort study of 73 children born before 27 weeks gestation in Japan.
  • Cognitive function assessed at 8 years using Wechsler Intelligence Scale for Children (WISC-IV/V) or Kyoto Scale of Psychological Development.
  • Perinatal characteristics compared across gestational age groups; longitudinal outcomes described.

Main Results:

  • Lower gestational age correlated with lower birth weight and higher rates of chorioamnionitis, retinopathy of prematurity, and bronchopulmonary dysplasia.
  • Median full-scale IQ scores at 8 years were below national average but increased significantly with gestational age (p=0.001).
  • Proportion of children in the normal cognitive range increased from 25.0% at 3 years to 51.3% at 8 years.

Conclusions:

  • Infants born before 27 weeks gestation, especially 22-23 weeks, are at risk for school-age cognitive impairment.
  • Cognitive outcomes show significant improvement with increasing gestational age.
  • Structured, long-term follow-up is crucial for supporting the evolving needs of this high-risk population.
Abstract

Keywords:
CognitionExtremely pretermFollow-up studiesInfantJapanNewborn

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