Functioning at school age of moderately preterm children born at 32 to 36 weeks' gestational age.
OBJECTIVE
To study outcome of low-risk moderately preterm birth between 32 and 36/7 weeks' gestation.


METHODS
377 Moderately preterm children (M: 34.7, SD: 1.2 complete weeks), without need for neonatal intensive care and without dysmaturity or congenital malformations, were compared with 182 term children and assessed at eight years (M: 8.9, SD: 0.54). School situation, IQ, sustained attention, behavior problems, and attention-deficit/hyperactivity characteristics were studied.


RESULTS
Special education was attended by 7.7% of the moderately preterm children, more than twice the rate of 2.8% in the general Dutch population of this age. Additional exploration for two preterm subgroups of 32 to 33 versus 34 to 36 weeks' gestation showed a need for special education in 9.7% versus 7.3% and a significant difference in grade retention for 30% versus 17%, respectively. Of the children attending mainstream primary schools, grade retention was found in 19% of the preterm versus 8% of the comparison children. Adjusting for maternal education, a group difference of 3 points was found in IQ. The preterm children needed more time for the sustained attention task. The preterm children had more behavior problems (specifically internalizing problems with 27% scoring above the borderline cut-off), as well as more attention-deficit/hyperactivity disorder characteristics (specifically attention deficits).


CONCLUSIONS
Cognitive and emotional regulation difficulties affect functioning of moderately preterm children, as school problems, a slightly lower IQ, attention and behavioral problems are found when they are compared with term-born children. Identification and monitoring of precursors of these problems at younger age is needed in view of prevention purposes.
van Baar
Anneloes L
AL
Department of Pediatric Psychology, Tilburg University, Tilburg, Netherlands. a.l.vanbaar@uu.nl
Vermaas
John
J
Knots
Edwin
E
de Kleine
Martin J K
MJ
Soons
Paul
P
D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology; D002648:Child; D002653:Child Behavior Disorders / Q000453:epidemiology*; D003072:Cognition Disorders / Q000453:epidemiology*; D002658:Developmental Disabilities / Q000453:epidemiology; D004519:Education, Special / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007360:Intelligence; D016015:Logistic Models; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D011795:Surveys and Questionnaires