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Very preterm birth and foetal growth restriction are associated with specific cognitive deficits in children attending mainstream school

Hanna Kallankari, Tuula Kaukola, Päivi Olsén, Marja Ojaniemiand Mikko Hallman

Acta Paediatrica, 7 OCT 2014

Editor’s comment: Prof. Jim Thornton: Premature birth and neurodevelopmental problems
Seventy seven babies born before 32 weeks, and without cerebral palsy, were compared with 27 term born children. Both groups underwent an inclusive neuropsychological test repertoire at the age of nine. The premature birth group had a 1.5-point [95% confidence interval (CI) 0.6–2.3] reduction in visuospatial–sensorimotor processing and a 1.2-point (95% CI 0.5–1.9) reduction in attention-executive function scores.

Abstract

Aim

This study investigated the association of prenatal and neonatal factors with cognitive outcomes in schoolchildren born very preterm without impairments at the age of nine.

Methods

We recruited a prospective regional cohort of 154 very low gestational age (VLGA) children of <32 weeks and 90 term-born comparison children born between November 1998 and November 2002 at Oulu University Hospital, Finland. Cognitive outcome was assessed using an inclusive neuropsychological test repertoire at the age of nine.

Results

The final study group comprised 77 VLGA children without cerebral palsy or any cognitive impairment and 27 term-born children. VLGA was associated with a 1.5-point [95% confidence interval (CI) 0.6–2.3] reduction in visuospatial–sensorimotor processing and a 1.2-point (95% CI 0.5–1.9) reduction in attention–executive functions scores. Foetal growth restriction (FGR) was the only clinical risk factor that was associated with cognitive outcome. Children with FGR had a significant decrease in language (1.7 points, 95% CI 0.50–3.0) and memory–learning (1.6 points, 95% CI 0.4–2.8) scores.% CI 0.50–3.0) and memory–learning (1.6 points, 95% CI 0.4–2.8) scores.

Conclusion

Children born very preterm without impairments had poorer performance in specific neurocognitive skills than term-born children. FGR was an independent risk factor for compromised neurocognitive outcome in VLGA children and predicted difficulties in language, memory and learning.

Children born very preterm without impairments had poorer performance in specific neurocognitive skills than term-born children. FGR was an independent risk factor for compromised neurocognitive outcome in VLGA children and predicted difficulties in language, memory and learning.

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Commentaries by Editor Prof. Jim Thornton