ADHD and Learning Disabilities in Former Late Preterm Infants: A Population-Based Birth Cohort

Abstract

BACKGROUND AND OBJECTIVE: Previous studies suggest that former late preterm infants are at increased risk for learning and behavioral problems compared with term infants. These studies have primarily used referred clinical samples of children followed only until early school age. Our objective was to determine the cumulative incidence of attention deficit/hyperactivity disorder (ADHD) and learning disabilities (LD) in former late preterm versus term infants in a population-based birth cohort. METHODS: Subjects included all children born 1976 to 1982 in Rochester, MN who remained in the community after 5 years. This study focused on the comparison of subjects in 2 subgroups, late preterm (34 to <37 weeks) and term (37 to <42 weeks). School and medical records were available to identify individuals who met research criteria for ADHD and LD in reading, written language, and math. The Kaplan-Meier method was used to estimate the cumulative incidence of each condition by 19 years of age. Cox models were fit to evaluate the association between gestational age group and condition, after adjusting for maternal education and perinatal complications. RESULTS: We found no statistically significant differences in the cumulative incidence of ADHD or LD between the late preterm (N = 256) versus term (N = 4419) groups: ADHD (cumulative incidence by age 19 years, 7.7% vs 7.2%; P = .84); reading LD (14.2% vs 13.1%; P = .57); written language LD (13.5% vs 15.7%; P = .36), and math LD (16.1% vs 15.5%; P = .89). CONCLUSIONS: These data from a population-based birth cohort indicate that former late preterm infants have similar rates of LD and ADHD as term infants.

Late Preterm Infants and Neurodevelopmental Outcomes at Kindergarten

“…38 Likewise, a United States-based group found similar rates of learning disability and attention deficit/hyperactivity disorder diagnoses in LPIs and FTIs in a white, middle class community without ethnic and racial diversity. 39 Our study cohort has the strengths of being a large nationally representative sample with robust follow-up at kindergarten and data collected from multiple sources including parents, birth certificates, and direct in-home assessments of children. The assessments were conducted by trained assessors with excellent quality control measures.…”

Efeitos da prematuridade na aquisição da linguagem e na maturação auditiva: revisão sistemática

“…In assessing performing functions and their relation to language, several studies indicated a positive correlation between attention abnormalities and other performing functions and poorer language performance (22,27) , having also related it to lower gestational age (27) and poorer nonverbal learning (27) . Premature children presented poorer performing functions (22) , although they are not different from full-term infants in terms of attention-deficit and hyperactivity disorder (21) . One study (14) , however, indicates that attention at 18 months predicts language abnormalities at 36 months, ratifying attention span as a precursor of language, although attention is not positively associated with the mother's educational level, as is language in general.…”

“…In contrast, two studies (20)(21)(22)(23) found no association of retinopathy of prematurity with language outcomes. However, the study suggests that gestational age, low weight at birth and gender may be more influential in the long term in these children, thus being necessary to monitor this population -as has been observed in other studies reviewed (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29) .…”

“…Some of the studies verified impairments related to language outcomes in premature children, these having presented compromised language in relation to full-term children (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32) . A study (19) also found association with hearing impairment.…”

“…The studies selected were divided into works that aimed to assess the effects and risks of the association of abnormalities and other aspects of development with prematurity. In these, assessments of language and hearing were part of the procedures to carry out such studies in a complementary basis (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27) . On the other hand, other studies found focused mainly on language and/or hearing impairments in premature infants (28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38) .…”