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Differential effects of preterm birth and small gestational age on cognitive and motor development
J L Hutton1, P O Pharoah, R W Cooke
1Department of Public Health, University of Liverpool.
Insights
Small for gestational age (SGA) impacts cognitive skills, while preterm birth affects motor abilities. Social factors influence reading speed and accuracy in children.
Area of Science:
- Pediatric Health
- Developmental Psychology
- Neonatal Research
Background:
- Preterm birth and being small for gestational age (SGA) are significant risk factors for adverse neurodevelopmental outcomes.
- Understanding the distinct impacts of these conditions is crucial for targeted interventions.
Purpose of the Study:
- To differentiate the effects of preterm birth versus being small for gestational age (SGA) on children's cognitive and motor development.
- To investigate the influence of social variables on these developmental outcomes.
Main Methods:
- A longitudinal cohort study of infants born at gestational age <= 32 weeks.
- Cognitive and motor abilities assessed at 8-9 years using standardized tests (WISC, Neale, Stott-Moyes-Henderson).
- Fetal growth adequacy determined by birthweight ratio; children with pre-existing disabilities excluded.
Main Results:
- Infant cognitive ability (IQ, reading comprehension) correlated with birthweight ratio (SGA indicator), independent of social factors.
- Motor ability associated with birthweight, gestational age, and birthweight ratio.
- Reading rate and accuracy primarily influenced by social variables and sex, not SGA or preterm birth.
Conclusions:
- Small for gestational age (SGA) is linked to cognitive deficits, whereas preterm birth is associated with motor impairments.
- Reading rate and accuracy are socially determined, independent of SGA or preterm birth status.
- Differential impacts highlight the need for tailored developmental support based on specific neonatal risk factors.
Aims:
To determine the differential effects of preterm birth and being small for gestational age on the cognitive and motor ability of the child.
Methods:
A longitudinal cohort of all infants of gestational age < or = 32 weeks born to mothers resident in the counties of Cheshire and Merseyside in 1980-1 was studied. The children were assessed at the age of 8 to 9 years using the Wechsler Intelligence Scale for Children, the Neale analysis of reading ability, and the Stott-Moyes-Henderson test of motor impairment. Adequacy of fetal growth was determined by the birthweight ratio--that is, the ratio of the observed birthweight to the expected birthweight for a given gestational age. Children with clinically diagnosed motor, learning or sensory disabilities were excluded. Information on social variables was obtained by a questionnaire completed by the parents. Of the 182 children, 158 were assessed.
Results:
IQ was positively correlated with birthweight ratio but not with birthweight or gestational age. Motor ability was associated with birthweight, gestational age, and birthweight ratio. Reading comprehension was associated with birthweight ratio, but reading rate and accuracy were best explained by social variables and sex. IQ remained associated with birthweight ratio, after adjusting for maternal education, housing status, and number of social service benefits received. Reading ability was related to these social variables but motor ability was not.
Conclusions:
The effects of SGA and preterm birth differed: SGA was associated with cognitive ability, as measured by IQ and reading comprehension; motor ability was additionally associated with preterm birth. Reading rate and accuracy were not associated with SGA or preterm birth but were socially determined.