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Executive function deficits in children born preterm or at low birthweight: a meta‐analysis
Author(s) -
Houdt Carolien A,
Oosterlaan Jaap,
WassenaerLeemhuis Aleid G,
Kaam Anton H,
AarnoudseMoens Cornelieke S H
Publication year - 2019
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/dmcn.14213
Subject(s) - gestational age , meta analysis , low birth weight , medicine , birth weight , small for gestational age , pediatrics , premature birth , executive functions , working memory , psychology , cognition , pregnancy , psychiatry , genetics , biology
Aim To investigate the magnitude of executive function deficits and their dependency on gestational age, sex, age at assessment, and year of birth for children born preterm and/or at low birthweight. Method PubMed, Psych INFO , Web of Science, and ERIC were searched for studies reporting on executive functions in children born preterm/low birthweight and term controls born in 1990 and later, assessed at a mean age of 4 years or higher. Studies were included if five or more studies reported on the same executive function measures. Results Thirty‐five studies (3360 children born preterm/low birthweight, 2812 controls) were included. Children born preterm/low birthweight performed 0.5 standardized mean difference ( SMD ) lower on working memory and cognitive flexibility and 0.4 SMD lower on inhibition. SMD s for these executive functions did not significantly differ from each other. Meta‐regression showed that heterogeneity in SMD s for working memory and inhibition could not be explained by study differences in gestational age, sex, age at assessment, or year of birth. Interpretation Children born preterm/low birthweight since 1990 perform half a SMD below term‐born peers on executive function, which does not seem to improve with more recent advances in medical care or with increasing age. What this paper adds Children born preterm/low birthweight perform below term‐born children on core executive functions. Lower gestational age or male sex are not risk factors for poorer executive functions. Executive function difficulties in children born preterm/low birthweight remain stable across childhood. Executive function difficulties are similar for children born recently and children born in earlier eras.