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Roettger ME, Tan J, Houle B, Najman JM, McGee T. Adolescent behavioral problems, preterm/low birth weight children and adult life success in a prospective Australian birth cohort study. Prev Med 2024; 185:108061. [PMID: 38972605 DOI: 10.1016/j.ypmed.2024.108061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 07/02/2024] [Accepted: 07/04/2024] [Indexed: 07/09/2024]
Abstract
BACKGROUND Preterm and/or low birthweight (PT/LBW) is predictive of a range of adverse adult outcomes, including lower employment, educational attainment, and mental wellbeing, and higher welfare receipt. Existing studies, however, on PT/LBW and adult psychosocial risks are often limited by low statistical power. Studies also fail to examine potential child or adolescent pathways leading to later adult adversity. Using a life course framework, we examine how adolescent problem behaviors may moderate the association between PT/LBW and a multidimensional measure of life success at age 30 to potentially address these limitations. METHODS We analyze 2044 respondents from a Brisbane, Australia cohort followed from birth in1981-1984 through age 30. We examine moderation patterns using obstetric birth outcomes for weight and gestation, measures of problem behaviors from the Child Behavioral Checklist at age 14, and measures of educational attainment and life success at 30 using multivariable normal and ordered logistic regression. RESULTS Associations between PT/LBW and life success was found to be moderated by adolescent problem behaviors in six scales, including CBCL internalizing, externalizing, and total problems (all p < 0.01). In comparison, associations between LBW and educational attainment illustrate how a single-dimensional measure may yield null results. CONCLUSION For PT/LBW, adolescent problem behaviors increase risk of lower life success at age 30. Compared to analysis of singular outcomes, the incorporation of multidimensional measures of adult wellbeing, paired with identification of risk and protective factors for adult life success as children develop over the lifespan, may further advance existing research and interventions for PT/LBW children.
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Affiliation(s)
- Michael E Roettger
- School of Demography, The Australian National University, 146 Ellory Crescent, Acton ACT 2601, Australia.
| | - Jolene Tan
- School of Demography, The Australian National University, 146 Ellory Crescent, Acton ACT 2601, Australia
| | - Brian Houle
- School of Demography, The Australian National University, 146 Ellory Crescent, Acton ACT 2601, Australia; MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Jake M Najman
- School of Public Health, Public Health Building, The University of Queensland, Herston 4006, Australia
| | - Tara McGee
- School of Criminology and Criminal Justice, Griffith University, 176 Messines Ridge Road, Mount Gravatt, QLD 4122, Australia
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Tekeba B, Techane MA, Workneh BS, Zegeye AF, Gonete AT, Ahmed MA, Wassie YA, Wassie M, Kassie AT, Ali MS, Mekonen EG, Tamir TT, Tsega SS. Determinants of preterm birth among reproductive age women in sub-Saharan Africa: Evidence from the most recent Demographic and Health Survey data-2019-2022. PLoS One 2024; 19:e0305810. [PMID: 38917208 PMCID: PMC11198911 DOI: 10.1371/journal.pone.0305810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 06/05/2024] [Indexed: 06/27/2024] Open
Abstract
INTRODUCTION Preterm birth is the leading cause of both infant and neonatal mortality. It also had long-term consequences for the physical and neurological development of a growing child. The majority of these and related problems occur in low- and middle-income countries, particularly in sub-Saharan Africa, due to resource scarcity to sustain the lives of premature babies. Despite this, there is a paucity of recent information on the pooled prevalence and factors associated with preterm birth in sub-Saharan Africa. Therefore, this study aimed to update the pooled prevalence and determinants of preterm birth in sub-Saharan Africa based on the most recent Demographic and Health Survey data. METHODS A cross-sectional study design using the most recent demographic and health survey data from eight sub-Saharan African countries was used. We included a total weighted sample of 74,871 reproductive-aged women who gave birth in the five years preceding the survey. We used a multilevel logistic regression model to identify associated factors of preterm birth in sub-Saharan Africa. The adjusted odds ratio at 95% Cl was computed to assess the strength and significance of the association between explanatory and outcome variables. Factors with a p-value of <0.05 are declared statistically significant. RESULTS In this study, the pooled prevalence of preterm birth among reproductive-aged women in eight sub-Saharan African countries was 3.11% (95% CI: 2.98-3.25). Working mothers (AOR = 0.61; 95% CI: 0.38-0.97), being married (AOR = 0.63; 95% CI: 0.40-0.99), and having media exposure (AOR = 0.59; 95% CI: 0.36-0.96) decrease the odds of preterm birth. On the other hand, being low birth weight (AOR = 17.7; 95% CI: 10.7-29.3), having multiple pregnancies (AOR = 3.43; 95% CI: 1.82-6.45), having a history of terminated pregnancies (AOR = 1.56; 95% CI: 1.01-2.41), being un-educated (AOR = 3.16; 95% CI: 1.12-8.93), being of a maternal age above 35 (AOR = 1.63; 95% CI: 1.08-2.45), maternal alcohol use (AOR = 19.18; 95% CI: 13.6-38.8), and being in the low socio-economic status (AOR = 1.85; 95% CI: 1.11-3.07) of the community increase the odds of preterm birth. CONCLUSION The burden of preterm birth among reproductive-age women in sub-Saharan Africa showed improvements as compared to previous findings. To further lessen the burden, policymakers and other pertinent organizations must prioritize maternal health, expand media access, educate and empower women, and promote a healthy lifestyle for reproductive-age women.
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Affiliation(s)
- Berhan Tekeba
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Masersha Asmare Techane
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Belayneh Shetie Workneh
- Department of Emergency and Critical Care Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Alebachew Ferede Zegeye
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Almaz Tefera Gonete
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Medina Abdela Ahmed
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yilkal Abebaw Wassie
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mulugeta Wassie
- School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Alemneh Tadesse Kassie
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mohammed Seid Ali
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Enyew Getaneh Mekonen
- Department of Surgical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadesse Tarik Tamir
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Sintayehu Simie Tsega
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Nguyen PT, Nguyen PH, Tran LM, Khuong LQ, Van Nguyen S, Young MF, DiGirolamo A, Ramakrishnan U. The Relationship of Preterm and Small for Gestational Age with Child Cognition During School-Age Years. J Nutr 2024:S0022-3166(24)00351-1. [PMID: 38936548 DOI: 10.1016/j.tjnut.2024.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Revised: 06/16/2024] [Accepted: 06/24/2024] [Indexed: 06/29/2024] Open
Abstract
BACKGROUND Children born preterm and/or small for gestational age (SGA) are at increased risk of poor cognitive outcomes, particularly in low and middle-income countries (LMICs). OBJECTIVES This study aimed to examine the cognitive and academic deficits during the school-age years in children born preterm or SGA compared with those in children born term adequate for gestational age (AGA) in rural Vietnam. METHODS Children born to women in a preconception micronutrient supplementation trial in Vietnam were classified into 3 groups: preterm AGA (n =138), term SGA (n =169), and term AGA (n = 1134). Cognitive abilities were assessed using the Wechsler Intelligence Scale for Children, measuring 4 domains [verbal comprehension index (VCI), perceptual reasoning index (PRI), working memory index (WMI), and processing speed index (PSI) scores] and full-scale intelligence quotient (FSIQ) at 6-7 and 10-11 y. Academic achievement was assessed with mathematic and language tests. Analysis of variance and multiple regression models were used to analyze differences in cognitive function and academic achievement at 6-7 and 10-11 y by birth phenotypes. RESULTS Compared with term AGA children, those born SGA had lower cognitive scores at both 6-7 y (VCI, -2.3; PRI, -3.7; PSI -2.1; and FSIQ, -2.9) and 10-11 y (VCI, -3.7; PRI, -3.5; WMI, -2.7; PSI, -1.9; and FSIQ, -3.9). Children born SGA also had poorer academic achievement with lower language (5.3) and mathematic (2.5) scores. Adjustments for maternal factors and home environment attenuated the associations, but the differences in VCI, PRI, FSIQ, and language at 10-11 y remained significant. There were no differences in cognitive function and academic achievement between children born preterm and AGA. CONCLUSIONS Our findings highlight the enduring association of birth phenotype on cognitive functioning and academic achievement during the school years, despite adjustments for maternal education and family environment. Further research is needed to implement effective interventions to improve birth outcomes and optimize child health and development in LMICs. The trial was registered at clinicaltrials.gov as NCT01665378 (URL: https://clinicaltrials.gov/ct2/show/NCT01665378).
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Affiliation(s)
- Phuong Thi Nguyen
- Pediatric Department, Thai Nguyen University of Pharmacy and Medicine, Thai Nguyen, Vietnam
| | - Phuong Hong Nguyen
- Pediatric Department, Thai Nguyen University of Pharmacy and Medicine, Thai Nguyen, Vietnam; Nutrition, Diet and Health Unit, International Food Policy Research Institute, Washington, DC, United States.
| | - Lan Mai Tran
- Nutrition and Health Sciences, Emory University, Atlanta, GA, United States
| | - Long Quynh Khuong
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA, United States
| | - Son Van Nguyen
- Pediatric Department, Thai Nguyen University of Pharmacy and Medicine, Thai Nguyen, Vietnam
| | - Melissa F Young
- Nutrition and Health Sciences, Emory University, Atlanta, GA, United States
| | - Ann DiGirolamo
- Georgia Health Policy Center, Georgia State University, Atlanta, GA, United States
| | - Usha Ramakrishnan
- Nutrition and Health Sciences, Emory University, Atlanta, GA, United States
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Ahmed AM, Pullenayegum E, McDonald SD, Beltempo M, Premji SS, Shoukry R, Pole JD, Bacchini F, Shah PS, Pechlivanoglou P. Preterm Birth, Family Income, and Intergenerational Income Mobility. JAMA Netw Open 2024; 7:e2415921. [PMID: 38857046 PMCID: PMC11165381 DOI: 10.1001/jamanetworkopen.2024.15921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 04/09/2024] [Indexed: 06/11/2024] Open
Abstract
Importance Preterm birth (PTB) has been associated with lower income in adulthood, but associations with intergenerational income mobility and the role of family socioeconomic status (SES) as modifying factor are unclear. Objectives To assess whether the association between PTB and income differs according to family SES at birth and to assess the association between PTB and intergenerational income mobility. Design, Setting, and Participants This study comprised a matched cohort of live births in Canada between January 1, 1990, and December 31, 1996, with follow-up until December 31, 2018. Statistical analysis was performed between May 2023 and March 2024. Exposure Preterm birth, defined as birth between 24 and 37 weeks' gestational age (with gestational age subcategories of 34-36, 32-33, 28-31, and 24-27 weeks) vs early and full term births (gestational age, 37-41 weeks). Main Outcomes and Measures Associations between PTB and annual adulthood income in 2018 Canadian dollars were assessed overall (current exhange rate: $1 = CAD $1.37) and stratified by family income quintiles, using generalized estimating equation regression models. Associations between PTB and percentile rank change (ie, difference between the rank of individuals and their parents in the income distribution within their respective generations) and upward or downward mobility (based on income quintile) were assessed using linear and multinomial logistic regressions, respectively. Results Of 1.6 million included births (51.1% boys and 48.9% girls), 6.9% infants were born preterm (5.4% born at 34-36 weeks, 0.7% born at 32-33 weeks, 0.5% born at 28-31 weeks, and 0.2% born at 24-27 weeks). After matching on baseline characteristics (eg, sex, province of birth, and parental demographics) and adjusting for age and period effects, PTB was associated with lower annual income (mean difference, CAD -$687 [95% CI, -$788 to -$586]; 3% lower per year), and the differences were greater among those belonging to families in the lowest family SES quintile (mean difference, CAD -$807 [95% CI, -$998 to -$617]; 5% lower per year). Preterm birth was also associated with lower upward mobility and higher downward mobility, particularly for those born earlier than 31 weeks' gestational age (24-27 weeks: mean difference in percentile rank change, -8.7 percentile points [95% CI, -10.5 to -6.8 percentile points]). Conclusions and Relevance In this population-based matched cohort study, PTB was associated with lower adulthood income, lower upward social mobility, and higher downward mobility, with greater differences among those belonging to economically disadvantaged families. Interventions to optimize socioeconomic outcomes of preterm-born individuals would need to define target population considering SES.
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Affiliation(s)
- Asma M. Ahmed
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Eleanor Pullenayegum
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Sarah D. McDonald
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada
| | - Marc Beltempo
- Department of Pediatrics, McGill University, Montreal, Quebec, Canada
| | - Shahirose S. Premji
- School of Nursing, Faculty of Health Sciences, Queen’s University, Kingston, Ontario, Canada
| | - Roaa Shoukry
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jason D. Pole
- Centre for Health Services Research, The University of Queensland, Brisbane, Queensland, Australia
| | | | - Prakesh S. Shah
- Department of Pediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Petros Pechlivanoglou
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
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Louis D, Akil H, Oberoi S, Sirski M, Alvaro R, Seshia M, Moddemann D, Lix LM, Ruth C, Garland A. Grade 7 school performance of children born preterm: a retrospective Canadian Cohort study. J Perinatol 2024; 44:827-834. [PMID: 38438788 DOI: 10.1038/s41372-024-01911-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 01/31/2024] [Accepted: 02/13/2024] [Indexed: 03/06/2024]
Abstract
IMPORTANCE Data on the middle school outcomes of preterm children are limited and have methodologic issues. OBJECTIVE To study the association between preterm birth and grade 7 school performance. METHODS A retrospective population-based cohort study of children born in Manitoba, Canada between 1994 and 2006 using their grade 7 school performance data. A secondary sibling cohort was created comprising children born preterm and their full-term siblings. Primary exposure was preterm birth categorized as <28, 28-33 and 34-36 weeks gestation. The two co-primary grade 7 outcome measures were: not meeting the mathematics competencies, and not meeting the student engagement competencies. Multivariable logistic regression models tested the association between preterm birth and both co-primary outcomes; adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were calculated. RESULTS 7653 preterm (gestational age median [IQR]: 35 weeks [34,36]) and 110,313 term (40 [39,40]) were included. 43% of < 28 weeks, 18% of 28-33 weeks and 17% of 34-36 weeks had the mathematics co-primary outcome compared to 13% of term children. The corresponding % for the student engagement outcome were 42%, 24%, 24% and 24% respectively. Preterm birth was associated with the mathematics (<28 weeks: 5.48, 3.89-7.70; 28-33 weeks: 1.47, 1.27-1.70; 34-36 weeks: 1.26, 1.16-1.35) and student engagement outcomes (<28 weeks: 2.49, 1.76-3.51; 28-33 weeks: 1.21, 1.06-1.39; 34-36 weeks: 1.09, 1.01-1.16). However, there was no difference in outcomes among the sibling cohort. CONCLUSIONS AND RELEVANCE Children born preterm had lower grade 7 performance compared to children born term in this population-based cohort. Screening and supports for them in their middle school years are warranted.
