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Executive function development in adolescents born very and extremely preterm
Stockholm University, Faculty of Social Sciences, Department of Psychology. Karolinska Institutet, Sweden.
Stockholm University, Faculty of Social Sciences, Department of Psychology.ORCID iD: 0000-0002-7824-0536
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(English)In: Article in journal (Refereed) Submitted
Abstract [en]

Executive function deficits are often reported as being a specific weakness in preterm born children. Yet, stability in function and development over time is largely unknown. In a prospective longitudinal study, 115 participants born very or extremely preterm, ≤ 31 weeks of gestation, participated in neuropsychological assessments at ages 5½ years and 18 years. Executive functions were separated into working memory and cognitive flexibility. Gestational age at birth, intrauterine growth, sex, perinatal medical complications, and parental education were tested as predictors, and developmental stability was investigated using Structural Equation Modeling. Working memory and cognitive flexibility were highly stable from preschool age to late adolescence. Higher parental education, higher gestational age, and female sex were related to better outcome at 5½ years which in turn fully mediated outcome at age 18 years. Perinatal medical complications and restricted intrauterine growth negatively influenced cognitive flexibility in late adolescence. The study poses an argument for identification of executive deficits before school entry among children born preterm, as such deficits are unlikely to diminish as a consequence of maturation.

Keyword [en]
cognitive flexibility, parental education, perinatal medical complications, structural equation modeling, working memory
National Category
Psychology
Research subject
Psychology
Identifiers
URN: urn:nbn:se:su:diva-106801OAI: oai:DiVA.org:su-106801DiVA: diva2:739337
Available from: 2014-08-20 Created: 2014-08-20 Last updated: 2017-07-28Bibliographically approved
In thesis
1. Rough beginnings: Executive function in adolescents and young adults after preterm birth and repeat antenatal corticosteroid treatment
Open this publication in new window or tab >>Rough beginnings: Executive function in adolescents and young adults after preterm birth and repeat antenatal corticosteroid treatment
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis investigates long-term cognitive outcome in two cohorts of adolescents and young adults exposed to stressors during the perinatal period: one group born preterm (<37 weeks of gestation and birth weight <1,500 g); one group exposed to two or more courses of antenatal corticosteroids (ACS), to stimulate lung maturation in the face of threatening preterm birth. In fetal life the brain undergoes dramatic growth, and a disruption to the early establishment of functional neural networks may interrupt development in ways that are difficult to predict. Executive function refers to a set of cognitive processes that are important for purposeful regulation of thought, emotion, and behavior, and even a subtle depreciation may influence overall functioning. Study I investigated the stability of executive function development after preterm birth. Executive functions were differentiated into working memory and cognitive flexibility. Both components were highly stable from preschool age to late adolescence. In Study II, we identified subgroups within the group of children born preterm with respect to cognitive profiles at 5½ and 18 years, and identified longitudinal streams. Outcome after preterm birth was diverse, and insufficiently predicted by perinatal and family factors. Individuals performing at low levels at 5½ years were unlikely to improve over time, while a group of individuals performing at or above norm at 5½ years had improved their performance relative to term-born peers by age 18. Studies I and II pointed to the need for developmental monitoring of those at risk, prior to formal schooling. Study III investigated long-term cognitive outcome after repeat ACS treatment. The study did not provide support for the concern that repeat ACS exposure will have an adverse impact on cognitive function later in life. In sum, exposure to perinatal stressors resulted in great variation in outcome. However, for many, their rough beginnings had not left a lasting mark.

Place, publisher, year, edition, pages
Stockholm: Department of Psychology, Stockholm University, 2014. 100 p.
Keyword
cognitive flexibility, cluster analysis, development, latent variable analysis, longitudinal studies, parental education, perinatal medical complications, person-oriented approach, structural equation modeling, working memory
National Category
Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:su:diva-106798 (URN)978-91-7447-945-4 (ISBN)
Public defence
2014-10-15, David Magnussonsalen (U31), Frescati Hagväg 8, Stockholm, 10:00 (English)
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Supervisors
Note

At the time of the doctoral defense, the following paper was unpublished and had a status as follows: Paper 1: Submitted.

Available from: 2014-09-23 Created: 2014-08-20 Last updated: 2014-10-03Bibliographically approved

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