title: Cognitive outcomes for extremely preterm/extremely low birth weight children in kindergarten.
abstract: Our objectives were to examine cognitive outcomes for extremely preterm/extremely low birth weight (EPT/ELBW, gestational age <28 weeks and/or birth weight <1000 g) children in kindergarten and the associations of these outcomes with neonatal factors, early childhood neurodevelopmental impairment, and socioeconomic status (SES). The sample comprised a hospital-based 2001-2003 birth cohort of 148 EPT/ELBW children (mean birth weight 818 g; mean gestational age 26 weeks) and a comparison group of 111 term-born normal birth weight (NBW) classmate controls. Controlling for background factors, the EPT/ELBW group had pervasive deficits relative to the NBW group on a comprehensive test battery, with rates of cognitive deficits that were 3 to 6 times higher in the EPT/ELBW group. Deficits on a measure of response inhibition were found in 48% versus 10%, odds ratio (95% confidence interval) = 7.32 (3.32, 16.16), p < .001. Deficits on measures of executive function and motor and perceptual-motor abilities were found even when controlling for acquired verbal knowledge. Neonatal risk factors, early neurodevelopmental impairment, and lower SES were associated with higher rates of deficits within the EPT/ELBW group. The findings document both global and selective cognitive deficits in EPT/ELBW children at school entry and justify efforts at early identification and intervention.
authors.affiliation: Department of Psychology, Case Western Reserve University, Cleveland, Ohio, USA.
authors.forename: Leah J
authors.initials: LJ
authors.lastname: Orchinik
authors.forename: H Gerry
authors.initials: HG
authors.lastname: Taylor
authors.forename: Kimberly Andrews
authors.initials: KA
authors.lastname: Espy
authors.forename: Nori
authors.initials: N
authors.lastname: Minich
authors.forename: Nancy
authors.initials: N
authors.lastname: Klein
authors.forename: Tiffany
authors.initials: T
authors.lastname: Sheffield
authors.forename: Maureen
authors.initials: M
authors.lastname: Hack
mesh_terms: D000704:Analysis of Variance; D002648:Child; D002675:Child, Preschool; D003072:Cognition Disorders / Q000209:etiology*; D002658:Developmental Disabilities / Q000150:complications*; D056344:Executive Function / Q000502:physiology; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D008297:Male; D009483:Neuropsychological Tests; D047928:Premature Birth / Q000503:physiopathology*; D012307:Risk Factors