Perinatal and postnatal factors in very preterm infants and subsequent cognitive and motor abilities.
BACKGROUND
Many children born very preterm have cognitive and minor motor problems later, even if attending mainstream schools.


OBJECTIVE
To examine associations between this suboptimal performance and perinatal and postnatal clinical factors.


METHODS
A geographically determined cohort of 280 infants born at less than 32 weeks gestation in 1991-92 in Liverpool, free of major disability and attending mainstream school at 7 years of age. A perinatal and postnatal data set were obtained from the clinical records retrospectively. Measurements of height, weight, and head circumference at 7 years were made, together with assessments of intelligence (Wechsler intelligence scale for children, IQ) and motor impairment (Movement assessment battery for children, MABC).


RESULTS
Multiple regression analysis showed IQ at 7 years to be independently significantly related to gestation, persistence of the arterial duct (PDA), and head circumference at 7 years. MABC was only significantly related to gestation. PDA was related to periventricular haemorrhage (OR 2.7, 95% confidence interval (CI) 1.3 to 5.8) and parenchymal lesions including ventriculomegaly (OR 4.1, 95% CI 1.5 to 11.4).


CONCLUSIONS
Cognitive ability in children born preterm is significantly related to gestation, but may also be related to the effects of PDA on early brain development, through either periventricular haemorrhage/ventriculomegaly or other disturbance of early brain growth.
Cooke
R W I
RW
Department of Child Health, University of Liverpool, Neonatal Unit, Liverpool Maternity Hospital, Liverpool L8 7SS, UK. mc19@liv.ac.uk
D000886:Anthropometry; D002508:Cephalometry; D002543:Cerebral Hemorrhage / Q000523:psychology; D002648:Child; D015331:Cohort Studies; D002658:Developmental Disabilities / Q000209:etiology*; D004374:Ductus Arteriosus, Patent / Q000523:psychology; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000523:psychology; D007360:Intelligence; D008297:Male; D009048:Motor Skills; D011597:Psychomotor Performance; D012044:Regression Analysis; D012307:Risk Factors