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Affiliation(s)
- Deepak Louis
- Section of Neonatology, Department of Pediatrics and Child Health, Rady Faculty of Medicine, University of Manitoba, Winnipeg, MB, Canada.
| | - Hammam Akil
- Section of Neonatology, Department of Pediatrics and Child Health, Rady Faculty of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Sapna Oberoi
- Division of Pediatric Hematology-Oncology, Department of Pediatrics and Child Health, Rady Faculty of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Monica Sirski
- Data analyst, Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, MB, Canada
| | - Ruben Alvaro
- Section of Neonatology, Department of Pediatrics and Child Health, Rady Faculty of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Mary Seshia
- Section of Neonatology, Department of Pediatrics and Child Health, Rady Faculty of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Diane Moddemann
- Neonatal Follow-up Program, Department of Pediatrics and Child Health, Rady Faculty of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Lisa M Lix
- Department of Community Health Sciences, Rady Faculty of Medicine, University of Manitoba, Winnipeg, MB, Canada
- Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, MB, Canada
| | - Chelsea Ruth
- Section of Neonatology, Department of Pediatrics and Child Health, Rady Faculty of Medicine, University of Manitoba, Winnipeg, MB, Canada
- Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, MB, Canada
| | - Allan Garland
- Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, MB, Canada
- Department of Medicine, Rady Faculty of Medicine, University of Manitoba, Winnipeg, MB, Canada
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Tamm L, McNally KA, Altaye M, Parikh NA. Mathematics abilities associated with adaptive functioning in preschool children born preterm. Child Neuropsychol 2024; 30:315-328. [PMID: 36939102 PMCID: PMC10509309 DOI: 10.1080/09297049.2023.2191942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 03/10/2023] [Indexed: 03/21/2023]
Abstract
It is well known that infants born very preterm (VPT) often demonstrate deficits in mathematical abilities in early childhood which are associated with poorer academic outcomes. Mathematic skills are also critical for other areas of functioning. However, it is not known whether mathematics skills are associated with adaptive functioning in children born preterm. Infants born at ≤31 weeks gestation and full term were recruited at birth and followed over time. At the 36-month corrected age assessment, children were administered the Early Number Concepts subtest of the Differential Abilities Scale, Second Edition, and caregivers completed the Adaptive Behavior Assessment System, Third Edition. After controlling for age, sex, cognitive abilities, and caregiver education, performance on the mathematics measure was uniquely and positively associated with adaptive behavior for preschool children in the VPT group only. Exploratory analyses revealed this association to be specifically related to the Practical and Social composites. Knowledge of concepts of number and quantity were associated with better adaptive functioning, particularly for behaviors related to functioning at home and in the community and play/social functioning, for children born VPT. Although replication is warranted, it would appear that mathematical skills may be an important early intervention target for children born VPT.
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Affiliation(s)
- Leanne Tamm
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, Cincinnati, Ohio 45229-3039
- University of Cincinnati College of Medicine, Cincinnati, Ohio
| | | | - Mekibib Altaye
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, Cincinnati, Ohio 45229-3039
- University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Nehal A. Parikh
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, Cincinnati, Ohio 45229-3039
- University of Cincinnati College of Medicine, Cincinnati, Ohio
- The Perinatal Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
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Baumann N, Voit F, Wolke D, Trower H, Bilgin A, Kajantie E, Räikkönen K, Heinonen K, Schnitzlein DD, Lemola S. Preschool Mathematics and Literacy Skills and Educational Attainment in Adolescents Born Preterm and Full Term. J Pediatr 2024; 264:113731. [PMID: 37722555 DOI: 10.1016/j.jpeds.2023.113731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/09/2023] [Accepted: 09/13/2023] [Indexed: 09/20/2023]
Abstract
OBJECTIVES To test whether preschool academic skills were associated with educational attainment in adolescence and whether associations differed between individuals born preterm and at full term. STUDY DESIGN This prospective cohort study comprised 6924 individuals, including n = 444 (6.4%) adolescents born preterm (<37 weeks of gestation) from the Avon Longitudinal Study of Parents and Children. Preschool academic (mathematics and literacy) skills were rated by teachers at 4-5 years. Educational attainment at 16 years was informed by attaining a General Certificate of Secondary Education (GCSE) in key subjects mathematics and English. Logistic regressions assessed the association between preterm birth, preschool mathematics, and GCSE Mathematics and between preterm birth, preschool literacy, and GCSE English. RESULTS Similar numbers of adolescents born preterm and at term achieved a GCSE in mathematics and English (53.6 % vs 57.4% and 59.5% vs 63.9%, respectively; P values > .05). Higher preschool academic skill scores in mathematics were associated with greater odds of attaining GCSE Mathematics and preschool literacy skills were associated with GCSE English. Adolescents born preterm with higher preschool mathematics (OR: 1.51, CI: 1.14, 2.00) and literacy skills (OR: 1.57, CI: 1.10, 2.25) were more likely to attain GCSEs in the respective subject than their term-born counterparts with equal levels of preschool skills. CONCLUSIONS Preschool academic skills in mathematics and literacy are associated with educational attainment of preterm and term-born individuals in adolescence. Children born prematurely may benefit more from preschool mathematics and literacy skills for academic and educational success into adolescence than term-born individuals.
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Affiliation(s)
- Nicole Baumann
- Department of Population Health Sciences, University of Leicester, Leicester, United Kingdom; Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia; Department of Psychology, University of Warwick, Coventry, United Kingdom.
| | - Falk Voit
- Institute of Labour Economics, Leibniz University Hannover, Hannover, Germany
| | - Dieter Wolke
- Department of Psychology, University of Warwick, Coventry, United Kingdom; Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Hayley Trower
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Ayten Bilgin
- Department of Psychology, University of Essex, Colchester, United Kingdom
| | - Eero Kajantie
- Department of Public Health and Welfare Promotion, Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland; Clinical Medicine Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Children's Hospital, Helsinki University Hospital and the University of Helsinki, Helsinki, Finland; Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Katri Räikkönen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Kati Heinonen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland; Psychology/Welfare Sciences, Tampere University, Tampere, Finland
| | - Daniel D Schnitzlein
- Institute of Labour Economics, Leibniz University Hannover, Hannover, Germany; IZA Institute of Labour Economics, Bonn, Germany
| | - Sakari Lemola
- Department of Psychology, University of Warwick, Coventry, United Kingdom; Department of Psychology, Bielefeld University, Bielefeld, Germany
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Schinz D, Schmitz‐Koep B, Zimmermann J, Brandes E, Tahedl M, Menegaux A, Dukart J, Zimmer C, Wolke D, Daamen M, Boecker H, Bartmann P, Sorg C, Hedderich DM. Indirect evidence for altered dopaminergic neurotransmission in very premature-born adults. Hum Brain Mapp 2023; 44:5125-5138. [PMID: 37608591 PMCID: PMC10502650 DOI: 10.1002/hbm.26451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 06/23/2023] [Accepted: 07/28/2023] [Indexed: 08/24/2023] Open
Abstract
While animal models indicate altered brain dopaminergic neurotransmission after premature birth, corresponding evidence in humans is scarce due to missing molecular imaging studies. To overcome this limitation, we studied dopaminergic neurotransmission changes in human prematurity indirectly by evaluating the spatial co-localization of regional alterations in blood oxygenation fluctuations with the distribution of adult dopaminergic neurotransmission. The study cohort comprised 99 very premature-born (<32 weeks of gestation and/or birth weight below 1500 g) and 107 full-term born young adults, being assessed by resting-state functional MRI (rs-fMRI) and IQ testing. Normative molecular imaging dopamine neurotransmission maps were derived from independent healthy control groups. We computed the co-localization of local (rs-fMRI) activity alterations in premature-born adults with respect to term-born individuals to different measures of dopaminergic neurotransmission. We performed selectivity analyses regarding other neuromodulatory systems and MRI measures. In addition, we tested if the strength of the co-localization is related to perinatal measures and IQ. We found selectively altered co-localization of rs-fMRI activity in the premature-born cohort with dopamine-2/3-receptor availability in premature-born adults. Alterations were specific for the dopaminergic system but not for the used MRI measure. The strength of the co-localization was negatively correlated with IQ. In line with animal studies, our findings support the notion of altered dopaminergic neurotransmission in prematurity which is associated with cognitive performance.
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Affiliation(s)
- David Schinz
- Department of Neuroradiology, School of MedicineTechnical University of MunichMunichGermany
- TUM‐NIC Neuroimaging Center, School of MedicineTechnical University of MunichMunichGermany
| | - Benita Schmitz‐Koep
- Department of Neuroradiology, School of MedicineTechnical University of MunichMunichGermany
- TUM‐NIC Neuroimaging Center, School of MedicineTechnical University of MunichMunichGermany
| | - Juliana Zimmermann
- Department of Neuroradiology, School of MedicineTechnical University of MunichMunichGermany
- TUM‐NIC Neuroimaging Center, School of MedicineTechnical University of MunichMunichGermany
| | - Elin Brandes
- Department of Neuroradiology, School of MedicineTechnical University of MunichMunichGermany
- TUM‐NIC Neuroimaging Center, School of MedicineTechnical University of MunichMunichGermany
| | - Marlene Tahedl
- Department of Neuroradiology, School of MedicineTechnical University of MunichMunichGermany
- TUM‐NIC Neuroimaging Center, School of MedicineTechnical University of MunichMunichGermany
| | - Aurore Menegaux
- Department of Neuroradiology, School of MedicineTechnical University of MunichMunichGermany
- TUM‐NIC Neuroimaging Center, School of MedicineTechnical University of MunichMunichGermany
| | - Juergen Dukart
- Institute of Neuroscience and MedicineBrain & Behaviour (INM‐7), Research Centre JülichJülichGermany
- Institute of Systems Neuroscience, Medical FacultyHeinrich Heine University DüsseldorfDüsseldorfGermany
| | - Claus Zimmer
- Department of Neuroradiology, School of MedicineTechnical University of MunichMunichGermany
- TUM‐NIC Neuroimaging Center, School of MedicineTechnical University of MunichMunichGermany
| | - Dieter Wolke
- Department of PsychologyUniversity of WarwickCoventryUK
- Warwick Medical SchoolUniversity of WarwickCoventryUK
| | - Marcel Daamen
- Clinical Functional Imaging Group, Department of Diagnostic and Interventional RadiologyUniversity Hospital BonnBonnGermany
- Department of NeonatologyUniversity Hospital BonnBonnGermany
| | - Henning Boecker
- Clinical Functional Imaging Group, Department of Diagnostic and Interventional RadiologyUniversity Hospital BonnBonnGermany
| | - Peter Bartmann
- Department of NeonatologyUniversity Hospital BonnBonnGermany
| | - Christian Sorg
- Department of Neuroradiology, School of MedicineTechnical University of MunichMunichGermany
- TUM‐NIC Neuroimaging Center, School of MedicineTechnical University of MunichMunichGermany
- Department of Psychiatry, School of MedicineTechnical University of MunichMunichGermany
| | - Dennis M. Hedderich
- Department of Neuroradiology, School of MedicineTechnical University of MunichMunichGermany
- TUM‐NIC Neuroimaging Center, School of MedicineTechnical University of MunichMunichGermany
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9
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Mathewson KJ, Saigal S, Van Lieshout RJ, Schmidt LA. Intellectual functioning in survivors of extremely low birthweight: Cognitive outcomes in childhood and adolescence. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2023; 67:186-204. [PMID: 36814136 DOI: 10.1111/jir.13021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 11/15/2021] [Accepted: 01/30/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Infants born at extremely low birthweight (ELBW: ≤1000 g) are vulnerable to intellectual disabilities, but the factors that may distinguish between ELBW survivors with and without these impairments are not well understood. In this study, prospective associations between neonatal factors and functional outcomes in childhood and adolescence were compared in ELBW survivors with and without borderline intellectual functioning (BIF). METHODS Borderline intellectual functioning was defined by IQ < 85, assessed at 8 years. Among 146 ELBW survivors, 48 (33%) had IQ scores under 85, and 98 (67%) had scores equal to or over 85. Group differences in demographic and risk factors were assessed via t-test, chi-squared analysis or non-parametric tests. Neonatal factors that differed between ELBW groups were tested for association with adaptive behaviour assessed at age 5 years, and reading and arithmetic skills assessed at ages 8 and 15 years, using hierarchical regression models. RESULTS Extremely low birthweight survivors with BIF had significantly lower birthweights than ELBW survivors without BIF (790 vs. 855 g, P < 0.01) and were more likely to be born to mothers with lower socioeconomic status (SES) (78% vs. 48%, P < 0.01). These ELBW survivors also were more likely to be diagnosed with significant neurosensory impairment (NSI; 35% vs. 19%, P < 0.04), experienced more bronchopulmonary dysplasia (56% vs. 38%, P < 0.04), received more days of respiratory support (median 33 vs. 14 days, P < 0.01) and remained in hospital for longer periods (median 81 vs. 63 days, P < 0.03). Birthweight, familial SES, NSI and duration of respiratory support were significant predictors for one or more outcomes. Across groups, lower familial SES was associated with lower academic scores (Ps < 0.05), and NSI predicted lower adaptive functioning (Ps < 0.001). Other associations were moderated by group: among ELBW survivors with BIF, heavier birthweights predicted better arithmetic skills, the presence of NSI was associated with poorer arithmetic skills and more ventilation days predicted poorer reading skills. CONCLUSIONS At birth, ELBW survivors with BIF faced more physiological and social disadvantages and required more medical intervention than their ELBW peers without BIF. Smaller birth size, NSI burden and prolonged neonatal ventilatory support displayed gradients of risk for childhood and adolescent academic outcomes across groups. Whereas academic performance in ELBW survivors with BIF was sensitive to variation in birth size, NSI or ventilation days, ELBW survivors without BIF attained thresholds of intellectual ability that were sufficient to support higher levels of academic performance at both ages, regardless of their status on these factors. The findings are discussed in relation to Zigler's developmental theory of intellectual disability.
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Affiliation(s)
- K J Mathewson
- Child Emotion Lab, Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, Canada
| | - S Saigal
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - R J Van Lieshout
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - L A Schmidt
- Child Emotion Lab, Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, Canada
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10
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Alenius S, Kajantie E, Sund R, Nurhonen M, Haaramo P, Näsänen-Gilmore P, Vääräsmäki M, Lemola S, Räikkönen K, Schnitzlein DD, Wolke D, Gissler M, Hovi P. Risk-Taking Behavior of Adolescents and Young Adults Born Preterm. J Pediatr 2023; 253:135-143.e6. [PMID: 36179892 DOI: 10.1016/j.jpeds.2022.09.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 08/24/2022] [Accepted: 09/22/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To study sexually transmitted Chlamydia trachomatis infections (STCTs), teenage pregnancies, and payment defaults in individuals born preterm as proxies for engaging in risk-taking behavior. STUDY DESIGN Our population-based register-linkage study included all 191 705 children alive at 10 years (8492 preterm [4.4%]) born without malformations in Finland between January 1987 and September 1990 as each mother's first child within the cohort. They were followed until young adulthood. We used Cox regression to assess the hazards of STCTs, teenage pregnancies, payment defaults, criminal offending, and substance abuse by gestational age. Gestational age was considered both as a continuous and categorical (extremely, very, moderately, late preterm, early term, post term, and full term as reference) exposure. RESULTS A linear dose-response relationship existed between gestational age and STCT and teenage pregnancy; adjusted hazard for STCT decreased by 1.6% (95% CI, 0.7%-2.6%), and for teenage pregnancy by 3.3% (95% CI, 1.9%-4.8%) per each week decrease in gestational age. Those born extremely preterm (23-27 completed weeks) had a 51% (95% CI, 31%-83%) lower risk for criminal offending than their full-term born counterparts, and those born very preterm (range, 28-31 weeks) had a 28% (95% CI, 7%-53%) higher hazard for payment defaults than those born at full term. Gestational age was not associated with substance abuse. CONCLUSIONS The lower risk-taking that characterizes people born preterm seems to generalize to sexual and to some extent criminal behavior. Those born very preterm are, however, more likely to experience payment defaults.
