Do healthy preterm children need neuropsychological follow-up? Preschool outcomes compared with term peers: Neuropsychological Follow-up of Healthy Preterm Children (original) (raw)
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A Follow-Up Study of Cognitive Development in Low Risk Preterm Children
International Journal of Environmental Research and Public Health, 2020
The results of a longitudinal study on the cognitive development of one group of full-term and three groups of low risk preterm children with different gestational ages (GA) are presented. The 181 participants were divided into four GA groups of similar size. The aims were: 1) To check if there are differences in cognitive development (measured through the Batelle scale) among the GA groups. 2) To establish the predictive factors of cognitive development at 22 and 60 months of age, taking into account biomedical, environmental and individual factors. The results of the repeated measures ANOVA performed at 22 and 60 months of age indicated that the cognitive trajectories of the four GA groups were similar. Linear regression analyses showed that the effect of the different predictors changed in relation to the time of measurement of cognitive development. Biological factors and the quality of home environment had a moderate effect on the cognitive development at 22 months of age. Cogn...
JAMA Pediatrics, 2018
Importance Despite apparent progress in perinatal care, children born extremely or very preterm (EP/VP) remain at high risk for cognitive deficits. Insight into factors contributing to cognitive outcome is key to improve outcomes after EP/VP birth. Objective To examine the cognitive abilities of children of EP/VP birth (EP/VP children) and the role of perinatal and demographic risk factors. Data Sources PubMed, Web of Science, and PsycINFO were searched without language restriction (last search March 2, 2017). Key search terms included preterm, low birth weight, and intelligence. Study Selection Peer-reviewed studies reporting intelligence scores of EP/VP children (<32 weeks of gestation) and full-term controls at age 5 years or older, born in the antenatal corticosteroids and surfactant era, were included. A total of 268 studies met selection criteria, of which 71 covered unique cohorts. Data Extraction and Synthesis MOOSE guidelines were followed. Data were independently extracted by 2 researchers. Standardized mean differences in intelligence per study were pooled using random-effects meta-analysis. Heterogeneity in effect size across studies was studied using multivariate, random-effects meta-regression analysis. Main Outcomes and Measures Primary outcome was intelligence. Covariates included gestational age, birth weight, birth year, age at assessment, sex, race/ethnicity, socioeconomic status, small for gestational age, intraventricular hemorrhage, periventricular leukomalacia, bronchopulmonary dysplasia (BPD), necrotizing enterocolitis, sepsis, and postnatal corticosteroid use. Results The 71 included studies comprised 7752 EP/VP children and 5155 controls. Median gestational age was 28.5 weeks (interquartile range [IQR], 2.4 weeks) and the mean age at assessment ranged from 5.0 to 20.1 years. The median proportion of males was 50.0% (IQR, 8.7%). Preterm children had a 0.86-SD lower IQ compared with controls (95% CI, −0.94 to −0.78, P < .001). Results were heterogeneous across studies (I2 = 74.13; P < .001). This heterogeneity could not be explained by birth year of the cohort. Multivariate meta-regression analysis with backward elimination revealed that BPD explained 65% of the variance in intelligence across studies, with each percent increase in BPD rate across studies associated with a 0.01-SD decrease in IQ (0.15 IQ points) (P < .001). Conclusions and Relevance Extremely or very preterm children born in the antenatal corticosteroids and surfactant era show large deficits in intelligence. No improvement in cognitive outcome was observed between 1990 and 2008. These findings emphasize that improving outcomes after EP/VP birth remains a major challenge. Bronchopulmonary dysplasia was found to be a crucial factor for cognitive outcome. Lowering the high incidence of BPD may be key to improving long-term outcomes after EP/VP birth.
Assessment of Some Cognitive Disorders in Preterm Infants
Globally, prematurity is a major cause of death and a significant cause of long-term loss of human potential amongst survivors all around the world. Complications of preterm birth are the single largest direct cause of neonatal deaths, responsible for 35% of the world’s 3.1 million deaths a year in almost all countries with reliable data. Preterm birth rates are increasing. An estimated 15 million babies are born too early every year. That is more than 1 in 10 babies. Almost 1 million children die each year due to complications of preterm birth. In addition to its significant contribution to mortality, the effect of preterm birth amongst some survivors may continue throughout life, impairing neuro developmental functioning through increasing the risk of cerebral palsy, learning impairment and visual disorders and affecting long-term physical health with a higher risk of non-communicable disease. The aim of this work is to assess the effect of prematurity on cognitive development in preterm infants at the first year of life and to evaluate the difference between preterm and full term regarding this development. This could help to maximize neurological development and reduce long term cognitive and behavioral problems. Forty -three premature infants (26 female and 17 male) were studied. Twenty-five full term infants of matched age and sex were included in the study as controls. All patients were neurologically free on clinical examination. Anthropometric measurement of patients were recorded at 3, 6, 9, 12 months old and included weight, recumbent length and head circumference. The Griffiths development scale was used to assess the cognitive and psychomotor development status of the infants. They covered locomotor skills, personal/social skills, hearing/speech, eyehand coordination, and cognitive performance .Total intellectual quotients (IQ %) were calculated. The IQ of the studied patients at three months ranged from 61-132% (mean 103.63±14.90), at six months ranged from 51-140% (mean 112.43±22.10), at nine months 40-141% (mean 115.56 ± 27.92) and at twelve months ranged from 95-140% (mean 130.64 ± 14.06). Performance was the most affected parameter in preterm infants, also there was positive correlation between gestational age and IQ % at 6 and12 months, no correlation was found between IQ% and head circumference and IQ% at 6 and 12 months was higher than at 3 and 9 months in preterm infants.
Neurological, cognitive and learning evaluation of students who were born preterm
Revista Paulista de Pediatria, 2022
Objective: To evaluate the cognitive and academic profile of preterm newborns at school age and to determine the factors related to prematurity and sociodemographic profile that influence these results. Methods: Patients aged 6-14 years old that were assisted in the preterm follow-up clinic were recruited. The cognitive, academic, and neurological capacities were accessed through a detailed evaluation with a child neurologist, a neuropsychologist and a psychopedagogue. Neonatal data were collected from patient records. Results: 97 children were included and 14 were excluded from the study, resulting in 83 children. Gestational age (GA) was 30±3 weeks and weight at birth was 1138g (605 to 4185g). Poor performance was shown in 38.4% for writing, 57.5% for reading and 42.5% for mathematics. The mean total intelligence quotient (IQ) was 96±14.9 points, and 10.9% were considered altered. Children with unstructured families presented 78.3% of failure in reading tests (p=0.029). The multiv...