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The Stockholm Neonatal Project: Stability and prediction of cognitive outcome from preschool age through adolescence in children born preterm
Stockholm University, Faculty of Social Sciences, Department of Psychology.
Stockholm University, Faculty of Social Sciences, Department of Psychology.
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Objective: To investigate the stability of development in general intelligence (IQ) and executive functions (EF), and to identify predictors of cognitive development from preschool age through adolescence, in a cohort of preterm and term-born children.

Participants and Methods:  As part of the longitudinal Stockholm Neonatal Project, 134 adolescents born preterm with very low birth weight (< 1500g) and 94 matched controls born at term, participated in follow-up studies at ages 5 ½ and 18 years. On both occasions, the participants were assessed with an age appropriate Wechsler IQ test and tests of executive functions (EF). Stability in cognitive outcome was tested with Pearson correlations. Stepwise regression analyses were used to investigate how cognitive outcome at age 18 was predicted by EF at age 5 ½, parental education, gender, medical risk, and birth weight ratio.

Results: IQ was quite stable form preschool age through adolescence (r =.78 in whole group, r = .84 in preterm and r= .61 in controls), as were EF (r =  .65 in whole group, r = .64 in preterm and r = .53 in controls).  In controls, EF at age 5 ½ and parental education predicted IQ (R² = .205) and EF at 18 years (R² = .249). In the preterm group, EF at age 5 ½, parental education, medical risks and birth weight ratio predicted IQ 18 years (R² = .508), and EF at age 5 ½ and medical risks predicted EF at18 years (R² = .432).

Conclusions: Stability in cognitive outcomes from preschool through adolescence was high, particularly in the preterm group. EF at 5 ½ strongly predicted cognitive and executive functions at 18 years, in both groups. Over the same period, parental education had a continued positive effect on cognitive development. Among preterm children, perinatal medical risks predicted a less favorable continued cognitive development, especially in EF, and a low birth-weight ratio had a negative impact on general intelligence.

National Category
Psychology
Research subject
Psychology
Identifiers
URN: urn:nbn:se:su:diva-78937OAI: oai:DiVA.org:su-78937DiVA: diva2:545826
Projects
The Stockholm Neonatal Project
Available from: 2012-08-21 Created: 2012-08-21 Last updated: 2012-08-24Bibliographically approved
In thesis
1. Longitudinal studies of executive and cognitive development after preterm birth
Open this publication in new window or tab >>Longitudinal studies of executive and cognitive development after preterm birth
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Stockholm Neonatal Project is a longitudinal population-based study of children born prematurely in 1988-93, with a very low birth weight (<1500 g), who have been followed prospectively from birth through adolescence. A matched control group was recruited at age 5 ½ years. The overall aim was to investigate long-term developmental outcome, paying particular attention to executive functions (EF) in relation to degree of prematurity, birth weight and medical risks. Study I showed a disadvantage in visuo-motor development at 5 ½ years, especially among the preterm boys. Visuo-motor skills were highly related to IQ, and also to EF. In Study II, neuropsychological profiles typical of preterm children and term born children, respectively, were identified through cluster analysis. The general level of performance corresponded well with IQ, motor functions and parental education in both groups, but preterm children had overall lower results and exhibited greater variability across domains. Study III showed that extremely preterm birth (w. 23-27) per se poses a risk for cognitive outcome at age 18, particularly for EF, and that perinatal medical complications add to the risk. By contrast, adolescents born very preterm (w. 28-31) performed just as well as term-born controls in all cognitive domains. However, adolescents born moderately preterm (w. 32-36) and small for gestational age showed general cognitive deficits. Study IV found that cognitive development was stable over time, with parental education and EF at 5 ½ years as significant predictors for cognitive outcome at age 18. Among preterm children, perinatal medical risks and being small for gestational age had a continued negative impact on cognitive development from 5 ½ to 18 years. Study V demonstrated that neuropsychological scoring of Bender drawings, developed in study I, predicted cognitive outcome in adolescence, indicating that the method  may be useful in developmental screening around school entry.

Place, publisher, year, edition, pages
Stockholm: Department of Psychology, Stockholm University, 2012. 98 p.
Keyword
Preterm birth, low birth-weight, degree of prematurity, medical risks, general intelligence, executive functions, parental education, gender, development
National Category
Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:su:diva-78946 (URN)9789174475500 (ISBN)
Public defence
2012-09-26, David Magnussonsalen (U31), hus 8, Frescati Hagväg 8, Stockholm, 10:00 (Swedish)
Opponent
Supervisors
Note

At the time of the doctoral defense, the following papers were unpublished and had a status as follows: Paper 3: Manuscript. Paper 4: Manuscript. Paper 5: Submitted.

Available from: 2012-09-04 Created: 2012-08-21 Last updated: 2016-05-27Bibliographically approved

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