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Affiliation(s)
- Suvi Alenius
- Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland; Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Eero Kajantie
- Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland; Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Faculty of Medicine, PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Reijo Sund
- Faculty of Health Sciences, School of Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Markku Nurhonen
- Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland
| | - Peija Haaramo
- Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland
| | - Pieta Näsänen-Gilmore
- Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland; Faculty of Medicine and Health Technology, Tampere Center for Child, Adolescent, and Maternal Health Research: Global Health Group, Tampere University, Tampere, Finland
| | - Marja Vääräsmäki
- Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland; Faculty of Medicine, PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Sakari Lemola
- Department of Psychology, Bielefeld University, Bielefeld, Germany; Department of Psychology, University of Warwick, Warwick, UK
| | - Katri Räikkönen
- Faculty of Medicine, Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Daniel D Schnitzlein
- Institute of Labor Economics, Leibniz University, Hannover, Germany; Institute of Labor Economics (IZA), Bonn, Germany
| | - Dieter Wolke
- Department of Psychology, University of Warwick, Warwick, UK
| | - Mika Gissler
- Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland; Region Stockholm, Academic Primary Health Care Center, Stockholm, Sweden; and the Karolinska Institute, Department of Molecular Medicine and Surgery, Stockholm, Sweden
| | - Petteri Hovi
- Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland; Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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11
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Louis D, Oberoi S, Ricci FM, Pylypjuk C, Alvaro R, Seshia M, de Cabo C, Moddemann D, Sirski M, Lix LM, Garland A, Ruth CA. Grade 3 school performance among children born preterm: a population-based cohort study. Arch Dis Child Fetal Neonatal Ed 2022; 108:286-293. [PMID: 36456174 DOI: 10.1136/archdischild-2022-324746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 11/17/2022] [Indexed: 12/03/2022]
Abstract
OBJECTIVE To study the association between prematurity and grade 3 school performance in a contemporary cohort of children. METHODS Population-based retrospective cohort study in Manitoba, Canada. Children born between 1999 and 2011 who had their grade 3 school performance data available were eligible. Preterm birth (<37 weeks) was the exposure of interest assessed using multivariable logistic regression models. Our primary outcomes were 'needs ongoing help' or 'outside the range' in at least two of each of the (1) four numeracy and (2) three reading competencies. RESULTS Of the 186 956 eligible children, 101 436 children (7187 preterm (gestational age, median (IQR) 35 weeks (34, 36)) and 94 249 term (40 weeks (39,40)) were included. Overall, 19% of preterm and 14% of term children had the numeracy outcome (adjusted OR (aOR) 1.38; 95% CI 1.29 to 1.47, p<0.001), while 19% and 13% had the reading outcome (aOR 1.38; 1.29 to 1.48, p<0.001). These differences showed a gestational age gradient. Gestational age (for numeracy, <28 weeks aOR 4.93 (3.45 to 7.03), 28-33 weeks 1.72 (1.50 to 1.98), 34-36 weeks 1.24 (1.15 to 1.34); for reading, <28 weeks 3.51 (2.40 to 5.14), 28-33 weeks 1.72 (1.49 to 1.98), 34-36 weeks 1.24 (1.17-1.37)), male sex, small for gestational age and maternal medical and sociodemographic factors were associated with the numeracy and reading outcomes in this cohort. CONCLUSIONS AND RELEVANCE Children born preterm had poorer performance in grade 3 numeracy and reading proficiencies than children born full term. All children born preterm, not just those born extremely preterm, should be screened for reading and numeracy performance in school and strategies implemented to address any deficits.
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Affiliation(s)
- Deepak Louis
- Section of Neonatology, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Sapna Oberoi
- Division of Pediatric Hematology-Oncology, Department of Pediatrics and Child Health, University of Manitoba, Winipeg, Manitoba, Canada
| | - Florencia M Ricci
- Section of Neonatology, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Christy Pylypjuk
- Department of Obstetrics and Gynecology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Ruben Alvaro
- Section of Neonatology, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Mary Seshia
- Section of Neonatology, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Cecilia de Cabo
- Section of Neonatology, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Diane Moddemann
- Neonatal Follow up program, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Monica Sirski
- Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Lisa M Lix
- Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Manitoba, Canada.,Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Allan Garland
- Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Manitoba, Canada.,Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Chelsea Anastasia Ruth
- Section of Neonatology, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada.,Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Manitoba, Canada
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12
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Jaekel J, Anderson PJ, Bartmann P, Cheong JLY, Doyle LW, Hack M, Johnson S, Marlow N, Saigal S, Schmidt L, Sullivan MC, Wolke D. Mathematical performance in childhood and early adult outcomes after very preterm birth: an individual participant data meta-analysis. Dev Med Child Neurol 2022; 64:421-428. [PMID: 34913160 DOI: 10.1111/dmcn.15132] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 11/12/2021] [Accepted: 11/12/2021] [Indexed: 11/30/2022]
Abstract
AIM To investigate the strength of the independent associations of mathematics performance in children born very preterm (<32wks' gestation or <1500g birthweight) with attending postsecondary education and their current employment status in young adulthood. METHOD We harmonized data from six very preterm birth cohorts from five different countries and carried out one-stage individual participant data meta-analyses (n=954, 52% female) using mixed effects logistic regression models. Mathematics scores at 8 to 11 years of age were z-standardized using contemporary cohort-specific controls. Outcomes included any postsecondary education, and employment/education status in young adulthood. All models were adjusted for year of birth, gestational age, sex, maternal education, and IQ in childhood. RESULTS Higher mathematics performance in childhood was independently associated with having attended any postsecondary education (odds ratio [OR] per SD increase in mathematics z-score: 1.36 [95% confidence interval {CI}: 1.03, 1.79]) but not with current employment/education status (OR 1.14 per SD increase [95% CI: 0.87, 1.48]). INTERPRETATION Among populations born very preterm, childhood mathematics performance is important for adult educational attainment, but not for employment status.
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Affiliation(s)
- Julia Jaekel
- Psychology, University of Oulu, Oulu, Finland.,Psychology, University of Warwick, Coventry, UK.,Child and Family Studies/Psychology, University of Tennessee Knoxville, Knoxville, TN, USA.,Department of Health Sciences, University of Leicester, Leicester, UK
| | - Peter J Anderson
- Turner Institute for Brain & Mental Health, School of Psychology Sciences, Monash University, Melbourne, VIC, Australia.,Clinical Sciences, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Peter Bartmann
- Children's Hospital, University Hospital Bonn, Bonn, Germany
| | - Jeanie L Y Cheong
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Obstetrics and Gynaecology, University of Melbourne, Melbourne, VIC, Australia.,Neonatal Services, Royal Women's Hospital, Melbourne, VIC, Australia
| | - Lex W Doyle
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Obstetrics and Gynaecology, University of Melbourne, Melbourne, VIC, Australia.,Neonatal Services, Royal Women's Hospital, Melbourne, VIC, Australia
| | - Maureen Hack
- Neonatology, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Samantha Johnson
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Neil Marlow
- EGA Institute for Women's Health, University College London, London, UK
| | - Saroj Saigal
- Pediatrics, McMaster University, Hamilton, ON, USA
| | - Louis Schmidt
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, Canada
| | - Mary C Sullivan
- College of Nursing, University of Rhode Island, Providence, RI, USA
| | - Dieter Wolke
- Psychology, University of Warwick, Coventry, UK.,Warwick Medical School, University of Warwick, Coventry, UK
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13
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Iantosca JAM, Stewart SL. Evaluation of the InterRAI Early Years for Degree of Preterm Birth and Gross Motor Delay. Front Psychol 2022; 13:788290. [PMID: 35282191 PMCID: PMC8904206 DOI: 10.3389/fpsyg.2022.788290] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 01/27/2022] [Indexed: 11/21/2022] Open
Abstract
Background The interRAI 0–3 Early Years was recently developed to support intervention efforts based on the needs of young children and their families. One aspect of child development assessed by the Early Years instrument are motor skills, which are integral for the maturity of cognition, language, social-emotional and other developmental outcomes. Gross motor development, however, is negatively impacted by pre-term birth and low birth weight. For the purpose of known-groups validation, an at-risk sample of preterm children using the interRAI 0–3 Early Years was included to examine correlates of preterm risk and the degree of gross motor delay. Methods Participant data included children and families (n = 591) from 17 health agencies in Ontario, Canada. Data were collected as part of a pilot study using the full interRAI 0–3 Early Years assessment. Correlational analyses were used to determine relationships between prenatal risk and preterm birth and bivariate analyses examined successful and failed performance of at-risk children on gross motor items. A Kruskal-Wallis test was used to determine the mean difference in gross motor scores for children born at various weeks gestation. Results Correlational analysis indicated that prenatal and perinatal factors such as maternal nicotine use during pregnancy did not have significant influence over gross motor achievement for the full sample, however, gross motor scores were lower for children born pre-term or low birth weight based on bivariate analysis. Gross motor scores decreased from 40 weeks’ gestation (mean rank = 310.77), to moderate to late preterm (mean rank = 258.96), and to very preterm (mean rank = 234.54), however extremely preterm (mean rank = 236.28) performed comparably to very preterm. Interpretation The interRAI 0–3 was evaluated to determine its efficacy and report findings which confirm the literature regarding delay in gross motor performance for preterm children. Findings confirm that pre-term and low birth weight children are at greater risk for motor delay via the interRAI 0–3 Early Years gross motor domain.
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Affiliation(s)
- Jo Ann M Iantosca
- School of Early Childhood Education, Seneca College, Toronto, ON, Canada
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14
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D’Agata AL, Kelly M, Green CE, Sullivan MC. Molding influences of prematurity: Interviews with adults born preterm. Early Hum Dev 2022; 166:105542. [PMID: 35085882 PMCID: PMC9186092 DOI: 10.1016/j.earlhumdev.2022.105542] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 01/05/2022] [Accepted: 01/12/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Tremendous medical advancements over the last several decades have supported the survival of younger and sicker newborns. Substantial quantitative research exists about health and developmental outcomes following preterm birth, however, limited published literature has explored what this experience means to the survivors. AIM The purpose was to describe, interpret and understand how adults born preterm perceive prematurity to have affected their lives. STUDY DESIGN Qualitative thematic analysis. METHODS Semi-structured interviews were conducted with 33 adults born preterm from the RHODĒ Study, a longitudinal preterm birth cohort. A cross-section of participants with high and low early life medical and environmental risk was interviewed. Data were analyzed using a constructionist method of latent theme analysis. RESULTS From the data, 3 themes were identified: 1) My parents call me their miracle, 2) It's not a big deal, I'm the same as everyone else, 3) I've overcome a lot. Themes represent a continuum of experience, from positive to neutral to negative. Common life experiences of family, education, friends, and health are subthemes that help to illuminate how participants assign meaning to their prematurity. Meaning was linked to how typical or not participants perceive their health, learning and friends compared to peers. CONCLUSION Perceptions about prematurity and adversity are influenced by the ways parents and families represent prematurity in shared stories and actions. These findings should inform future research with adult survivors of prematurity. Participants identified ongoing need for support and advocacy, particularly from healthcare and education communities.
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Affiliation(s)
- Amy L. D’Agata
- University of Rhode Island, College of Nursing, 350 Eddy Street, Providence, RI 02903, United States of America,Corresponding author at: University of Rhode Island, Rhode Island Nursing Education Center, 350 Eddy Street, Providence, RI 02903, United States of America. (A.L. D’Agata)
| | - Michelle Kelly
- University of Rhode Island, College of Nursing, 350 Eddy Street, Providence, RI 02903, United States of America,Villanova University, Fitzpatrick College of Nursing, 800 E. Lancaster Avenue, Villanova, PA 19085, United States of America
| | - Carol E. Green
- Department of Family Medicine, Brown University, Alpert School of Medicine, 111 Brewster Street, Pawtucket, RI 02860, United States of America
| | - Mary C. Sullivan
- University of Rhode Island, College of Nursing, 350 Eddy Street, Providence, RI 02903, United States of America
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15
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Alamneh TS, Teshale AB, Worku MG, Tessema ZT, Yeshaw Y, Tesema GA, Liyew AM, Alem AZ. Preterm birth and its associated factors among reproductive aged women in sub-Saharan Africa: evidence from the recent demographic and health surveys of sub-Sharan African countries. BMC Pregnancy Childbirth 2021; 21:770. [PMID: 34781891 PMCID: PMC8591945 DOI: 10.1186/s12884-021-04233-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 10/25/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Globally, preterm birth is the leading cause of neonatal and under-five children mortality. Sub-Saharan African (SSA) accounts for the majority of preterm birth and death following its complications. Despite this, there is limited evidence about the pooled prevalence and associated factors of preterm birth at SSA level using nation-wide representative large dataset. Therefore, this study aimed to determine the pooled prevalence and associated factors of preterm birth among reproductive aged women. METHODS The recent Demographic and Health Surveys (DHSs) data of 36 SSA countries were used. We included a total weighted sample of 172,774 reproductive-aged women who were giving birth within five years preceding the most recent survey of SSA countries were included in the analysis. We used a multilevel logistic regression model to identify the associated factors of preterm birth in SSA. We considered a statistical significance at a p-value less than 0.05. RESULTS In this study, 5.33% (95% CI: 5.23, 5.44%) of respondents in SSA had delivered preterm baby. Being form eastern Africa, southern Africa, rural area, being educated, substance use, having multiple pregnancy, currently working history, having history of terminated pregnancy, and previous cesarean section delivery, primi-parity, and short birth interval were associated with higher odds of preterm birth among reproductive aged women. However, having better wealth index, being married, wanted pregnancy, and having four or more antenatal care visit were associated with lower odds for a preterm birth among reproductive aged women. CONCLUSION The prevalence of preterm birth among reproductive-aged women remains a major public health problem in SSA. Preterm birth was affected by various socio-economic and obstetrical factors. Therefore, it is better to consider the high-risk groups during intervention to prevent the short-term and long-term consequences of preterm birth.
