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Background Although survival rates for infants born extremely preterm (gestation &lt; 28 weeks) have improved significantly in recent decades, neurodevelopmental impairment remains a major concern. Children born extremely preterm remain at high risk for cognitive impairment from early childhood to adulthood. However, there is limited evidence on genetic factors associated with cognitive impairment in this population. Methods First, we used a latent profile analysis (LPA) approach to characterize neurocognitive function at age 10 for children born extremely preterm. Children were classified into two groups: (1) no or low cognitive impairment, and (2) moderate-to-severe cognitive impairment. Second, we performed TOPMed-based genotype imputation on samples with genotype array data ( n  = 528). Third, we then conducted a genome-wide association study (GWAS) for LPA-inferred cognitive impairment. Finally, computational analysis was conducted to explore potential mechanisms underlying the variant x LPA association. Results We identified two loci reaching genome-wide significance ( p  value &lt; 5e-8): TEA domain transcription factor 4 ( TEAD4  at rs11829294,  p  value = 2.40e-8) and syntaxin 18 ( STX18  at rs79453226,  p  value = 1.91e-8). Integrative analysis with brain expression quantitative trait loci (eQTL), chromatin conformation, and epigenomic annotations suggests tetraspanin 9 ( TSPAN9 ) and protein arginine methyltransferase 8 ( PRMT8 ) as potential functional genes underlying the GWAS signal at the  TEAD4  locus. Conclusions We conducted a novel computational analysis by utilizing an LPA-inferred phenotype with genetics data for the first time. This study suggests that rs11829294 and its LD buddies have potential regulatory roles on genes that could impact neurocognitive impairment for extreme preterm born children.

Innovative computational approaches shed light on genetic mechanisms underlying cognitive impairment among children born extremely preterm