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Extreme prematurity and neuropsychological outcome in the preschool years

Published online by Cambridge University Press:  10 November 2009

SARAH RAZ ,
ANGELA K. DEBASTOS ,
JULIE BAPP NEWMAN  and
DANIEL BATTON
SARAH RAZ*
Affiliation:
Developmental Neuropsychology Laboratory, Department of Psychology and the Merrill-Palmer Institute, Wayne State University, Detroit, Michigan
ANGELA K. DEBASTOS
Affiliation:
Neuropsychology Program, Department of Psychiatry, Children’s Hospital, Boston, Massachusetts
JULIE BAPP NEWMAN
Affiliation:
Department of Psychology, Wayne State University, Detroit, Michigan
DANIEL BATTON
Affiliation:
Professor of Pediatrics, Southern Illinois University Medical School, Springfield, Illinois
*
*Correspondence and reprint requests to: Sarah Raz, Developmental Neuropsychology Laboratory, Department of Psychology and the Merrill-Palmer Institute, Wayne State University, 71 E. Ferry, Detroit, MI 48202. E-mail: sarahraz@wayne.edu
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Abstract

With the increasing survival of extremely preterm (EP) birth infants in the surfactant era, the longer-term outcome of infants born at the threshold of viability has become a vital topic of study. The goal of this investigation was twofold. First, while taking into account the influence of sociodemographic confounds, we wished to investigate neuropsychological outcome differences between two groups of EP preschoolers: 23–24 weeks (n = 20), and 25–26 weeks’ (n = 21) gestation at delivery. Second, we wished to explore whether, within the population of EP preschoolers, gestational maturity accounts for a unique portion of the variance in neuropsychological outcome, over and above the variance explained by ante-, peri-, and neonatal complications, or treatment factors. The findings revealed group differences, ranging from .70 to .80 of a standard deviation in general intellectual abilities, nonverbal intelligence, and global motor performance, in favor of the more mature EP group. Additionally, gestational maturity was found to explain a unique portion of the variance in global intellectual and motor abilities. These findings are interpreted from the perspective that gestational age is an index of the vulnerability of the central nervous system to disruption of developmentally regulated processes. (JINS, 2010, 16, 169–179.)

Keywords

Preterm birthNeurobehavioral manifestationsCognitive aspectsMotor skillsChildrenLanguage
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 16 , Issue 1 , January 2010 , pp. 169 - 179
Copyright
Copyright © The International Neuropsychological Society 2009

