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Extremely preterm infants show neurocognitive deficits 10 years later
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A cohort study published in Pediatrics showed that extremely preterm infants demonstrated moderate neurocognitive deficits at 10 years of age, maintaining the same rate of risk as children born 10 years earlier.
“We were somewhat surprised to find that children in our extremely preterm (EP) cohort were at similarly high risk of cognitive and academic deficits at age 10 years as comparable samples of EP children born a decade earlier,” Robert M. Joseph, PhD, in the department of anatomy and neurobiology at Boston University School of Medicine, told Healio.com/Pediatrics. “We suspect that this finding, to some extent, reflects a trade-off resulting from medical advances that have increased survival rates among children born at the limits of viability — 23 to 24 weeks gestational age — over the last 2 decades.”
Robert M. Joseph
Extremely preterm infants are at higher risk for deficits in IQ, attention, executive function, processing speed, visual perception and visual-motor function, Joseph and colleagues wrote. However, evidence of these deficits has been inconsistent, and Joseph said, “it is very important to note that a large proportion of children in the [study] cohort appeared to be doing quite well.”
Between 2002 and 2004, 873 children who were born extremely preterm, or at less than 28 weeks’ gestation, were enrolled at 14 sites in five states. Ten years later, the researchers assessed their IQ, language, attention, executive function, processing speed, visual perception, visual-motor function and academic achievement. They conducted multivariate analysis that adjusted for socioeconomic status and growth restriction.
The investigators wrote that between one-third and two-thirds of all children performed greater than 1 standard deviation below age expectation, with the most extreme deficits seen in executive control and processing speed. The multivariate analysis showed the risk for neurocognitive deficit was greatest at the lowest gestational age for each measure gauged by the investigators.
“Our findings underscore the continued need to monitor EP infants, including those without medical conditions or neurological impairments, for neurocognitive deficits so that they may be remediated as early as possible, when interventions are most effective,” Joseph said. – by Will Offit
Disclosure: The researchers report no relevant financial disclosures.
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