Cognitive and Learning Outcomes in Late Preterm Infants at School Age: A Systematic Review

Abstract

Late preterm children born between 340/7 and 366/7 weeks’ gestation account for ≈70% of prematurely born infants. There is growing concern about this population at risk of mild neurodevelopmental problems, learning disabilities and lower academic performance. Following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement, this paper analyzes recent published evidence from 16selected studies involving late preterm children and control group assessments at preschool and/or school age, mainly focusing on cognitive functioning, language learning and academic achievement. The review identifies the assessment tools used in these studies (standardized tests, parental questionnaires and laboratory tasks) and the areas being evaluated from preschool (age 3 years) to primary school levels. Results reveal the presence of mild difficulties, pointing to suboptimal outcomes in areas such as executive function, short term verbal memory, literacy skills, attention and processing speed. Some difficulties are transient, but others persist, possibly compromising academic achievement, as suggested by the few studies reporting on higher risk for poor school performance. Given the increasing number of late preterm children in our society the review highlights the need to implement screening strategies to facilitate early risk detection and minimize the negative effects of this morbidity in childhood.

An Early Collaborative Intervention Focusing on Parent-Infant Interaction in the Neonatal Period. A Descriptive Study of the Developmental Framework

“…It is important to pay attention to all preterm infants in the neonatal intensive care unit, regardless of gestational age, as delays in physical and cognitive developmental outcomes are evident even for moderate and late preterm infants [ 12 , 49 ]. It is vitally important to involve parents in the care, as this is recommended for optimal development [ 35 , 50 ].…”

Neurobehavioral Phenotype and Dysexecutive Syndrome of Preterm Children: Comorbidity or Trigger? An Update

“…Academic failures increase with the decrease in the child’s gestational age. However, as reported in a recent review, moderately preterm children are also at risk of learning disabilities in reading and mathematics [ 46 ]. In Twilhaar et al [ 13 ], 2390 children showed performance scores of −0.71 SD in mathematics, −0.44 SD in reading and −0.52 SD in spelling (confirmed by Allotey, with scores of, respectively, −0.78 SD, −0.67 SD and −0.56 SD) in VP children aged from 5 to 8 years as compared with the control group born at term [ 14 ].…”

Commentary — The late preterm infant: Vulnerable cerebral cortex and large burden of disability

“…A large series of recent studies have elucidated the specific deficits encompassed by the subsequent NDD in LPT infants [ 2, 4–8, 9 ]. Although the specific deficits are not marked, they are appreciable enough to lead to impaired academic performance.…”

“…LPT infants have increased rates of perinatal morbidities as well as subsequent NDD (see later). However, importantly, a major proportion of the NDD occurs in the absence of recognized perinatal problems [ 2 ]. The absolute number of LPT infants with subsequent NDD yearly is approximately 3,500 [ 3 ].…”