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References

REFERENCES

Ajayi-Obe, M., Saeed, N., Cowan, F.M., Rutherford, M.A., & Edwards, A.D. (2000). Lancet, 356, 1162–1163.CrossRefGoogle Scholar
Anderson, P.J., & Doyle, L.W. (2004). Executive functioning in school-aged children who were born very preterm or with extremely low birth weight in the 1990s. Pediatrics, 114, 50–57.CrossRefGoogle ScholarPubMed
Anderson, P.J., & Doyle, L.W. (2006). Neurodevelopmental outcome of bronchopulmonary dysplasia. Seminars in Perinatology, 30, 227–232.Google Scholar
Anderson, P.J., & Doyle, L.W. (2008). Cognitive and educational deficits in children born extremely preterm. Seminars in Perinatology, 32, 51–58.CrossRefGoogle ScholarPubMed
Anderson, P.J., Doyle, L.W., & the Victorian Collaborative Study Group. (2003). Neurobehavioral outcomes of school-age children born extremely low birth weight or very preterm in the 1990s. Journal of the American Medical Association, 289, 3264–3272.Google Scholar
Aylward, G.P. (2002). Cognitive and neuropsychologial outcomes: More than IQ scores. Mental Retardation and Developmental Disabilities Research Reviews, 8, 234–240.CrossRefGoogle Scholar
Ayoubi, J.M., Audibert, F., Boithias, C., Zupan, V., Taylor, S., Bosson, J.L., & Frydman, R. (2002). Perinatal factors affecting survival and survival without disability of extreme premature infants at two years of age. European Journal of Obstetrics & Gynecology and Reproductive Biology, 105, 124–131.Google Scholar
Baron, I.S., Ahronovich, M.D., Erickson, K., Gidley Larson, J.C., & Litman, F.R. (2009). Age-appropriate early school age neurobehavioral outcomes of extremely preterm birth without severre intraventricular hemorrhage: A single center experience. Early Human Development, 85, 191–196.CrossRefGoogle Scholar
Bednarek, N., Akhavi, A., Pietrement, C., Mesmin, F., Loron, G., & Morville, P. (2008). Outcome of cerebellar injury in very low birth-weight infants: 6 case reports. Journal of Child Neurology, 23, 906–911.CrossRefGoogle ScholarPubMed
Bodensteiner, J.B., & Johnsen, S.D. (2005). Cerebellar injury in the extremely premature infant: Newly recognized but relatively common outcome. Jounal of Child Neurology, 20, 139–142.CrossRefGoogle ScholarPubMed
Bodensteiner, J.B., & Johnsen, S.D. (2006). Magnetic resonance imaging (MRI) findings in preterm infants. Seminars in Fetal & Neonatal Medicine, 11, 363–368.Google Scholar
Coalson, D., & Spruill, J. (2007). Cognitive Assessment with the Wechsler Preschool and Primary Scale of Intelligence. In Bracken, B. & Nagle, R. (Eds.), Psychoeducational Assessment (3rd ed.), pp. 241–246. Mahawah, NJ: Lawrence Erlbaum.Google Scholar
Dammann, O., & Leviton, A. (2006). Inflammation, brain damage and visual dysfunction in children surviving extremely premature delivery and extremely low birthweight with cerebral palsy. Journal of Child Neurology, 21, 743–747.Google Scholar
Dammann, O., Leviton, A., Gappa, M., & Dammann, C.E.I. (2005). Lung and brain damage in preterm newborns, and their association with gestational age, prematurity subgroup, infection/inflammation and long term outcome. BJOG: An International Journal of Obstetrics and Gynaecology, 112, 4–9.CrossRefGoogle ScholarPubMed
Doyle, L. (2004). The Victorian Infant Collaborative Study Group: Neonatal intensive care of borderline viability – Is it worth it? Early Human Development, 80, 103–113.Google Scholar
Dyet, L.E., Kennea, N., Counsell, S.J., Maalouf, E.F., Ajayi-Obe, M., Duggan, P.J., et al. (2006). Natural history of brain lesions in extremely preterm infants studied with serial magnetic resonance imaging from birth and neurodevelopmental assessment. Pediatrics, 118, 536–548.CrossRefGoogle ScholarPubMed
Express Group, Fellman, V., Hellstrom-Westas, L., Norman, M., Westgren, M., Kallen, K., Lagercrantz, H., et al. . (2009). One-year survival of extremely preterm infants after active perinatal care in Sweden. Journal of the American Medical Association, 301, 2225–2233.Google ScholarPubMed
