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Individual neuropsychological profiles at age 5 1/2 years in children born preterm in relation to medical risk factors
Stockholm University, Faculty of Social Sciences, Department of Psychology. Karolinska Institutet.
Stockholm University, Faculty of Social Sciences, Department of Psychology.
2013 (English)In: Child Neuropsychology, ISSN 0929-7049, E-ISSN 1744-4136, Vol. 19, no 3, 313-331 p.Article in journal (Refereed) Published
Abstract [en]

Follow-up studies of preterm children have reported a range of cognitive deficits, particularly in executive functions, visuospatial abilities, and learning. However, few researchers have adopted a person-oriented approach, exploring individual neuropsychological profiles. The aim of this study was to identify typical neuropsychological profiles among preterm children and control children, respectively. A second aim was to investigate if neuropsychological profiles at age 51/2 might be associated with perinatal medical risk factors. As part of the longitudinal Stockholm Neonatal Project, NEPSY for 4- to 7-year-old children (Korkman, 1990), WPPSI-R, and Movement ABC were administered at age 51/2 years to 145 preterm (mean gestational age 28 weeks) and 117 control children born at term. For the present study, the NEPSY results of each child were transformed into summary z scores for each of 5 neuropsychological domains: attention, memory, sensory-motor, verbal, and visuospatial functions. Subsequently, Ward's cluster analysis was performed for the preterm and control groups separately, identifying 5 neuropsychological profiles in both groups explaining around 56% and 57% of the variance, respectively. Overall, preterm children had lower neuropsychological results but also more diverging profiles compared to controls. The variability in outcome could not be sufficiently explained by birth weight, gestational age, or medical risks. The results suggest that prematurity interacts dynamically with genetic, medical, and environmental factors in neuropsychological development.

Place, publisher, year, edition, pages
2013. Vol. 19, no 3, 313-331 p.
Keyword [en]
Preterm, Neuropsychological profiles, Cluster analysis, NEPSY
National Category
Psychology
Research subject
Psychology
Identifiers
URN: urn:nbn:se:su:diva-78944DOI: 10.1080/09297049.2011.653331ISI: 000317290900006OAI: oai:DiVA.org:su-78944DiVA: diva2:545849
Available from: 2012-08-21 Created: 2012-08-21 Last updated: 2017-12-07Bibliographically 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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