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Affiliation(s)
- Tesfa Sewunet Alamneh
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Achamyeleh Birhanu Teshale
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Misganaw Gebrie Worku
- Department of Human Anatomy, University of Gondar, College of Medicine and Health Science, School of Medicine, Gondar, Ethiopia
| | - Zemenu Tadesse Tessema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yigizie Yeshaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Department of Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Getayeneh Antehunegn Tesema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Alemneh Mekuriaw Liyew
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Adugnaw Zeleke Alem
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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16
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Collins SE, Thompson DK, Kelly CE, Yang JYM, Pascoe L, Inder TE, Doyle LW, Cheong JLY, Burnett AC, Anderson PJ. Development of brain white matter and math computation ability in children born very preterm and full-term. Dev Cogn Neurosci 2021; 51:100987. [PMID: 34273749 PMCID: PMC8319459 DOI: 10.1016/j.dcn.2021.100987] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 07/07/2021] [Accepted: 07/11/2021] [Indexed: 11/08/2022] Open
Abstract
Children born very preterm (VPT; <32 weeks' gestation) have alterations in brain white matter and poorer math ability than full-term (FT) peers. Diffusion-weighted magnetic resonance imaging studies suggest a link between white matter microstructure and math in VPT and FT children, although longitudinal studies using advanced modelling are lacking. In a prospective longitudinal cohort of VPT and FT children we used Fixel-Based Analysis to investigate associations between maturation of white matter fibre density (FD), fibre-bundle cross-section (FC), and combined fibre density and cross-section (FDC) and math computation ability at 7 (n = 136 VPT; n = 32 FT) and 13 (n = 130 VPT; n = 44 FT) years, as well as between change in white matter and math computation ability from 7 to 13 years (n = 103 VPT; n = 21 FT). In both VPT and FT children, higher FD, FC and FDC in visual, sensorimotor and cortico-thalamic/thalamo-cortical white matter tracts were associated with better math computation ability at 7 and 13 years. Longitudinally, accelerated maturation of the posterior body of the corpus callosum (FDC) was associated with greater math computation development. White matter-math associations were similar for VPT and FT children. In conclusion, white matter maturation is associated with math computation ability across late childhood, irrespective of birth group.
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Affiliation(s)
- Simonne E Collins
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia; Victorian Infant Brain Study (VIBeS), Murdoch Children's Research Institute, Melbourne, Australia; Developmental Imaging, Murdoch Children's Research Institute, Melbourne, Australia.
| | - Deanne K Thompson
- Victorian Infant Brain Study (VIBeS), Murdoch Children's Research Institute, Melbourne, Australia; Developmental Imaging, Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Australia; Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
| | - Claire E Kelly
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia; Victorian Infant Brain Study (VIBeS), Murdoch Children's Research Institute, Melbourne, Australia; Developmental Imaging, Murdoch Children's Research Institute, Melbourne, Australia
| | - Joseph Y M Yang
- Developmental Imaging, Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Australia; Neuroscience Advanced Clinical Imaging Suite (NACIS), Department of Neurosurgery, The Royal Children's Hospital, Melbourne, Australia; Neuroscience Research, Murdoch Children's Research Institute, Melbourne, Australia
| | - Leona Pascoe
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia; Victorian Infant Brain Study (VIBeS), Murdoch Children's Research Institute, Melbourne, Australia
| | - Terrie E Inder
- Victorian Infant Brain Study (VIBeS), Murdoch Children's Research Institute, Melbourne, Australia; Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | - Lex W Doyle
- Victorian Infant Brain Study (VIBeS), Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Australia; Newborn Research, The Royal Women's Hospital, Melbourne, Australia; Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Australia; Premature Infant Follow-Up Program, Royal Women's Hospital, Melbourne, Australia
| | - Jeanie L Y Cheong
- Victorian Infant Brain Study (VIBeS), Murdoch Children's Research Institute, Melbourne, Australia; Newborn Research, The Royal Women's Hospital, Melbourne, Australia; Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Australia; Premature Infant Follow-Up Program, Royal Women's Hospital, Melbourne, Australia
| | - Alice C Burnett
- Victorian Infant Brain Study (VIBeS), Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Australia; Premature Infant Follow-Up Program, Royal Women's Hospital, Melbourne, Australia; Neonatal Medicine, Royal Children's Hospital, Melbourne, Australia
| | - Peter J Anderson
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia; Victorian Infant Brain Study (VIBeS), Murdoch Children's Research Institute, Melbourne, Australia.
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17
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Medise BE. Growth and Development in Preterm Infants: What is The Long-Term Risk? AMERTA NUTRITION 2021. [DOI: 10.20473/amnt.v5i1sp.2021.27-33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Background: Indonesia comes in the fifth for the greatest number of preterm births. Preterm infants may inflict various complication as the result of underdeveloped immunity, affecting their growth and development in the long run until they reach adult phase. Such complications could be prevented through adequate nutrition fulfillment. Purpose: This article aimed to elaborate the characteristics of growth and development of premature babies, long term effect on the development and the impact of immunity and gut health of preterm infants in supporting their growth and development. Methods: References cited in this article were obtained from the latest primary literature within the last 10 years. Discussion: The rate and ability of infants to perform catch-up growth depends on the birth weight and gestation age, at which the lower birth weight and lower gestational age had slower rate. Brain structures that of preterm infants differ compared to the term, and these changes give rise to various clinical outcomes, including long term emotional, behavioral changes, cognitive and executive functioning. Immature immune system in preterm infants reduces the protective ability by innate and adaptive immunity in overcoming pathogens compared to term infants, including gut microbiota prematurity which affects nutrition absorption and growth and development catch up ability. Appropriate and adequate nutrition supplementation has shown beneficial effects in promoting the growth of normal gut flora, which allow better absorption of nutrition and therefore enhancing growth rate and supporting the development of preterm infants. Conclusions: Optimal growth and development of preterm infants are supported by sufficient nutrition supplementation to support the growth of gut microbiota, facilitating the catch-up growth and development of premature infants and immune system maturity.
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Clayton S, Simms V, Cragg L, Gilmore C, Marlow N, Spong R, Johnson S. Etiology of persistent mathematics difficulties from childhood to adolescence following very preterm birth. Child Neuropsychol 2021; 28:82-98. [PMID: 34472423 DOI: 10.1080/09297049.2021.1955847] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Children born very preterm (VP; <32 weeks' gestation) have poorer mathematics achievement than term-born peers. This study aimed to determine whether VP children's mathematics difficulties persist from primary to secondary school and to explore the nature of mathematics difficulties in adolescence. For this study, 127 VP and 95 term-born adolescents were assessed at age 11-15 years. Mathematics achievement was assessed using the Wechsler Individual Achievement Test-II. Specific mathematics skills and general cognitive skills were assessed using standardized and experimental tests. VP adolescents had poorer mathematics achievement than term-born adolescents (-10.95 points; 95% CI -16.18, -5.73) and poorer number fact knowledge, understanding of arithmetic concepts, written arithmetic, counting, reading and writing large numbers, and algebra. Between-group differences in mathematics skills were no longer significant when working memory and visuospatial skills were controlled for (p's >0.05), with the exception of writing large numbers and conceptual understanding of arithmetic. In a previous study, 83 of the VP adolescents and 49 of the term-born adolescents were assessed at age 8-10 years using measures of the same skills. Amongst these, the between-group difference in mathematics achievement remained stable over time. This study extends findings of a persistent deficit in mathematics achievement among VP children over the primary and secondary school years, and provides evidence of a deficit in factual, procedural and conceptual mathematics skills and in higher order mathematical operations among VP adolescents. We provide further evidence that VP children's mathematics difficulties are driven by deficits in domain-general rather than domain-specific cognitive skills.
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Affiliation(s)
- Sarah Clayton
- Department of Health Sciences, University of Leicester, George Davies Centre, University Road, Leicester, UK
| | | | - Lucy Cragg
- School of Psychology, University of Nottingham, University Park, Nottingham, UK
| | - Camilla Gilmore
- Centre for Mathematical Cognition, Loughborough University, Loughborough, UK
| | - Neil Marlow
- Research Department of Academic Neonatology, Institute for Women's Health, University College London, London, UK
| | - Rebecca Spong
- Department of Health Sciences, University of Leicester, George Davies Centre, University Road, Leicester, UK
| | - Samantha Johnson
- Department of Health Sciences, University of Leicester, George Davies Centre, University Road, Leicester, UK
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19
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Eves R, Mendonça M, Baumann N, Ni Y, Darlow BA, Horwood J, Woodward LJ, Doyle LW, Cheong J, Anderson PJ, Bartmann P, Marlow N, Johnson S, Kajantie E, Hovi P, Nosarti C, Indredavik MS, Evensen KAI, Räikkönen K, Heinonen K, Zeitlin J, Wolke D. Association of Very Preterm Birth or Very Low Birth Weight With Intelligence in Adulthood: An Individual Participant Data Meta-analysis. JAMA Pediatr 2021; 175:e211058. [PMID: 34047752 PMCID: PMC8329745 DOI: 10.1001/jamapediatrics.2021.1058] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
IMPORTANCE Birth before 32 weeks' gestation (very preterm [VPT]) and birth weight below 1500 g (very low birth weight [VLBW]) have been associated with lower cognitive performance in childhood. However, there are few investigations of the association of neonatal morbidities and maternal educational levels with the adult cognitive performance of individuals born VPT or VLBW (VPT/VLBW). OBJECTIVE To assess differences in adult IQ between VPT/VLBW and term-born individuals and to examine the association of adult IQ with cohort factors, neonatal morbidities, and maternal educational level among VPT/VLBW participants. DATA SOURCES Systematic review of published data from PubMed and meta-analysis of individual participant data (IPD) of cohorts from 2 consortia (Research on European Children and Adults Born Preterm [RECAP] and Adults Born Preterm International Collaboration [APIC]). STUDY SELECTION The meta-analysis included prospective longitudinal cohort studies that assessed the full-scale IQ of adults born VPT or VLBW and respective control groups comprising term-born adults. DATA EXTRACTION AND SYNTHESIS The study followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline for analyses of individual participant data and identified 8 studies that provided data from 2135 adults (1068 VPT/VLBW and 1067 term-born participants) born between 1978 and 1995. Meta-analyses of IPD were performed using a 1-stage approach, treating VPT birth or VLBW and cohort as random effects. MAIN OUTCOMES AND MEASURES Full-scale IQ scores were converted to z scores within each cohort using the combined SD of VPT/VLBW participants and a control group of term-born participants, with scores centered on the mean of the control group. RESULTS A total of 426 records were identified and screened. After exclusions, 13 studies were included in the aggregate meta-analysis. The IPD meta-analysis included 8 of the 9 RECAP and APIC cohorts with adult IQ data. The mean (SD) age among the 8 IPD cohorts was 24.6 (4.3) years, and 1163 participants (54.5%) were women. In unadjusted analyses, VPT/VLBW participants had mean adult IQ scores that were 0.78 SD (95% CI, -0.90 to -0.66 SD) lower than term-born participants, equivalent to a difference of 12 IQ points. Among VPT/VLBW participants, lower gestational age (score difference per week of gestation, 0.11; 95% CI, 0.07-0.14), lower birth weight z scores (score difference per 1.0 SD, 0.21; 95% CI, 0.14-0.28), the presence of neonatal bronchopulmonary dysplasia (score difference, -0.16; 95% CI, -0.30 to -0.02) or any grade of intraventricular hemorrhage (score difference, -0.19; 95% CI, -0.33 to -0.05), and lower maternal educational level (score difference, 0.26; 95% CI, 0.17-0.35) were all significantly associated with lower IQ scores in adulthood. CONCLUSIONS AND RELEVANCE In this IPD meta-analysis, lower gestational age, lower weight for gestational age, neonatal morbidities, and lower maternal educational levels were all important risk factors associated with lower IQ among young adults born VPT or VLBW.
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Affiliation(s)
- Robert Eves
- Department of Psychology, University of Warwick, Coventry, United Kingdom
| | - Marina Mendonça
- Department of Psychology, University of Warwick, Coventry, United Kingdom
| | - Nicole Baumann
- Department of Psychology, University of Warwick, Coventry, United Kingdom
| | - Yanyan Ni
- Department of Psychology, University of Warwick, Coventry, United Kingdom
| | - Brian A. Darlow
- Department of Paediatrics, University of Otago at Christchurch, Christchurch, New Zealand
| | - John Horwood
- Department of Psychological Medicine, University of Otago at Christchurch, Christchurch, New Zealand
| | - Lianne J. Woodward
- School of Health Sciences and Child Wellbeing Research Institute, University of Canterbury, Christchurch, New Zealand
| | - Lex W. Doyle
- Department of Obstetrics and Gynaecology, Royal Women's Hospital, University of Melbourne, Melbourne, Victoria, Australia,Neonatal Services, Royal Women’s Hospital, Melbourne, Victoria, Australia,Clinical Sciences, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
| | - Jeanie Cheong
- Department of Obstetrics and Gynaecology, Royal Women's Hospital, University of Melbourne, Melbourne, Victoria, Australia,Neonatal Services, Royal Women’s Hospital, Melbourne, Victoria, Australia,Clinical Sciences, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
| | - Peter J. Anderson
- Clinical Sciences, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia,Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Peter Bartmann
- Department of Neonatology, University Hospital Bonn, Bonn, Germany
| | - Neil Marlow
- UCL Elizabeth Garrett Anderson Institute for Women’s Health, University College London, London, United Kingdom
| | - Samantha Johnson
- Department of Health Sciences, University of Leicester, George Davies Centre, Leicester, United Kingdom
| | - Eero Kajantie
- National Institute for Health and Welfare, Department of Chronic Disease Prevention, Helsinki, Finland,PEDEGO Research Unit, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland,Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway,Children’s Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Petteri Hovi
- National Institute for Health and Welfare, Department of Chronic Disease Prevention, Helsinki, Finland,Children’s Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Chiara Nosarti
- Institute of Psychiatry, Psychology and Neuroscience, Department of Child and Adolescent Psychiatry, King’s College London, London, United Kingdom,Centre for the Developing Brain, Department of Perinatal Imaging and Health, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Marit S. Indredavik
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kari-Anne I. Evensen
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway,Unit for Physiotherapy Services, Trondheim Municipality, Torgarden, Trondheim, Norway,Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
| | - Katri Räikkönen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Kati Heinonen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland,Psychology and Welfare Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Jennifer Zeitlin
- Université de Paris, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, INRA, Paris, France
| | - Dieter Wolke
- Department of Psychology, University of Warwick, Coventry, United Kingdom,Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom
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20
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Saigal S, Morrison K, Schmidt LA. "Health, wealth and achievements of former very premature infants in adult life". Semin Fetal Neonatal Med 2020; 25:101107. [PMID: 32312673 DOI: 10.1016/j.siny.2020.101107] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Very preterm survivors born in the early neonatal intensive care era are now in their middle adulthood. The literature from cohort studies and population-linked registries indicate that extreme prematurity is associated with lower educational attainment and income, higher need for social assistance, and lower rates of marriage/partnership and reproduction. In addition, with increasing age, many general and system-specific adverse health outcomes, such as psychiatric problems, hypertension, and cardio-metabolic disorders have emerged, resulting in high cumulative health care costs across the life-span. Yet, a significant majority of adults born preterm are leading productive lives and contributing to society. Although this information may not be directly applicable to survivors of modern neonatal intensive care, there is much to learn from these findings to inform and guide us into designing effective strategies to improve the health and well-being of future very premature infants. The longer-term outcome of more recent survivors remains to be determined.
