title: The Association of Urbanicity with Cognitive Development at Five Years of Age in Preterm Children.
abstract: OBJECTIVE
  To determine the association of urbanicity, defined as living in an urban area, with cognitive development at five years of age in preterm children who were free of any disabilities or neurodevelopmental delays.
  
  
  METHODS
  Prospective population-based cohort.
  
  
  METHODS
  French regional Loire Infant Follow-up Team (LIFT) network.
  
  
  METHODS
  Included in the study were 1738 surviving infants born between March 2003 and December 2008 before 35 weeks of gestational age. At two years of age, the children were free of any disabilities and neurodevelopmental delays and were living in the Pays de la Loire region from their birth to five years of age.
  
  
  METHODS
  The cognitive development at five years of age was evaluated with the Global School Adaptation score (GSA). The urbanicity of the residence for each child was classified into three groups: urban, quasi-rural, and rural area.
  
  
  RESULTS
  Quantile regression approaches were used to identify a significant association between urbanicity and the GSA score at five years of age (adjusting for child and family characteristics). We found that the negative impact of urbanicity on the GSA score was more important for the lower quantile of the GSA scores.
  
  
  CONCLUSIONS
  Urbanicity was significantly associated with cognitive neurodevelopment at five years of age in preterm children born before 35 weeks of gestation. Complementary results additionally suggest that this relation could be mediated at the residence level by a high socioeconomic deprivation level. If these results are confirmed, more personalized follow-ups could be developed for preterm children. Further studies are needed to finely identify the contextual characteristics of urbanicity that underlie this association.
authors.affiliation: Department of Neonatal Medicine, Nantes University Hospital, Nantes, France.
authors.forename: Marion
authors.initials: M
authors.lastname: Gouin
authors.affiliation: Department of Neonatal Medicine, Nantes University Hospital, Nantes, France; National Institute of Health and Medical Research CIC 1413, Nantes University Hospital, Nantes, France.
authors.forename: Cyril
authors.initials: C
authors.lastname: Flamant
authors.affiliation: Department of Neonatal Medicine, Angers University Hospital, Angers, France.
authors.forename: Géraldine
authors.initials: G
authors.lastname: Gascoin
authors.affiliation: Réseau "Grandir ensemble", Nantes University Hospital, Nantes, France.
authors.forename: Valérie
authors.initials: V
authors.lastname: Rouger
authors.affiliation: Faculty of psychology, University of Nantes, Research Center of Education, CREN EA 2661, Nantes, France.
authors.forename: Agnès
authors.initials: A
authors.lastname: Florin
authors.affiliation: Faculty of psychology, University of Nantes, Research Center of Education, CREN EA 2661, Nantes, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Guimard
authors.affiliation: Department of Neonatal Medicine, Nantes University Hospital, Nantes, France; National Institute of Health and Medical Research CIC 1413, Nantes University Hospital, Nantes, France.
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Rozé
authors.affiliation: National Institute of Health and Medical Research CIC 1413, Nantes University Hospital, Nantes, France.
authors.forename: Matthieu
authors.initials: M
authors.lastname: Hanf
mesh_terms: D000223:Adaptation, Psychological / Q000502:physiology; D001724:Birth Weight / Q000502:physiology; D002657:Child Development / Q000502:physiology*; D002675:Child, Preschool; D002947:Cities; D003071:Cognition / Q000502:physiology*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D015999:Multivariate Analysis; D011446:Prospective Studies; D012044:Regression Analysis; D012923:Social Class; D014504:Urban Health / Q000706:statistics & numerical data*