Fields, R.D. (2008). White matter in learning, cognition and psychiatric disorders. Trends in Neuroscience, 31, 361–370.Google Scholar
Flynn, J.R. (1987). Massive IQ gains in 14 nations: What IQ tests really measure. Psychological Bulletin, 101, 171–191.Google Scholar
Folio, M.R., & Fewell, R.R. (2000). Peabody Developmental Motor Scales (2nd ed.), Austin, TX: Pro-Ed, Inc.Google Scholar
Hack, M., Taylor, H.G., Drotar, D., Schluchter, M. Carter, L., Andreias, L., et al. (2005a). Chronic conditions, functional limitations, and special health care needs of school-aged children born with extremely low-birth-weight in the 1990s. Journal of the American Medical Association, 294, 318–325.CrossRefGoogle ScholarPubMed
Hack, M., Taylor, H., Drotar, D. Schluchter, M., Cartar, L., Wilson-Costello, D., et al. (2005b). Poor predictive validity of the Bayley Scales of Infant Development for cognitive function of extremely low birth weight children at school age. Pediatrics, 116, 333–341.CrossRefGoogle ScholarPubMed
Hack, M., Taylor, G., Klein, N., Eiben, R., Schatschneider, C., & Mercuri-Minich, N. (1994). School-age outcomes in children with birth weights under 750 g. New England Journal of Medicine, 331, 753–759.CrossRefGoogle ScholarPubMed
Hack, M., Taylor, H.S., Schluchter, M., Andreias, L., Drotar, D., & Klein, N. (2009). Behavioral outcomes of extremely low birth weight children at age 8 years. Journal of Developmental and Behavioral Pediatrics, 30, 122–130.Google Scholar
Hintz, S.R., Kendrick, D.E., Vohr, B.R., Poole, K., & Higgins, R. (2005). Changes in neurodevelopmental outcomes at 18 to 22 months’ corrected age among infants of less than 25 weeks’ gestational age born in 1993–1999. Pediatrics, 115, 1645–1651.Google Scholar
Hollingshhead, A.B. (1975). Four-Factor Index of Social Status. Unpublished manuscript, Department of Sociology, Yale University, New Haven, CT.Google Scholar
Horsch, S., Hallberg, B., Leifsdottir, K., Skiold, B., Nagy, Z., Mosskin, M., et al. (2007). Brain abnormalities in extremely low gestational age infants: A Swedish population based MRI study. Acta Paediatrica, 96, 950–951.CrossRefGoogle ScholarPubMed
Inder, T.E., Huppi, P.S., Warfield, S., Kikinis, R., Zientara, G.P., Barnes, P.D., et al. (1999). Periventricular white matter injury in the premature infant is followed by reduced cerebral cortical gray matter volume at term. Annals of Neurology, 46, 755–760.Google Scholar
Inder, T.E., Wells, S.J., Mogridge, N.B., Spencer, C., & Volpe, J.J. (2003). Defining the nature of the cerebral abnormalities in the premature infant: A qualitative magnetic resonance imaging study. Journal of Pediatrics, 143, 171–179.Google Scholar
Jacobs, S.E., O’Brien, K., Inwood, S., Kelly, E.N., & Whyte, H.E. (2000). Outcome of infants 23–26 weeks’ gestation pre and post surfactant. Acta Paediatrica, 89, 959–965.Google Scholar
Jobe, A.H., & Bancalari, E. (2001). Bronchopulmonary dysplasia. American Review of Respiratory Critical Care Medicine, 163, 1723–1729.Google Scholar
Kramer, M.S., Platt, R.W., Wen, S.W., Joseph, K.S., Allen, A., Abrahamowicz, M., et al. (2001). A new and improved population-based Canadian reference for birth weight for gestational age, Pediatrics, 108, e35.Google Scholar
Leviton, A., Blair, E., Dammann, O., & Allred, E. (2005a). The wealth of information conveyed by gestational age. Journal of Pediatrics, 46, 123–127.Google Scholar
Leviton, A., Dammann, O., & Durum, S.K. (2005b). The adaptive immune response in neonatal cerebral white matter damage. Annals of Neurology, 58, 821–828.Google Scholar
Maalouf, E.F., Duggan, P.J., Rutherford, M.A., Counsell, S.J., Fletcher, A.M., Battin, M., et al. (1999). Journal of Pediatrics, 135, 351–357.CrossRefGoogle Scholar
Maring, J.R., & Elbaum, L. (2007). Concurrent validity of the Early Intervention Developmental Profile and the Peabody Developmental Motor Scale-2. Pediatric Physical Therapy, 19, 116–120.CrossRefGoogle ScholarPubMed