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Affiliation(s)
- Saroj Saigal
- McMaster University, Room 4F 1280 Main Street West, Hamilton, Ontario, L8S 4K1, Canada.
| | - Katherine Morrison
- McMaster University, Room 3A59, 1280 Main Street West, Hamilton, Ontario, L8S 4K1, Canada.
| | - Louis A Schmidt
- Neuroscience & Behaviour, McMaster University, Psychology Building, Room 405, 1280 Main St West, Hamilton, Ontario, L8S 4K1, Canada.
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21
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Adrian JA, Bakeman R, Akshoomoff N, Haist F. Cognitive functions mediate the effect of preterm birth on mathematics skills in young children. Child Neuropsychol 2020; 26:834-856. [PMID: 32396760 DOI: 10.1080/09297049.2020.1761313] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Children born preterm are at risk for cognitive deficits and lower academic achievement. Notably, mathematics achievement is generally most affected. Here, we investigated the cognitive functions mediating early mathematics skills and how these are impacted by preterm birth. Healthy children born preterm (gestational age at birth < 33 weeks; n = 51) and children born full term (n = 27) were tested at ages 5, 6, and 7 years with a comprehensive battery of tests. We categorized items of the TEMA-3: Test for Early Mathematics Abilities Third Edition into number skills and arithmetic skills. Using multiple mediation models, we assessed how the effect of preterm birth on mathematics skills is mediated by spatial working memory, inhibitory control, visual-motor integration, and phonological processing. Both number and arithmetic skills showed group differences, but with different developmental trajectories. The initial performance gap observed in the preterm children decreased over time for number skills but increased for arithmetic skills. Phonological processing, visual-motor integration, and inhibitory control were poorer in children born preterm. These cognitive functions, particularly phonological processing, had a mediating effect on both types of mathematics skills. These findings help define and chart the trajectory of the specific cognitive skills directly influencing math deficit phenotypes in children born very preterm. This knowledge provides guidance for targeted evaluation and treatment implementation.
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Affiliation(s)
- Julia Anna Adrian
- Department of Cognitive Science, UC San Diego , San Diego, CA, USA.,Center for Human Development, UC San Diego , San Diego, CA, USA
| | - Roger Bakeman
- Department of Psychology, Georgia State University , Atlanta, GA, USA
| | - Natacha Akshoomoff
- Center for Human Development, UC San Diego , San Diego, CA, USA.,Department of Psychiatry, UC San Diego , San Diego, CA, USA
| | - Frank Haist
- Center for Human Development, UC San Diego , San Diego, CA, USA.,Department of Psychiatry, UC San Diego , San Diego, CA, USA
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22
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McBryde M, Fitzallen GC, Liley HG, Taylor HG, Bora S. Academic Outcomes of School-Aged Children Born Preterm: A Systematic Review and Meta-analysis. JAMA Netw Open 2020; 3:e202027. [PMID: 32242904 PMCID: PMC7125435 DOI: 10.1001/jamanetworkopen.2020.2027] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
IMPORTANCE Children born preterm are at an elevated risk of academic underachievement. However, the extent to which performance across domain-specific subskills in reading and mathematics is associated with preterm birth remains unclear. OBJECTIVE To conduct a systematic review and meta-analysis of academic outcomes of school-aged children born preterm, compared with children born at term, appraising evidence for higher- and lower-order subskills in reading and mathematics. DATA SOURCES PubMed/MEDLINE, PsycINFO, and the Cumulative Index of Nursing and Allied Health Literature electronic databases from January 1, 1980, to July 30, 2018, were searched for population, exposure, and outcome terms such as child (population), preterm birth (exposure), and education* (outcome). STUDY SELECTION Peer-reviewed English-language publications that included preterm-born children and a comparison group of term-born children aged 5 to 18 years and born during or after 1980 and that reported outcomes on standardized assessments from cohort or cross-sectional studies were screened. Of the 9833 articles screened, 33 unique studies met the inclusion criteria. DATA EXTRACTION AND SYNTHESIS Data were analyzed from August 1 to September 29, 2018. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed. Two reviewers independently screened the databases and extracted sample characteristics and outcomes scores. Pooled mean differences (MDs) were analyzed using random-effects models. MAIN OUTCOMES AND MEASURES Performance on standardized assessment of higher-order subskills of reading comprehension and applied mathematics problems; lower-order reading subskills of decoding, pseudoword decoding, and word identification; and lower-order mathematics subskills of knowledge, calculation, and fluency. RESULTS Outcomes data were extracted for 4006 preterm and 3317 term-born children, totaling 7323 participants from 33 unique studies. Relative to children born at term, children born preterm scored significantly lower in reading comprehension (mean difference [MD], -7.96; 95% CI, -12.15 to -3.76; I2 = 81%) and applied mathematical problems (MD, -11.41; 95% CI, -17.57 to -5.26; I2 = 91%) assessments. Across the assessments of lower-order skills, children born preterm scored significantly lower than their term-born peers in calculation (MD, -10.57; 95% CI, -15.62 to -5.52; I2 = 92%), decoding (MD, -10.18; 95% CI, -16.83 to -3.53; I2 = 71%), mathematical knowledge (MD, -9.88; 95% CI, -11.68 to -8.08; I2 = 62%), word identification (MD, -7.44; 95% CI, -9.08 to -5.80; I2 = 69%), and mathematical fluency (MD, -6.89; 95% CI, -13.54 to -0.23; I2 = 72%). The associations remained unchanged after sensitivity analyses for reducing heterogeneity. CONCLUSIONS AND RELEVANCE These findings provide evidence that preterm birth is associated with academic underperformance in aggregate measures of reading and mathematics, as well as a variety of related subskills.
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Affiliation(s)
- Melinda McBryde
- Currently graduate students at School of Psychology, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Australia
- Mothers, Babies and Women’s Health Program, Mater Research Institute, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Grace C. Fitzallen
- Currently graduate students at School of Psychology, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Australia
- Mothers, Babies and Women’s Health Program, Mater Research Institute, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Helen G. Liley
- Mothers, Babies and Women’s Health Program, Mater Research Institute, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - H. Gerry Taylor
- Abigail Wexner Research Institute, Biobehavioral Health Centre, Nationwide Children’s Hospital, Columbus, Ohio
- Department of Pediatrics, The Ohio State University, Columbus
| | - Samudragupta Bora
- Mothers, Babies and Women’s Health Program, Mater Research Institute, Faculty of Medicine, The University of Queensland, Brisbane, Australia
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23
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Socioeconomic status and brain injury in children born preterm: modifying neurodevelopmental outcome. Pediatr Res 2020; 87:391-398. [PMID: 31666689 DOI: 10.1038/s41390-019-0646-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 08/30/2019] [Accepted: 10/01/2019] [Indexed: 12/14/2022]
Abstract
Improved intensive care therapies have increased the survival of children born preterm. Yet, many preterm children experience long-term neurodevelopmental sequelae. Indeed, preterm birth remains a leading cause of lifelong neurodevelopmental disability globally, posing significant challenges to the child, family, and society. Neurodevelopmental disability in children born preterm is traditionally linked to acquired brain injuries such as white matter injury and to impaired brain maturation resulting from neonatal illness such as chronic lung disease. Socioeconomic status (SES) has long been recognized to contribute to variation in outcome in children born preterm. Recent brain imaging data in normative term-born cohorts suggest that lower SES itself predicts alterations in brain development, including the growth of the cerebral cortex and subcortical structures. Recent evidence in children born preterm suggests that the response to early-life brain injuries is modified by the socioeconomic circumstances of children and families. Exciting new data points to the potential of more favorable SES circumstances to mitigate the impact of neonatal brain injury. This review addresses emerging evidence suggesting that SES modifies the relationship between early-life exposures, brain injury, and neurodevelopmental outcomes in children born preterm. Better understanding these relationships opens new avenues for research with the ultimate goal of promoting optimal outcomes for those children born preterm at highest risk of neurodevelopmental consequence.
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24
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Nielsen TM, Pedersen MV, Milidou I, Glavind J, Henriksen TB. Long‐term cognition and behavior in children born at early term gestation: A systematic review. Acta Obstet Gynecol Scand 2019; 98:1227-1234. [DOI: 10.1111/aogs.13644] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 04/09/2019] [Accepted: 05/11/2019] [Indexed: 01/15/2023]
Affiliation(s)
- Trine M. Nielsen
- Perinatal Epidemiology Research Unit Aarhus University Aarhus Denmark
| | - Mette V. Pedersen
- Department of Pediatrics and Adolescent Medicine Aarhus University Aarhus Denmark
| | - Ioanna Milidou
- Perinatal Epidemiology Research Unit Aarhus University Aarhus Denmark
- Department of Pediatrics and Adolescent Medicine Herning Regional Hospital Herning Denmark
| | - Julie Glavind
- Perinatal Epidemiology Research Unit Aarhus University Aarhus Denmark
- Department of Obstetrics and Gynecology Aarhus University Hospital Aarhus Denmark
| | - Tine B. Henriksen
- Perinatal Epidemiology Research Unit Aarhus University Aarhus Denmark
- Department of Pediatrics and Adolescent Medicine Aarhus University Aarhus Denmark
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25
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Johnson S, Bamber D, Bountziouka V, Clayton S, Cragg L, Gilmore C, Griffiths R, Marlow N, Simms V, Wharrad HJ. Improving developmental and educational support for children born preterm: evaluation of an e-learning resource for education professionals. BMJ Open 2019; 9:e029720. [PMID: 31171555 PMCID: PMC6561404 DOI: 10.1136/bmjopen-2019-029720] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES Children born preterm are at higher risk for special educational needs and poor academic attainment compared with term-born peers, yet education professionals receive limited training and have poor knowledge of preterm birth. We have developed an interactive e-learning resource and evaluated its efficacy in improving teachers' knowledge of preterm birth and their confidence in supporting the learning of children born preterm. SETTING Eight primary, infant or junior schools in England. PARTICIPANTS 61 teachers of children aged 4-11 years, of which 55 (90%) were female. INTERVENTION Interactive e-learning resource designed to improve education professionals' knowledge of long-term outcomes following preterm birth and strategies that can be used to support children's learning (www.pretermbirth.info). In a repeated measures design, participants were given up to 30 days access to the e-learning resource, before and after which they completed the Preterm Birth Knowledge Scale (PB-KS; scores 0-33; higher scores indicate greater knowledge) to assess knowledge of outcomes of prematurity. Four Likert scale items were used to assess confidence in supporting children's learning and 10 items were used to evaluate the utility of the resource. PB-KS scores and responses on confidence item were compared pre-resource and post-resource use. RESULTS PB-KS scores significantly increased after accessing the e-learning resource (median (95% CI): pre-resource 13 (11 to 14); post-resource 29 (28 to 30)), equating to a 2.6 SD increase in PB-KS scores. Teachers' confidence in supporting children born preterm was also significantly improved after using the resource. The utility of the resource was evaluated positively by participants with 97% reporting that they would recommend its use to others. CONCLUSIONS The e-learning resource substantially improved teachers' knowledge of preterm birth and their confidence in supporting preterm children in the classroom. Use of this resource may represent a key advance in improving educational outcomes for children born preterm.
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Affiliation(s)
| | | | | | - Sarah Clayton
- Health Sciences, University of Leicester, Leicester, UK
| | - Lucy Cragg
- Psychology, University of Nottingham, Nottingham, Notts, UK
| | - Camilla Gilmore
- Centre for Mathematics Education, University of Loughborough, Loughborough, Leics, UK
| | - Rose Griffiths
- School of Education, University of Leicester, Leicester, UK
| | - Neil Marlow
- Institute for Womens Health, University College London, London, UK
| | - Victoria Simms
- School of Psychology, University of Ulster, Coleraine, Londonderry, UK
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26
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Kelly MM, Michalek R. Children Born Preterm: How Are We Educating Providers? J Nurs Educ 2019; 58:339-346. [DOI: 10.3928/01484834-20190521-04] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 02/20/2019] [Indexed: 12/19/2022]
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27
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Norris T, Johnson W, Petherick E, Cameron N, Oddie S, Johnson S, Wright J, Draper E, Baker PN. Investigating the relationship between fetal growth and academic attainment: secondary analysis of the Born in Bradford (BiB) cohort. Int J Epidemiol 2019; 47:1475-1484. [PMID: 30060064 PMCID: PMC6208280 DOI: 10.1093/ije/dyy157] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 07/16/2018] [Indexed: 11/13/2022] Open
Abstract
Background The relationship between ultrasongraphically derived estimates of fetal growth and educational attainment in the postnatal period is unknown. Results from previous studies focusing on cognitive ability, however, suggest there may be gestation-specific associations. Our objective was to model growth in fetal weight (EFW) and head circumference (HC) and identify whether growth variation in different periods was related to academic attainment in middle childhood. Methods Data come from the Born in Bradford (BiB) cohort study, which has performed data linkage to both routine antenatal scans and national academic attainment tests at age 6-7 years. Multilevel linear spline models were used to model EFW and HC. Random effects from these were related to Key Stage 1 (KS1) results in reading, writing, mathematics, science and a composite of all four (age 6-7 years), using ordinal logistic and logistic regression. Associations were adjusted for potential confounders, facilitated by directed acyclic graphs. Missing covariate data were imputed using multiple imputation. Results In all, 6995 and 8438 children had complete KS1, and EFW and HC data, respectively. Positive associations were observed between both fetal weight in early pregnancy (14 weeks) and EFW growth in mid-pregnancy (14-26 weeks) and the individual KS1 outcomes. Furthermore, after adjustment for previous size and confounders, a 1-z score increase in growth in mid-pregnancy was associated with an 8% increased odds of achieving the expected standard for all KS1 outcomes [odds ratio (OR): 1.08, 95% confidence interval (CI): 1.02; 1.13]. Similar results were observed for HC, with generally larger effect sizes. Smaller associations were observed with growth in the early-third trimester, with no associations observed with growth in the later-third trimester. Conclusions We observed consistent positive associations between fetal size and growth in early and mid-gestation and academic attainment in childhood. The smaller and null associations with growth in the early-third and later-third trimester, respectively, suggests that early-mid gestation may be a sensitive period for future cognitive development.
