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The Stockholm Neonatal Project: Cognitive and executive functioning in adolecents born preterm
Stockholm University, Faculty of Social Sciences, Department of Psychology.
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Objective: Research has shown that premature birth poses a risk for later cognitive development, particularly in the executive domain, but few studies extend beyond the early school years. Adolescence is a critical period for cognitive maturation, and this study investigated the cognitive outcome in a Swedish cohort of prematurely born 18-year olds, in relation to gestational age at birth and medical risks in the perinatal period.

Participants and Methods:  As part of Stockholm Neonatal Project, 134 adolescents born preterm with very low birth weight (< 1500g) and 94 matched controls born at term, participated in a follow-up study at age 18. General intelligence, as well as executive, memory, language and visual motor functions were measured by WISC-III, Delis-Kaplan Executive Function System, naming tests, Rey Auditory Verbal Learning test, face recognition, and Visual Motor Integration test.

Results: Extremely preterm adolescents (EPT, GA 23-27, n=74) performed worse than adolescents born either very preterm or at term, on all cognitive tasks and particularly on executive measures. 50% of the EPT group had suffered perinatal medical complications, and had more pervasive cognitive deficits than EPTs with low medical risk.  By contrast, very preterm adolescents (GA 28-31; n=36) performed consistently on a par with the controls.  Moderately preterm with very low birth weight (GA 32-36; n=25), who had experienced varying degrees of intrauterine growth retardation, tended to score lower than very preterm and control adolescents, particularly on complex cognitive measures.

Conclusions: Extremely preterm birth per se poses a risk for long-term cognitive outcome, particularly in executive functions. These risks may be exacerbated by medical complications.  Children born after 28 weeks of gestation or later, with normal birth weight and no perinatal complications, do not have an elevated risk for cognitive deficits at age 18.

National Category
Psychology
Research subject
Psychology
Identifiers
URN: urn:nbn:se:su:diva-78940OAI: oai:DiVA.org:su-78940DiVA: diva2:545832
Available from: 2012-08-21 Created: 2012-08-21 Last updated: 2012-08-27Bibliographically 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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