Executive function development between ages 2 and 6 in children exposed to threatened preterm labor

Area of Science:

• Neuroscience
• Developmental Psychology
• Pediatrics

Background:

• Children born after threatened preterm labor (TPL) exhibit increased risk for executive function (EF) difficulties.
• EF development in TPL-exposed children is understudied, particularly concerning gestational age and psychosocial adversity.
• Prenatal stress and postnatal environmental factors may influence EF outcomes.

Purpose of the Study:

• To investigate executive function (EF) development in children born after threatened preterm labor (TPL) up to age 6.
• To examine the roles of gestational age, prenatal stress, and early psychosocial adversity in EF outcomes.
• To assess changes in EF from ages 2 to 6 in relation to TPL and environmental factors.

Main Methods:

• Prospective cohort study with 180 mother-child dyads (120 TPL, 60 controls).
• EF assessed at ages 2 and 6 using the Behavior Rating Inventory of Executive Function-Preschool Version (BRIEF-P).
• Bayesian mixed-effects models analyzed associations between EF, gestational age, time, and prenatal/postnatal factors.

Main Results:

• A group × time interaction for global EF scores was observed.
• At age 2, all TPL groups had higher EF difficulties than controls; very-preterm infants showed the largest deficits.
• Between ages 2 and 6, EF difficulties decreased in TPL groups relative to controls, with variations across EF domains.

Conclusions:

• Children born after TPL demonstrate early EF vulnerabilities across all gestational ages, including full-term infants.
• EF outcomes evolve throughout early childhood, influenced by biological and environmental factors.
• Early monitoring of TPL-exposed children is crucial, emphasizing the impact of maternal mental health and family context on EF development.