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Affiliation(s)
- Tom Norris
- Department of Health Sciences, University of Leicester, Leicester, UK.,School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - William Johnson
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Emily Petherick
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Noel Cameron
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Sam Oddie
- Bradford Neonatology, Bradford Royal Infirmary, Bradford Teaching Hospitals Foundation Trust, Bradford, UK
| | - Samantha Johnson
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - John Wright
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
| | - Elizabeth Draper
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Philip N Baker
- College of Life Sciences, University of Leicester, Leicester, UK
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Jurcoane A, Daamen M, Keil VC, Scheef L, Bäuml JG, Meng C, Wohlschläger AM, Sorg C, Busch B, Baumann N, Wolke D, Bartmann P, Boecker H, Lüchters G, Marinova M, Hattingen E. Automated quantitative evaluation of brain MRI may be more accurate for discriminating preterm born adults. Eur Radiol 2019; 29:3533-3542. [PMID: 30903339 DOI: 10.1007/s00330-019-06099-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 02/01/2019] [Accepted: 02/11/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To investigate the structural brain abnormalities and their diagnostic accuracy through qualitative and quantitative analysis in term born and very preterm birth or with very low birth weight (VP/VLBW) adults. METHODS We analyzed 3-T MRIs acquired in 2011-2013 from 67 adults (27 term born controls, mean age 26.4 years, 8 females; 40 VP/VLBWs, mean age 26.6 years, 16 females). We compared automatic segmentations of the white matter, deep gray matter and cortical gray matter, manual corpus callosum measurements and visual ratings of the ventricles and white matter with t tests, logistic regression, and receiver operator characteristic (ROC) curves. RESULTS Automatic segmentation correctly classified 84% of cases; visual ratings correctly classified 63%. Quantitative volumetry based on automatic segmentation revealed higher ventricular volume, lower posterior corpus callosum, and deep gray matter volumes in VP/VLBW subjects compared to controls (p < 0.01). Visual rating and manual measurement revealed a thinner corpus callosum in VP/VLBW adults (p = 0.04) and deformed lateral ventricles (p = 0.03) and tendency towards more "dirty" white matter (p = 0.06). Automatic/manual measures combined with visual ratings correctly classified 87% of cases. Stepwise logistic regression identified three independent features that correctly classify 81% of cases: ventricular volume, deep gray matter volume, and white matter aspect. CONCLUSION Enlarged and deformed lateral ventricles, thinner corpus callosum, and "dirty" white matter are prevalent in preterm born adults. Their visual evaluation has low diagnostic accuracy. Automatic volume quantification is more accurate but time consuming. It may be useful to ask for prematurity before initiating further diagnostics in subjects with these alterations. KEY POINTS • Our study confirms prior reports showing that structural brain abnormalities related to preterm birth persist into adulthood. • In the clinical practice, if large and deformed lateral ventricles, small and thin corpus callosum, and "dirty" white matter are visible on MRI, ask for prematurity before considering other diagnoses. • Although prevalent, visual findings have low accuracy; adding automatic segmentation of lateral ventricles and deep gray matter nuclei improves the diagnostic accuracy.
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Affiliation(s)
- Alina Jurcoane
- Functional Neuroimaging Group, Department of Radiology, University Hospital Bonn, Bonn, Germany.
- Section of Neuroradiology, Department of Radiology, University Hospital Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Germany.
- Department of Neonatology, University Hospital Bonn, Bonn, Germany.
- Institute for Neuroradiology, University Hospital Frankfurt, Frankfurt, Germany.
| | - Marcel Daamen
- Functional Neuroimaging Group, Department of Radiology, University Hospital Bonn, Bonn, Germany
- Department of Neonatology, University Hospital Bonn, Bonn, Germany
| | - Vera C Keil
- Section of Neuroradiology, Department of Radiology, University Hospital Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Germany
| | - Lukas Scheef
- Functional Neuroimaging Group, Department of Radiology, University Hospital Bonn, Bonn, Germany
| | - Josef G Bäuml
- Department of Neuroradiology, Klinikum rechts der Isar, Munich, Germany
- TUM-NIC Neuroimaging Center, Technische Universität München, Munich, Germany
| | - Chun Meng
- Department of Neuroradiology, Klinikum rechts der Isar, Munich, Germany
- TUM-NIC Neuroimaging Center, Technische Universität München, Munich, Germany
| | - Afra M Wohlschläger
- Department of Neuroradiology, Klinikum rechts der Isar, Munich, Germany
- TUM-NIC Neuroimaging Center, Technische Universität München, Munich, Germany
| | - Christian Sorg
- Department of Neuroradiology, Klinikum rechts der Isar, Munich, Germany
- TUM-NIC Neuroimaging Center, Technische Universität München, Munich, Germany
- Department of Psychiatry, Klinikum rechts der Isar, Munich, Germany
| | - Barbara Busch
- Department of Neonatology, University Hospital Bonn, Bonn, Germany
| | - Nicole Baumann
- Department of Psychology, University of Warwick, Coventry, UK
| | - Dieter Wolke
- Department of Psychology, University of Warwick, Coventry, UK
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Peter Bartmann
- Department of Neonatology, University Hospital Bonn, Bonn, Germany
| | - Henning Boecker
- Functional Neuroimaging Group, Department of Radiology, University Hospital Bonn, Bonn, Germany
| | - Guido Lüchters
- Center for Development Research, University of Bonn, Bonn, Germany
| | - Milka Marinova
- Section of Neuroradiology, Department of Radiology, University Hospital Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Germany
| | - Elke Hattingen
- Section of Neuroradiology, Department of Radiology, University Hospital Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Germany
- Institute for Neuroradiology, University Hospital Frankfurt, Frankfurt, Germany
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Jaekel J, Baumann N, Bartmann P, Wolke D. General cognitive but not mathematic abilities predict very preterm and healthy term born adults' wealth. PLoS One 2019; 14:e0212789. [PMID: 30865719 PMCID: PMC6415831 DOI: 10.1371/journal.pone.0212789] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 02/09/2019] [Indexed: 11/27/2022] Open
Abstract
Objective Very preterm (<32 weeks gestation; VP) and/or very low birth weight (<1500g; VLBW) children often have cognitive and mathematic difficulties. It is unknown whether VP/VLBW children’s frequent mathematic problems significantly add to the burden of negative life-course consequences over and above effects of more general cognitive deficits. Our aim was to determine whether negative consequences of VP/VLBW versus healthy term birth on adult wealth are mediated by mathematic abilities in childhood, or rather explained by more general cognitive abilities. Methods 193 VP/VLBW and 217 healthy term comparison participants were studied prospectively from birth to adulthood as part of a geographically defined study in Bavaria (South Germany). Mathematic and general cognitive abilities were assessed at 8 years with standardized tests; wealth information was assessed at 26 years with a structured interview and summarized into a comprehensive index score. All scores were z-standardized. Results At 8 years, VP/VLBW (n = 193, 52.3% male) had lower mathematic and general cognitive abilities than healthy term comparison children (n = 217, 47.0% male). At 26 years, VP/VLBW had accumulated significantly lower overall wealth than term born comparison adults (-0.57 (1.08) versus -0.01 (1.00), mean difference 0.56 [0.36–0.77], p < .001). Structural equation modeling confirmed that VP/VLBW birth (β = -.13, p = .022) and childhood IQ (β = .24, p < .001) both directly predicted adult wealth, but math did not (β = .05, p = .413). Analyses were controlled for small-for-gestational-age (SGA) birth, child sex, and family socioeconomic status. Conclusion This longitudinal study from birth to adulthood shows that VP/VLBW survivors’ general cognitive rather than specific mathematic problems explain their diminished life-course success. These findings are important in order to design effective interventions at school age that reduce the burden of prematurity for those individuals who were born at highest neonatal risk.
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Affiliation(s)
- Julia Jaekel
- Department of Child and Family Studies, University of Tennessee, Knoxville, Tennessee, United States of America
- Department of Psychology, University of Warwick, Coventry, United Kingdom
- * E-mail:
| | - Nicole Baumann
- Department of Psychology, University of Warwick, Coventry, United Kingdom
| | | | - Dieter Wolke
- Department of Psychology, University of Warwick, Coventry, United Kingdom
- Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, United Kingdom
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Abstract
OBJECTIVE Prematurity affects children's functioning in domains such as cognitive skills and math skills. However, there is limited research examining math skills as gestational age (GA) increases weekly. We aimed at determining, in a population-based cohort of children aged 8 to 9 years, the association between the GA spectrum and math skills and working memory's (WM's) role in this relationship. METHODS Children aged 8 to 9 years in 2014 (n = 1761), from 44 primary schools in a metropolitan city, were recruited through the Memory Maestros study in 2012. GA was measured using the parent report. Math skills were measured using the Wide Range Achievement Test 4 math computation subtest (mean, 100; SD, 15), and WM was measured using 2 subtests of the Automated Working Memory Assessment. The method of analysis was multivariate linear regression, with adjustment for both WM measures and social risk indicators as potential confounders. RESULTS A total of 1168 children (66%) had analyzable data. Compared with children of ≤34-week gestation, there was a mean difference increase of 0.48 in math standard scores per weekly increase in GA (95% confidence interval, 0.11-0.85%; p = 0.01). This equates to a difference of 6.29 (0.42 SD) standard math scores between the ≤34- and ≥42-week group. The relationship was independent of WM. CONCLUSION Weekly increases in GA beyond 34 weeks are associated with higher mathematics achievement scores for children aged 8 to 9 years, independent of the child's WM. This assists with identification of individuals at risk of poorer math skills.
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Une étude du concept d’innumérisme. PSYCHOLOGIE FRANCAISE 2018. [DOI: 10.1016/j.psfr.2018.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Weber A, Harrison TM, Steward D, Ludington-Hoe S. Paid Family Leave to Enhance the Health Outcomes of Preterm Infants. Policy Polit Nurs Pract 2018; 19:11-28. [PMID: 30134774 DOI: 10.1177/1527154418791821] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Prematurity is the largest contributor to perinatal morbidity and mortality. Preterm infants and their families are a significant vulnerable population burdened with limited resources, numerous health risks, and poor health outcomes. The social determinants of health greatly shape the economic and psychosocial resources that families possess to promote optimal outcomes for their preterm infants. The purposes of this article are to analyze the resource availability, relative risks, and health outcomes of preterm infants and their families and to discuss why universal paid family leave could be one potential public policy that would promote optimal outcomes for this infant population. First, we discuss the history of family leave in the United States and draw comparisons with other countries around the world. We use the vulnerable populations conceptual model as a framework to discuss why universal paid family leave is needed and to review how disparities in resource availability are driving the health status of preterm infants. We conclude with implications for research, nursing practice, and public policy. Although health care providers, policy makers, and other key stakeholders have paid considerable attention to and allocated resources for preventing and treating prematurity, this attention is geared toward individual-based health strategies for promoting preconception health, preventing a preterm birth, and improving individual infant outcomes. Our view is that public policies addressing the social determinants of health (e.g., universal paid family leave) would have a much greater impact on the health outcomes of preterm infants and their families than current strategies.
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Affiliation(s)
- Ashley Weber
- 1 University of Cincinnati College of Nursing, Cincinnati, OH, USA
| | - Tondi M Harrison
- 2 The Ohio State University College of Nursing, Columbus, OH, USA
| | - Deborah Steward
- 2 The Ohio State University College of Nursing, Columbus, OH, USA
| | - Susan Ludington-Hoe
- 3 Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
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Bilgin A, Mendonca M, Wolke D. Preterm Birth/Low Birth Weight and Markers Reflective of Wealth in Adulthood: A Meta-analysis. Pediatrics 2018; 142:peds.2017-3625. [PMID: 29875181 DOI: 10.1542/peds.2017-3625] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/03/2018] [Indexed: 11/24/2022] Open
Abstract
CONTEXT Preterm birth and/or low birth weight (PT/LBW) increases the risk of cognitive deficits, which suggests an association between PT/LBW and lower wealth in adulthood. Nevertheless, studies have revealed inconsistent findings so far. OBJECTIVE To systematically investigate whether PT/LBW is associated with markers of adulthood wealth. DATA SOURCES We searched Medline, PubMed, PsycINFO, Web of Science, and Embase. STUDY SELECTION Prospective longitudinal and registry studies containing reports on selected wealth-related outcomes in PT/LBW-born adults compared with term-born controls. DATA EXTRACTION Two independent reviewers extracted data on educational qualifications, employment rates, social benefits, and independent living. RESULTS Of 1347 articles screened, 23 studies met the inclusion criteria. PT/LBW was associated with decreased likelihood of attainment of higher education qualifications (odds ratio [OR] = 0.74; 95% confidence interval [CI] = 0.69-0.80), lower employment rate (OR = 0.83; 95% CI = 0.74-0.92), and increased likelihood of receiving social benefits (OR = 1.25; 95% CI = 1.09-1.42). A dose-response relationship according to gestational age was only found for education qualifications. PT/LBW-born adults did not differ significantly from those born at term in independent living. LIMITATIONS There was high heterogeneity between studies. There were unequal numbers of studies from different regions in the world. CONCLUSIONS PT/LBW is associated with lower educational qualifications, decreased rate of employment, and an increased rate of receipt of social benefits in adulthood. Low educational qualifications were most prevalent in those born very preterm and consistent across geographic regions. However, the findings are less clear for independent living.
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Affiliation(s)
- Ayten Bilgin
- Department of Psychology, University of Warwick, Coventry, United Kingdom; and.,Department of Psychology, Istanbul Medeniyet University, Istanbul, Turkey
| | - Marina Mendonca
- Department of Psychology, University of Warwick, Coventry, United Kingdom; and
| | - Dieter Wolke
- Department of Psychology, University of Warwick, Coventry, United Kingdom; and .,Division of Mental Health and Wellbeing, Warwick Medical School and
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Twilhaar ES, de Kieviet JF, Aarnoudse-Moens CSH, van Elburg RM, Oosterlaan J. Academic performance of children born preterm: a meta-analysis and meta-regression. Arch Dis Child Fetal Neonatal Ed 2018; 103:F322-F330. [PMID: 28847871 PMCID: PMC6047144 DOI: 10.1136/archdischild-2017-312916] [Citation(s) in RCA: 97] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 06/28/2017] [Accepted: 07/12/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND Advances in neonatal healthcare have resulted in decreased mortality after preterm birth but have not led to parallel decreases in morbidity. Academic performance provides insight in the outcomes and specific difficulties and needs of preterm children. OBJECTIVE To study academic performance in preterm children born in the antenatal steroids and surfactant era and possible moderating effects of perinatal and demographic factors. DESIGN PubMed, Web of Science and PsycINFO were searched for peer-reviewed articles. Cohort studies with a full-term control group reporting standardised academic performance scores of preterm children (<37 weeks of gestation) at age 5 years or older and born in the antenatal steroids and surfactant era were included. Academic test scores and special educational needs of preterm and full-term children were analysed using random effects meta-analysis. Random effects meta-regressions were performed to explore the predictive role of perinatal and demographic factors for between-study variance in effect sizes. RESULTS The 17 eligible studies included 2390 preterm children and 1549 controls. Preterm children scored 0.71 SD below full-term peers on arithmetic (p<0.001), 0.44 and 0.52 SD lower on reading and spelling (p<0.001) and were 2.85 times more likely to receive special educational assistance (95% CI 2.12 to 3.84, p<0.001). Bronchopulmonarydysplasia explained 44% of the variance in academic performance (p=0.006). CONCLUSION Preterm children born in the antenatal steroids and surfactant era show considerable academic difficulties. Preterm children with bronchopulmonarydysplasia are at particular risk for poor academic outcome.