Marlow, N., Hennessy, E., Bracewell, M., Wolke, D., & the EPICure Study Group. (2007). Motor and executive function at 6 years of age after extremely preterm birth. Pediatrics, 120, 793–804.Google Scholar
Marlow, N., Wolke, D., Bracewell, M.A., & Samara, M. (2005). Neurologic and developmental disability at six years of age after extremely preterm birth. The New England Journal of Medicine, 352, 9–19.Google Scholar
Ment, L.R., Vohr, B., Allan, W., Westerveld, M., Katz, K.H., Schneider, K.C., & Makuch, R.W. (1999). The etiology and outcome of cerebral ventriculomegaly at term in very low birth weight preterm infants. Pediatrics, 104, 243–248.CrossRefGoogle ScholarPubMed
Pignotti, M.S., & Donzelli, G. (2008). Perinatal care at the threshold of viability: An international comparison of practical guidelines for the treatment of extremely preterm births. Pediatrics, 121, e193–e199.CrossRefGoogle ScholarPubMed
Short, E.J., Klein, N.K., Lewis, B.A., Fulton, M.A., Eisengart, S., Kercsmar, C., et al. (2003). Cognitive and academic consequences of bronchopulmonary dysplasia and very low birth weight: 8-year-old outcomes. Pediatrics, 112, e359–e366.CrossRefGoogle ScholarPubMed
Singh, J., Fanaroff, J., Andrews, B., Caldarelli, L., Lagatta, J., Plesha-Troyke, S., et al. (2007). Resuscitation in the “Gray Zone” of viability: Determining physician preferences and predicting infant outcomes. Pediatrics, 120, 519–526.CrossRefGoogle ScholarPubMed
Spittle, A.J., Brown, N.C., Doyle, I.W., Boyd, R.N., Hunt, R.W., Bear, M., & Inder, T.E. (2008). Quality of general movements is related to white matter pathology in very preterm infants. Pediatrics, 121, e1184–e1189.CrossRefGoogle ScholarPubMed
Subramanian, K.N.S., (2006). Neonatal ethics. In Kurjak, A. & Chervenak, F.A. (Eds.), Textbook of perinatal medicine, Vol. I (2nd ed., pp. 209–216), Informa, Abingdon, UK: CRC Press.Google Scholar
Taylor, H., Hack, M., Klein, N., & Schatschneider, C. (1995). Achievement in children with birth weights less than 750 grams with normal cognitive abilities: Evidence for specific learning disabilities. Journal of Pediatric Psychology 20, 703–719.Google Scholar
Taylor, H., Klein, N., Minich, N.M., & Hack, M. (2000). Middle-school-age outcomes in children with very low birthweight. Child Development, 71, 1495–1511.Google Scholar
Taylor, H.G., Minich, N., Bangert, B., Filipek, P.A., & Hack, M. (2004). Long-term neuropsychological outcomes of very low birth weight: Associations with early risks for periventricular brain insults. Journal of the International Neuropsychological Society, 10, 987–1004.Google Scholar
VICS (The Victorian Infant Collaborative Study Group) (1997). Outcome at 2 years of children 23–27 weeks’ gestation born in Victoria in 1991–1992. Journal of Paediatrics and Child Health 33, 161–165.Google Scholar
Volpe, J.J. (2001). Neurology of the newborn (4th ed.). Philadelphia: W.B. Saunders.Google Scholar
Wechsler, D. (1989). Wechsler Preschool and Primary Scale of Intelligence–Revised. San Antonio, TX: The Psychological Corporation.Google Scholar
Wechsler, D. (1997). Wechsler Adult Intelligence Scale (3rd ed.). San Antonio, TX: The Psychological Corporation.Google Scholar
Woods, N.S., Marlow, N., Costeloe, K., Gibson, A.T., & Wilkinson, A.R. (2000). Neurologic and developmental disability after extremely preterm birth, EPICure Study Group. New England Journal of Medicine, 343, 378–384.CrossRefGoogle Scholar
Woodward, L.J., Anderson, P.J., Austin, N.C., Howard, K., & Inder, T.E. (2006). Neonatal MRI to predict neurodevelopmental outcomes in preterm infants. The New England Journal of Medicine, 355, 685–694.CrossRefGoogle ScholarPubMed
Yeh, T.F., Lin, Y.J., Lin, H.C., Huang, C.C., Hsieh, W.S., Lin, C.H., & Tsai, C.H. (2004). Outcomes at school age after postnatal dexamethasone therapy for lung disease of prematurity. New England Journal of Medicine, 350, 1304–1313.Google Scholar
Zimmerman, I.L., Steiner, V.G., & Pond, R.E. (1992). Preschool Language Scale (3rd ed.). San Antonio, TX: The Psychological Corporation.Google Scholar