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Very preterm birth and foetal growth restriction are associated with specific cognitive deficits in children attending mainstream school
Author(s) -
Kallankari Hanna,
Kaukola Tuula,
Olsén Päivi,
Ojaniemi Marja,
Hallman Mikko
Publication year - 2015
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.12811
Subject(s) - medicine , neurocognitive , pediatrics , cognition , neuropsychology , gestational age , confidence interval , prospective cohort study , pregnancy , psychiatry , biology , genetics
Aim This study investigated the association of prenatal and neonatal factors with cognitive outcomes in schoolchildren born very preterm without impairments at the age of nine. Methods We recruited a prospective regional cohort of 154 very low gestational age ( VLGA ) children of <32 weeks and 90 term‐born comparison children born between November 1998 and November 2002 at Oulu University Hospital, Finland. Cognitive outcome was assessed using an inclusive neuropsychological test repertoire at the age of nine. Results The final study group comprised 77 VLGA children without cerebral palsy or any cognitive impairment and 27 term‐born children. VLGA was associated with a 1.5‐point [95% confidence interval ( CI ) 0.6–2.3] reduction in visuospatial–sensorimotor processing and a 1.2‐point (95% CI 0.5–1.9) reduction in attention–executive functions scores. Foetal growth restriction ( FGR ) was the only clinical risk factor that was associated with cognitive outcome. Children with FGR had a significant decrease in language (1.7 points, 95% CI 0.50–3.0) and memory–learning (1.6 points, 95% CI 0.4–2.8) scores. Conclusion Children born very preterm without impairments had poorer performance in specific neurocognitive skills than term‐born children. FGR was an independent risk factor for compromised neurocognitive outcome in VLGA children and predicted difficulties in language, memory and learning.