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Affiliation(s)
- E Sabrina Twilhaar
- Clinical Neuropsychology Section, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Jorrit F de Kieviet
- Clinical Neuropsychology Section, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Cornelieke SH Aarnoudse-Moens
- Clinical Neuropsychology Section, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands,Emma Children’s Hospital AMC, Amsterdam, The Netherlands
| | - Ruurd M van Elburg
- Emma Children’s Hospital AMC, Amsterdam, The Netherlands,Nutricia Research, Utrecht, The Netherlands,Department of Paediatrics, Vrije Universiteit Medical Center, Amsterdam, The Netherlands
| | - Jaap Oosterlaan
- Clinical Neuropsychology Section, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands,Emma Children’s Hospital AMC, Amsterdam, The Netherlands,Department of Paediatrics, Vrije Universiteit Medical Center, Amsterdam, The Netherlands
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Arrieta A, Guillen J. The birthweight toll of mining pollution: evidence from the most contaminated mine site in the Andean region. BJOG 2018; 125:1272-1278. [PMID: 29700946 DOI: 10.1111/1471-0528.15257] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To assess the effect of mining pollution on birthweight. DESIGN A retrospective before-and-after study with an untreated comparison group. SETTING La Oroya, a mining town in the Peruvian Andes, considered the most contaminated town in the Andean region. POPULATION All pregnant women who delivered in the social security healthcare system in years 2005, 2006, 2008 and 2009. A total of 214 983 births records were used, 957 from La Oroya and 214 026 from the rest of the country. METHODS A difference-in-difference estimation is used to assess the effect of mining pollution on birthweight before and after two business policy changes: a partial environmental improvement and a subsequent closure of smelter operations in La Oroya. Birthweight was compared with a group not affected by the environmental changes in La Oroya. MAIN OUTCOME MEASURES Birthweight in grams. RESULTS A steep reduction in mining pollution due to the closure of smelter operations in La Oroya showed an increased birthweight of 71.6 g after controlling for socio-economic and medical characteristics. None of the environmental improvements prior to the closure had a statistically significant effect on birthweight. CONCLUSIONS Mining pollution in La Oroya had a negative impact on birthweight. Partial environmental improvements were not enough to improve birthweight. Only after the closure of all mining and smelter operations in La Oroya was a significant gain in birthweight shown. TWEETABLE ABSTRACT The closure of the most contaminated mine site in the Andean region increased birthweight by 72 g.
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Affiliation(s)
- A Arrieta
- Department of Health Policy and Management, Florida International University, Miami, FL, USA
| | - J Guillen
- Graduate School of Business, ESAN, Lima, Peru
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Twilhaar ES, Wade RM, de Kieviet JF, van Goudoever JB, van Elburg RM, Oosterlaan J. Cognitive Outcomes of Children Born Extremely or Very Preterm Since the 1990s and Associated Risk Factors: A Meta-analysis and Meta-regression. JAMA Pediatr 2018; 172:361-367. [PMID: 29459939 PMCID: PMC5875339 DOI: 10.1001/jamapediatrics.2017.5323] [Citation(s) in RCA: 322] [Impact Index Per Article: 53.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 11/22/2017] [Indexed: 11/14/2022]
Abstract
Importance Despite apparent progress in perinatal care, children born extremely or very preterm (EP/VP) remain at high risk for cognitive deficits. Insight into factors contributing to cognitive outcome is key to improve outcomes after EP/VP birth. Objective To examine the cognitive abilities of children of EP/VP birth (EP/VP children) and the role of perinatal and demographic risk factors. Data Sources PubMed, Web of Science, and PsycINFO were searched without language restriction (last search March 2, 2017). Key search terms included preterm, low birth weight, and intelligence. Study Selection Peer-reviewed studies reporting intelligence scores of EP/VP children (<32 weeks of gestation) and full-term controls at age 5 years or older, born in the antenatal corticosteroids and surfactant era, were included. A total of 268 studies met selection criteria, of which 71 covered unique cohorts. Data Extraction and Synthesis MOOSE guidelines were followed. Data were independently extracted by 2 researchers. Standardized mean differences in intelligence per study were pooled using random-effects meta-analysis. Heterogeneity in effect size across studies was studied using multivariate, random-effects meta-regression analysis. Main Outcomes and Measures Primary outcome was intelligence. Covariates included gestational age, birth weight, birth year, age at assessment, sex, race/ethnicity, socioeconomic status, small for gestational age, intraventricular hemorrhage, periventricular leukomalacia, bronchopulmonary dysplasia (BPD), necrotizing enterocolitis, sepsis, and postnatal corticosteroid use. Results The 71 included studies comprised 7752 EP/VP children and 5155 controls. Median gestational age was 28.5 weeks (interquartile range [IQR], 2.4 weeks) and the mean age at assessment ranged from 5.0 to 20.1 years. The median proportion of males was 50.0% (IQR, 8.7%). Preterm children had a 0.86-SD lower IQ compared with controls (95% CI, -0.94 to -0.78, P < .001). Results were heterogeneous across studies (I2 = 74.13; P < .001). This heterogeneity could not be explained by birth year of the cohort. Multivariate meta-regression analysis with backward elimination revealed that BPD explained 65% of the variance in intelligence across studies, with each percent increase in BPD rate across studies associated with a 0.01-SD decrease in IQ (0.15 IQ points) (P < .001). Conclusions and Relevance Extremely or very preterm children born in the antenatal corticosteroids and surfactant era show large deficits in intelligence. No improvement in cognitive outcome was observed between 1990 and 2008. These findings emphasize that improving outcomes after EP/VP birth remains a major challenge. Bronchopulmonary dysplasia was found to be a crucial factor for cognitive outcome. Lowering the high incidence of BPD may be key to improving long-term outcomes after EP/VP birth.
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Affiliation(s)
- E. Sabrina Twilhaar
- Clinical Neuropsychology Section, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Rebecca M. Wade
- Clinical Neuropsychology Section, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Jorrit F. de Kieviet
- Clinical Neuropsychology Section, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Johannes B. van Goudoever
- Department of Pediatrics, Emma Children’s Hospital, Academic Medical Center, Amsterdam, the Netherlands
- Department of Pediatrics, Vrije Universiteit Medical Center, Amsterdam, the Netherlands
| | - Ruurd M. van Elburg
- Department of Pediatrics, Emma Children’s Hospital, Academic Medical Center, Amsterdam, the Netherlands
- Nutricia Research, Utrecht, the Netherlands
| | - Jaap Oosterlaan
- Clinical Neuropsychology Section, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Department of Pediatrics, Emma Children’s Hospital, Academic Medical Center, Amsterdam, the Netherlands
- Department of Pediatrics, Vrije Universiteit Medical Center, Amsterdam, the Netherlands
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Edwards AD, Redshaw ME, Kennea N, Rivero-Arias O, Gonzales-Cinca N, Nongena P, Ederies M, Falconer S, Chew A, Omar O, Hardy P, Harvey ME, Eddama O, Hayward N, Wurie J, Azzopardi D, Rutherford MA, Counsell S. Effect of MRI on preterm infants and their families: a randomised trial with nested diagnostic and economic evaluation. Arch Dis Child Fetal Neonatal Ed 2018; 103:F15-F21. [PMID: 28988160 PMCID: PMC5750369 DOI: 10.1136/archdischild-2017-313102] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 08/10/2017] [Accepted: 08/13/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND We tested the hypothesis that routine MRI would improve the care and well-being of preterm infants and their families. DESIGN Parallel-group randomised trial (1.1 allocation; intention-to-treat) with nested diagnostic and cost evaluations (EudraCT 2009-011602-42). SETTING Participants from 14 London hospitals, imaged at a single centre. PATIENTS 511 infants born before 33 weeks gestation underwent both MRI and ultrasound around term. 255 were randomly allocated (siblings together) to receive only MRI results and 255 only ultrasound from a paediatrician unaware of unallocated results; one withdrew before allocation. MAIN OUTCOME MEASURES Maternal anxiety, measured by the State-Trait Anxiety inventory (STAI) assessed in 206/214 mothers receiving MRI and 217/220 receiving ultrasound. Secondary outcomes included: prediction of neurodevelopment, health-related costs and quality of life. RESULTS After MRI, STAI fell from 36.81 (95% CI 35.18 to 38.44) to 32.77 (95% CI 31.54 to 34.01), 31.87 (95% CI 30.63 to 33.12) and 31.82 (95% CI 30.65 to 33.00) at 14 days, 12 and 20 months, respectively. STAI fell less after ultrasound: from 37.59 (95% CI 36.00 to 39.18) to 33.97 (95% CI 32.78 to 35.17), 33.43 (95% CI 32.22 to 34.63) and 33.63 (95% CI 32.49 to 34.77), p=0.02. There were no differences in health-related quality of life. MRI predicted moderate or severe functional motor impairment at 20 months slightly better than ultrasound (area under the receiver operator characteristic curve (CI) 0.74; 0.66 to 0.83 vs 0.64; 0.56 to 0.72, p=0.01) but cost £315 (CI £295-£336) more per infant. CONCLUSIONS MRI increased costs and provided only modest benefits. TRIAL REGISTRATION ClinicalTrials.gov NCT01049594 https://clinicaltrials.gov/ct2/show/NCT01049594. EudraCT: EudraCT: 2009-011602-42 (https://www.clinicaltrialsregister.eu/).
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Affiliation(s)
- A David Edwards
- Centre for the Developing Brain, School of Bioengineering and Imaging Sciences, King’s College London and Evelina London Children’s Hospital, London, UK
| | - Maggie E Redshaw
- National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK
| | | | | | - Nuria Gonzales-Cinca
- Centre for the Developing Brain, School of Bioengineering and Imaging Sciences, King’s College London and Evelina London Children’s Hospital, London, UK
| | - Phumza Nongena
- Division of Clinical Sciences, Imperial College London, London, UK
| | - Moegamad Ederies
- Division of Clinical Sciences, Imperial College London, London, UK
| | - Shona Falconer
- Centre for the Developing Brain, School of Bioengineering and Imaging Sciences, King’s College London and Evelina London Children’s Hospital, London, UK
| | - Andrew Chew
- Centre for the Developing Brain, School of Bioengineering and Imaging Sciences, King’s College London and Evelina London Children’s Hospital, London, UK
| | - Omar Omar
- National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK
| | - Pollyanna Hardy
- National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK
| | - Merryl Elizabeth Harvey
- Faculty of Health, School of Midwifery, Nursing and Social Work, Birmingham City University, Birmingham, UK
| | - Oya Eddama
- National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK
| | - Naomi Hayward
- Division of Clinical Sciences, Imperial College London, London, UK
| | - Julia Wurie
- Centre for the Developing Brain, School of Bioengineering and Imaging Sciences, King’s College London and Evelina London Children’s Hospital, London, UK
| | - Denis Azzopardi
- Centre for the Developing Brain, School of Bioengineering and Imaging Sciences, King’s College London and Evelina London Children’s Hospital, London, UK
| | - Mary A Rutherford
- Centre for the Developing Brain, School of Bioengineering and Imaging Sciences, King’s College London and Evelina London Children’s Hospital, London, UK
| | - Serena Counsell
- Centre for the Developing Brain, School of Bioengineering and Imaging Sciences, King’s College London and Evelina London Children’s Hospital, London, UK
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Hüning BM, Assing B, Weishaupt E, Dransfeld F, Felderhoff-Müser U, Zmyj N. Delay of gratification and time comprehension is impaired in very preterm children at the age of 4years. Early Hum Dev 2017; 115:77-81. [PMID: 28954245 DOI: 10.1016/j.earlhumdev.2017.09.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Revised: 09/20/2017] [Accepted: 09/20/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND Very preterm infants more likely exhibit deficient executive functions than term born controls. Delay of gratification, as part of the executive functions, allows for rejecting an immediate in favor of a greater future reward. Time comprehension might help to delay gratification. AIMS We hypothesized that delay of gratification and time comprehension is less developed in preterm children and that time comprehension is associated with the ability to wait for a greater reward. STUDY DESIGN Very preterm children (<32weeks' gestation) and term born controls were tested for receptive language skills, time comprehension and delay of gratification at the (corrected) age of 4years. SUBJECTS 25 preterm subjects (12 female; median: gestational age (GA) 28.3weeks, corrected age 4years, 22days) and 26 controls (16 female, median GA: 40.0weeks, age 4years, 25days) participated. OUTCOME MEASURES Correct answers in the time comprehension and receptive language task, waiting time in the delay-of-gratification task were measured. RESULTS Preterm subjects had less time comprehension than controls (43% vs. 53%, p=0.017, one-tailed) but receptive language skills were similar. Waiting time in the delay-of-gratification task was 3:42min in preterm subjects, versus 10:09min in controls (p=0.043, one-tailed). Even after controlling for language skills, waiting time correlated positively with time comprehension in both groups (r=0.399, p=0.004, two-tailed). CONCLUSIONS Preterm children's time comprehension and delay of gratification ability is impaired. Future research is warranted to investigate whether training in time comprehension increases the ability to delay gratification.
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Affiliation(s)
- B M Hüning
- Department of Pediatrics I, Neonatology, Pediatric Intensive Care, Pediatric Neurology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45122 Essen, Germany.
| | - B Assing
- Department of Pediatrics I, Neonatology, Pediatric Intensive Care, Pediatric Neurology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45122 Essen, Germany
| | - E Weishaupt
- Department of Pediatrics I, Neonatology, Pediatric Intensive Care, Pediatric Neurology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45122 Essen, Germany.
| | - F Dransfeld
- Department of Pediatrics I, Neonatology, Pediatric Intensive Care, Pediatric Neurology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45122 Essen, Germany.
| | - U Felderhoff-Müser
- Department of Pediatrics I, Neonatology, Pediatric Intensive Care, Pediatric Neurology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45122 Essen, Germany.
| | - N Zmyj
- Developmental Psychology, Institute of Psychology, Faculty 12, Educational Science, Psychology and Sociology, Technical University Dortmund, Emil-Figge-Str. 50, 44227 Dortmund, Germany.
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Segura-Roldán M, Rivera-Rueda M, Fernández-Carrocera L, Sánchez-Méndez M, Yescas-Buendía G, Cordero González G, Coronado-Zarco I, Cardona-Pérez J. Factores de riesgo asociados para el desarrollo de hemorragia intraventricular en recién nacidos < 1500 g ingresados a una UCIN. PERINATOLOGÍA Y REPRODUCCIÓN HUMANA 2017. [DOI: 10.1016/j.rprh.2018.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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How do childhood intelligence and early psychosocial adversity influence income attainment among adult extremely low birth weight survivors? A test of the cognitive reserve hypothesis. Dev Psychopathol 2017; 30:1421-1434. [PMID: 29166964 DOI: 10.1017/s0954579417001651] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Perinatal and later postnatal adversities have been shown to adversely affect socioeconomic trajectories, while enhanced early cognitive abilities improve them. However, little is known about the combined influence of these exposures on social mobility. In this study, we examined if childhood IQ moderated the association between four different types of postnatal adversity (childhood socioeconomic disadvantage, childhood sexual abuse, lifetime psychiatric disorder, and trait neuroticism) and annual earnings at 30-35 years of age in a sample of 88 extremely low birth weight survivors. Our results suggested that higher childhood IQ was associated with greater personal income at age 30-35. Extremely low birth weight survivors who did not face psychological adversities and who had higher childhood IQ reported higher income in adulthood. However, those who faced psychological adversity and had higher childhood IQ generally reported lower income in adulthood. Our findings suggest that cognitive reserve may not protect preterm survivors against the complex web of risk factors affecting their later socioeconomic attainment.
