Effects of correcting for prematurity on cognitive test scores in childhood

Wilson-Ching, Michelle; Pascoe, Leona; Doyle, Lex W.; Anderson, Peter J.

doi:10.1111/jpc.12475

Cited by 101 publications

(62 citation statements)

References 14 publications

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“…This may suggest—in line with several recent studies 30–32 —that correction for prematurity may be warranted beyond two or three years of age, an issue that remains under debate. Use of a prematurity correction relies on an assumption that developmental outcomes of preterm children temporarily lag behind full-term children due to their early delivery and therefore shorter time since conception for central nervous system maturation.…”

Section: Commentsupporting

confidence: 73%

Describing the Shape of the Relationship Between Gestational Age at Birth and Cognitive Development in a Nationally Representative U.S. Birth Cohort

Richards

Drews‐Botsch

Sales

et al. 2016

Paediatric Perinatal Epid

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Background Preterm children face higher risk of cognitive and academic deficits compared with their full-term peers. The objective of this study was to describe early childhood cognitive ability and kindergarten academic achievement across gestational age at birth in a population-based longitudinal cohort. Methods The study population included singletons born at 24-42 weeks GA enrolled in the Early Childhood Longitudinal Study-Birth Cohort (n=6,150 for 2-year outcome, n=4,450 for kindergarten outcome). Home-based assessments measured cognitive ability at 2 years and reading and mathematics achievement at kindergarten age. Linear regression models estimated the association between gestational age and cognitive and academic scores using four different ways of modeling gestational age: continuous variable in linear and quadratic terms; categories for individual weeks; and clinical categories for early preterm, moderate preterm, late preterm, early term, full term, late term, and post-term. Results Children born at early preterm (24-27 weeks), moderate preterm (28-33 weeks), and late preterm (34-36 weeks) scored significantly worse than full-term (39-40 weeks) peers on 2-year and kindergarten assessments; however, no deficits were observed for early term (37-38 weeks). These categories were a clinically useful and parsimonious approach to stratifying risk of adverse cognitive and academic outcomes. Conclusions This study estimated the relative performance of children born at 24-42 weeks in a population-based birth cohort using multiple approaches to modeling gestational age, providing a more rigorous understanding of the relationships between the full spectrum of gestational age and cognitive and academic outcomes in early childhood and at school age.

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Section: Commentsupporting

confidence: 73%

Describing the Shape of the Relationship Between Gestational Age at Birth and Cognitive Development in a Nationally Representative U.S. Birth Cohort

Richards

Drews‐Botsch

Sales

et al. 2016

Paediatric Perinatal Epid

View full text Add to dashboard Cite

show abstract

“…All assessment results are reported using standardized scores based on the child’s corrected age to avoid bias in cognitive test scores (Wilson-Ching, Pascoe, Doyle, & Anderson, 2014). All assessments were performed by trained pediatric assessors, psychologists or pediatricians.…”

Section: Methodsmentioning

confidence: 99%

Neurodevelopmental Outcomes and Neural Mechanisms Associated with Non-right Handedness in Children Born Very Preterm

Pascoe

Scratch

Burnett

et al. 2015

J Int Neuropsychol Soc

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Objective Non-right handedness (NRH) is reportedly more common in very preterm (VPT; <32 weeks’ gestation) children compared with term-born peers, but it is unclear whether neonatal brain injury or altered brain morphology and microstructure underpins NRH in this population. Given that NRH has been inconsistently reported to be associated with cognitive and motor difficulties, this study aimed to examine associations between handedness and neurodevelopmental outcomes in VPT 7 year-olds. Further, the relationship between neonatal brain injury and integrity of motor tracts (corpus callosum and corticospinal tract) with handedness at age 7 years in VPT children was explored. Method One hundred and seventy-five VPT and 69 term-born children completed neuropsychological and motor assessments and a measure of handedness at 7 years’ corrected age. At term-equivalent age, brain injury on MRI was assessed and diffusion tensor measures were obtained for the corpus callosum and posterior limb of the internal capsule. Results There was little evidence of stronger NRH in the VPT group compared with term controls (regression coefficient [b] −1.95, 95% confidence interval [CI] −5.67 to 1.77). Poorer academic and working memory outcomes were associated with stronger NRH in the VPT group. While there was little evidence that neonatal unilateral brain injury was associated with stronger NRH, increased area and fractional anisotropy of the corpus callosum splenium were predictive of stronger NRH in the VPT group. Conclusions VPT birth may alter the relationship between handedness and academic outcomes, and neonatal corpus callosum integrity predicts hand preference in VPT children at school age.

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“…Age correction eliminates an important bias in cognitive test scores, which occurs even after the first few years of life in EP children. 12 …”

Section: Methodsmentioning

confidence: 99%

Biological and Social Influences on Outcomes of Extreme-Preterm/Low-Birth Weight Adolescents

Doyle¹,

et al. 2015

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BACKGROUND AND OBJECTIVES: The importance of biological versus social influences on long-term outcomes of extremely preterm children is debatable. The goal of this study was to determine the relative contributions of biological and social exposures to outcomes into adolescence in extremely preterm survivors, hypothesizing that biological exposures would be more important early, but social exposures would dominate later. METHODS: The study included 298 consecutive survivors born at <28 weeks’ gestation or weighing <1000 g in Victoria, Australia (during 1991–1992), and 262 normal birth weight (>2499 g) control subjects who were used to standardize outcomes for the preterm group. Cognitive ability was assessed at 2, 5, 8, and 18 years of age. Academic achievement was assessed at 8 and 18 years of age. RESULTS: The differences between the preterm and control groups for cognitive and academic scores remained relatively constant over time. The biological variables most associated with worse outcomes within the extremely preterm group were intraventricular hemorrhage and postnatal corticosteroid therapy. Of the social variables, being reared in a multilingual household was disadvantageous early, with social class and maternal education becoming more important for later outcomes. The strength of the biological associations mostly equaled or exceeded those of social exposures, even in late adolescence. CONCLUSIONS: Contrary to expectations, several perinatal biological exposures had large and persistent adverse associations with cognitive and academic outcomes among extremely preterm survivors. As expected, some social variables assumed increasing importance in later years but mostly did not diminish or exceed the important biological associations.

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Effects of correcting for prematurity on cognitive test scores in childhood

Abstract: Chronological age results in a lowering of scores at all ages for preterm-born subjects that is greater in the first few years and in those born at earlier gestational ages. Whether or not to correct for prematurity depends upon the context of the assessment.

Cited by 101 publications

References 14 publications

Describing the Shape of the Relationship Between Gestational Age at Birth and Cognitive Development in a Nationally Representative U.S. Birth Cohort

Describing the Shape of the Relationship Between Gestational Age at Birth and Cognitive Development in a Nationally Representative U.S. Birth Cohort

Neurodevelopmental Outcomes and Neural Mechanisms Associated with Non-right Handedness in Children Born Very Preterm

Biological and Social Influences on Outcomes of Extreme-Preterm/Low-Birth Weight Adolescents

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