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Gestational age modulates neural correlates of intentional, but not automatic number magnitude processing in children born preterm. Int J Dev Neurosci 2017; 65:38-44. [DOI: 10.1016/j.ijdevneu.2017.10.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 09/12/2017] [Accepted: 10/12/2017] [Indexed: 11/20/2022] Open
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Zohsel K, Hohm E, Schmidt MH, Brandeis D, Banaschewski T, Laucht M. Die langfristigen Auswirkungen von Frühgeburtlichkeit auf kognitive Entwicklung und Schulerfolg. KINDHEIT UND ENTWICKLUNG 2017. [DOI: 10.1026/0942-5403/a000235] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. In einer prospektiven Längsschnittstudie wurde der Zusammenhang zwischen früher Responsivität der Mutter und kognitiver Entwicklung ihrer früh- bzw. reifgeborenen Kinder untersucht. Im Alter von drei Monaten wurde dafür die Mutter-Kind-Interaktion mittels Verhaltensbeobachtung erfasst. Bei n=351 der teilnehmenden Kinder (101 frühgeboren) wurde die allgemeine Intelligenz (IQ) im Alter von 11 Jahren und bei n=313 (85 frühgeboren) zusätzlich der höchste erreichte Schulabschluss bis 25 Jahren erhoben. Frühgeborene wiesen mit 11 Jahren einen signifikant niedrigeren IQ als Reifgeborene auf, nachdem für mögliche konfundierende Faktoren kontrolliert worden war. Nur bei Früh-, nicht aber bei Reifgeborenen zeigte sich ein signifikanter positiver Zusammenhang zwischen mütterlicher Responsivität und IQ. Für die Wahrscheinlichkeit einen höheren Schulabschluss (mind. Fachabitur) zu erreichen, fand sich weder ein signifikanter Effekt von Frühgeburtlichkeit noch von mütterlicher Responsivität.
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Affiliation(s)
- Katrin Zohsel
- Klinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters, Zentralinstitut für Seelische Gesundheit, Medizinische Fakultät Mannheim/Universität Heidelberg
| | - Erika Hohm
- Klinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters, Zentralinstitut für Seelische Gesundheit, Medizinische Fakultät Mannheim/Universität Heidelberg
| | - Martin H. Schmidt
- Klinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters, Zentralinstitut für Seelische Gesundheit, Medizinische Fakultät Mannheim/Universität Heidelberg
| | - Daniel Brandeis
- Klinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters, Zentralinstitut für Seelische Gesundheit, Medizinische Fakultät Mannheim/Universität Heidelberg
- Zentrum für Kinder- und Jugendpsychiatrie und Psychotherapie, Psychiatrische Universitätsklinik, Universität Zürich
- Zürcher Zentrum für Integrative Humanphysiologie, Universität Zürich
- Zentrum für Neurowissenschaften, Universität und ETH Zürich
| | - Tobias Banaschewski
- Klinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters, Zentralinstitut für Seelische Gesundheit, Medizinische Fakultät Mannheim/Universität Heidelberg
| | - Manfred Laucht
- Klinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters, Zentralinstitut für Seelische Gesundheit, Medizinische Fakultät Mannheim/Universität Heidelberg
- Department Psychologie, Universität Potsdam
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Developmental trajectories of children's symbolic numerical magnitude processing skills and associated cognitive competencies. J Exp Child Psychol 2017; 166:232-250. [PMID: 28946044 DOI: 10.1016/j.jecp.2017.08.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 07/09/2017] [Accepted: 08/16/2017] [Indexed: 11/23/2022]
Abstract
Although symbolic numerical magnitude processing skills are key for learning arithmetic, their developmental trajectories remain unknown. Therefore, we delineated during the first 3years of primary education (5-8years of age) groups with distinguishable developmental trajectories of symbolic numerical magnitude processing skills using a model-based clustering approach. Three clusters were identified and were labeled as inaccurate, accurate but slow, and accurate and fast. The clusters did not differ in age, sex, socioeconomic status, or IQ. We also tested whether these clusters differed in domain-specific (nonsymbolic magnitude processing and digit identification) and domain-general (visuospatial short-term memory, verbal working memory, and processing speed) cognitive competencies that might contribute to children's ability to (efficiently) process the numerical meaning of Arabic numerical symbols. We observed minor differences between clusters in these cognitive competencies except for verbal working memory for which no differences were observed. Follow-up analyses further revealed that the above-mentioned cognitive competencies did not merely account for the cluster differences in children's development of symbolic numerical magnitude processing skills, suggesting that other factors account for these individual differences. On the other hand, the three trajectories of symbolic numerical magnitude processing revealed remarkable and stable differences in children's arithmetic fact retrieval, which stresses the importance of symbolic numerical magnitude processing for learning arithmetic.
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Costa DS, Miranda DM, Burnett AC, Doyle LW, Cheong JLY, Anderson PJ. Executive Function and Academic Outcomes in Children Who Were Extremely Preterm. Pediatrics 2017; 140:peds.2017-0257. [PMID: 28853418 DOI: 10.1542/peds.2017-0257] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/13/2017] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Cognitive and behavioral impairments of children born extremely preterm (EP) (<28 weeks' gestation) and extremely low birth weight (ELBW) (<1000 g) may change with age. We assessed the individual stability of behavioral executive function (EF) from 8 to 18 years of age in children born EP or ELBW and their academic outcomes. METHODS Participants comprised 180 children born EP or ELBW from a large geographic cohort. We investigated the frequency of 4 developmental groups (persistent, remitting, late-onset, and typical development) on the basis of dichotomized scores (typical versus elevated) at ages 8 and 18 years in 2 indices (the Behavioral Regulation Index [BRI] and the Metacognition Index [MCI]) of the parental form of the Behavior Rating Inventory of Executive Function. Adolescent academic outcomes were measured by using the word reading, spelling, and math computation subtests of the Wide Range Achievement Test, Fourth Edition. RESULTS Most participants had a typical EF (BRI 61%, MCI 53%), followed by persistent (BRI 15%, MCI 16%), late-onset (BRI 12%, MCI 19%), or remitting (BRI 12%, MCI 13%) executive difficulties. Groups with executive impairments at age 18 years (persistent and late onset) had poorer academic outcomes than the typical and remitting groups. Shifting impairment categories between 8 and 18 years old was relevant to later academic outcomes. CONCLUSIONS Most children showed stable and age-appropriate EF, although persistent and transient difficulties were observed and related to uneven academic outcomes. Studying the origins and consequences of the developmental stability of EF may contribute to the development of interventions to decrease the adverse neurodevelopmental outcomes of preterm birth.
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Affiliation(s)
- Danielle S Costa
- Coordenação de Aperfeiçoamento de Pessoal de Nivel Superior, Ministry of Education of Brazil, Brasília, Brazil
| | - Débora M Miranda
- Department of Pediatrics, Federal University of Minas Gerais, Belo Horizonte, Brazil.,Conselho Nacional de Desenvolvimento Científico e Tecnológico, Ministry of Science, Technology, and Innovation of Brazil, Brasília, Brazil
| | - Alice C Burnett
- Neonatal Services, Royal Women's Hospital, Parkville, Victoria, Australia.,Clinical Sciences, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Lex W Doyle
- Neonatal Services, Royal Women's Hospital, Parkville, Victoria, Australia.,Clinical Sciences, Murdoch Childrens Research Institute, Parkville, Victoria, Australia.,Department of Obstetrics and Gynecology, and.,Department of Pediatrics, Melbourne Medical School, University of Melbourne, Parkville, Victoria, Australia; and
| | - Jeanie L Y Cheong
- Neonatal Services, Royal Women's Hospital, Parkville, Victoria, Australia.,Clinical Sciences, Murdoch Childrens Research Institute, Parkville, Victoria, Australia.,Department of Obstetrics and Gynecology, and
| | - Peter J Anderson
- Clinical Sciences, Murdoch Childrens Research Institute, Parkville, Victoria, Australia; .,Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
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Raju TNK, Buist AS, Blaisdell CJ, Moxey-Mims M, Saigal S. Adults born preterm: a review of general health and system-specific outcomes. Acta Paediatr 2017; 106:1409-1437. [PMID: 28419544 DOI: 10.1111/apa.13880] [Citation(s) in RCA: 179] [Impact Index Per Article: 25.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 03/27/2017] [Accepted: 04/11/2017] [Indexed: 12/22/2022]
Abstract
In this review of 126 publications, we report that an overwhelming majority of adults born at preterm gestations remain healthy and well. However, a small, but a significant fraction of them remain at higher risk for neurological, personality and behavioural abnormalities, cardio-pulmonary functional limitations, systemic hypertension and metabolic syndrome compared to their term-born counterparts. The magnitude of increased risk differed across organ systems and varied across reports. The risks were proportional to the degree of prematurity at birth and seemed to occur more frequently among preterm infants born in the final two decades of the 20th century and later. These findings have considerable public health and clinical practice relevance. CONCLUSION Preterm birth needs to be considered a chronic condition, with a slight increase in the risk for long-term morbidities among adults born preterm. Therefore, obtaining a history of gestational age and weight at birth should be a routine part of care for patients of all age groups.
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Affiliation(s)
- Tonse N. K. Raju
- Eunice Kennedy Shriver National Institute of Child Health and Human Development; Portland OR USA
| | | | | | - Marva Moxey-Mims
- National Institute of Diabetes and Kidney Diseases; Bethesda MD USA
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Abstract
OBJECTIVES Children and adolescents who were born very preterm (≤32 weeks' gestation) are vulnerable to experiencing cognitive problems, including in executive function. However, it remains to be established whether cognitive deficits are evident in adulthood and whether these exert a significant effect on an individual's real-lifeachievement. METHODS Using a cross-sectional design, we tested a range of neurocognitive abilities, with a focus on executive function, in a sample of 122 very preterm individuals and 89 term-born controls born between 1979 and 1984. Associations between executive function and a range of achievement measures, indicative of a successful transition to adulthood, were examined. RESULTS Very preterm adults performed worse compared to controls on measures of intellectual ability and executive function with moderate to large effect sizes. They also demonstrated significantly lower achievement levels in terms of years spent in education, employment status, and on a measure of functioning in work and social domains. Results of regression analysis indicated a stronger positive association between executive function and real-life achievement in the very preterm group compared to controls. CONCLUSIONS Very preterm born adults demonstrate executive function impairments compared to full-term controls, and these are associated with lower achievement in several real-life domains. (JINS, 2017, 23, 381-389).
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48
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Dobson KG, Ferro MA, Boyle MH, Schmidt LA, Saigal S, Van Lieshout RJ. Socioeconomic Attainment of Extremely Low Birth Weight Survivors: The Role of Early Cognition. Pediatrics 2017; 139:peds.2016-2545. [PMID: 28223371 DOI: 10.1542/peds.2016-2545] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/01/2016] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To determine: (1) if childhood cognitive and academic abilities mediate the association between being born at extremely low birth weight (ELBW) and socioeconomic attainment at age 29 to 36 years; (2) which cognitive abilities (IQ, verbal abilities, fluid intelligence, mathematical abilities, or academic achievement) most strongly mediate this association; and (3) if the mediating role of cognition is different in ELBW survivors with significant neurosensory impairment (NSI). METHODS A prospective, longitudinal cohort of 100 Canadian ELBW survivors born between 1977 and 1982 and 89 normal birth weight comparison participants were used to examine the mediating role of childhood cognition by using 5 cognitive mediators assessed at age 8 years (overall IQ, verbal IQ, performance IQ, quantitative ability, and academic achievement) on socioeconomic attainment at adulthood. Socioeconomic attainment was defined as personal annual earnings and full-time employment assessed via self-report at age 29 to 36 years. RESULTS Mediation models revealed that childhood cognition mediated the association between ELBW status and income attainment, with mathematical abilities and overall IQ each accounting for 26% of the direct effect. Mediated effects were not statistically significant in full-time employment models. For both outcomes, the mediating effect of cognition was stronger for ELBW survivors with NSI. CONCLUSIONS Childhood cognitive abilities partially mediate associations between ELBW status and adult income attainment. Early life cognition is a critical predictor of socioeconomic attainment in ELBW survivors, particularly in those born with NSI. Interventions aimed at enhancing early cognition in ELBW survivors may help optimize their later socioeconomic attainment.
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Affiliation(s)
| | - Mark A Ferro
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | | | | | - Saroj Saigal
- Pediatrics, McMaster University, Hamilton, Ontario, Canada; and
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Raju TNK, Pemberton VL, Saigal S, Blaisdell CJ, Moxey-Mims M, Buist S. Long-Term Healthcare Outcomes of Preterm Birth: An Executive Summary of a Conference Sponsored by the National Institutes of Health. J Pediatr 2017; 181:309-318.e1. [PMID: 27806833 DOI: 10.1016/j.jpeds.2016.10.015] [Citation(s) in RCA: 111] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 08/17/2016] [Accepted: 10/04/2016] [Indexed: 12/22/2022]
Affiliation(s)
- Tonse N K Raju
- Eunice Kennedy Shriver National Institutes of Child Health and Human Development, National Institutes of Health, Bethesda, MD.
| | | | - Saroj Saigal
- National Heart, Lung, and Blood Institute, Bethesda, MD
| | | | - Marva Moxey-Mims
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD
| | - Sonia Buist
- Oregon Health & Sciences University, Portland, OR
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Spittle A, Treyvaud K. The role of early developmental intervention to influence neurobehavioral outcomes of children born preterm. Semin Perinatol 2016; 40:542-548. [PMID: 27817913 DOI: 10.1053/j.semperi.2016.09.006] [Citation(s) in RCA: 95] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Children who are born preterm are at risk of adverse long-term neurobehavioral outcomes, including cognitive, motor, and behavioral impairments. Early developmental interventions that commence within the first year after preterm birth have a preventative focus, with the aim to positively influence the developmental trajectory. While there is a great deal of heterogeneity in the research trials to date, there is evidence that early developmental interventions have a moderate effect on cognitive and behavioral outcomes up to preschool age, with some evidence for improved motor outcomes. This review discusses key components of early developmental interventions including commencing the intervention as early as possible, ideally in the neonatal intensive care unit, and promoting developmental skills overtime with an appropriate enriched environment. The importance of involving and supporting parents in early intervention is also highlighted, particularly given the influence of the parent-infant relationship on developmental outcomes and higher rates of mental health problems in parents after preterm birth.
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Affiliation(s)
- Alicia Spittle
- Department of Physiotherapy, University of Melbourne, Level 7 Alan Gilbert Building, 161 Barry St, Parkville 3010, Victoria, Australia; Victorian Infant Brain Studies, Murdoch Childrens Research Institute, Parkville, Victoria, Australia; Neonatal Services, The Royal Women's Hospital, Melbourne, Victoria, Australia.
| | - Karli Treyvaud
- Victorian Infant Brain Studies, Murdoch Childrens Research Institute, Parkville, Victoria, Australia; Neonatal Services, The Royal Women's Hospital, Melbourne, Victoria, Australia; Department of Psychology and Counselling, La Trobe University, Bundoora, Victoria, Australia; Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
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