title: Girls and Boys Born before 28 Weeks Gestation: Risks of Cognitive, Behavioral, and Neurologic Outcomes at Age 10 Years.
abstract: OBJECTIVE
  To compare the prevalence of cognitive, neurologic, and behavioral outcomes at 10 years of age in 428 girls and 446 boys who were born extremely preterm.
  
  
  METHODS
  A total of 889 of 966 eligible children previously enrolled in the multicenter Extremely Low Gestational Age Newborns Study from 2002-2004 were evaluated at 10 years of age. Children underwent a neuropsychological battery and testing for autism spectrum disorder (ASD), and parents reported on their child's behavior, development, and seizures.
  
  
  RESULTS
  Of the children, 28% of boys and 21% of girls exhibited moderate to severe impairment on summary measures of cognitive abilities. Boys had a higher prevalence of impairment than girls in nearly all measures of cognition, were more than twice as likely to have microcephaly (15% in boys, 8% in girls), and require more often assistive devices to ambulate (6% in boys, 4% in girls). In contrast, boys and girls had comparable risk for a history of seizure (identified in 10% of the cohort) or epilepsy (identified in 7% of the cohort). The boy-to-girl ratio of ASD (9% in boys, 5% in girls) was lower than expected compared with the overall US autism population.
  
  
  CONCLUSIONS
  In this contemporary cohort of children born extremely premature and evaluated at school age, boys had higher prevalence of cognitive, neurologic, and behavioral deficits than girls. The ratio of boys to girls among those with ASD deserves further study as does the perinatal environmental-genetic interactions that might contribute to male preponderance of deficits in this high-risk sample.
authors.affiliation: Department of Pediatrics, Boston Medical Center, Boston, MA. Electronic address: karl.kuban@bmc.org.
authors.forename: Karl C K
authors.initials: KC
authors.lastname: Kuban
authors.affiliation: Department of Anatomy and Neuroanatomy, Boston University, Boston, MA.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Joseph
authors.affiliation: Department of Pediatrics, Division of Neonatal-Perinatal Medicine, University of North Carolina, Chapel Hill, NC.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: O'Shea
authors.affiliation: Department of Neurology, Harvard Medical School, Boston, MA; Department of Neurology, Neuroepidemiology Unit, Boston Children's Hospital, Boston, MA.
authors.forename: Elizabeth N
authors.initials: EN
authors.lastname: Allred
authors.affiliation: Department of Biostatistics, Boston University School of Public Health, Boston, MA.
authors.forename: Timothy
authors.initials: T
authors.lastname: Heeren
authors.affiliation: Department of Pediatrics, Boston Medical Center, Boston, MA.
authors.forename: Laurie
authors.initials: L
authors.lastname: Douglass
authors.affiliation: Division of Pediatric Neurology, Department of Neurology, Johns Hopkins Hospital, Baltimore, MD.
authors.forename: Carl E
authors.initials: CE
authors.lastname: Stafstrom
authors.affiliation: Department of Radiology, Boston Medical Center, Boston University, Boston, MA.
authors.forename: Hernan
authors.initials: H
authors.lastname: Jara
authors.affiliation: Department of Psychiatry, University of Massachusetts Medical School/University of Massachusetts Memorial Health Care, Worcester, MA.
authors.forename: Jean A
authors.initials: JA
authors.lastname: Frazier
authors.affiliation: National Institute of Neurological Disorders and Stroke, Bethesda, MD.
authors.forename: Deborah
authors.initials: D
authors.lastname: Hirtz
authors.affiliation: Department of Neurology, Harvard Medical School, Boston, MA; Department of Neurology, Neuroepidemiology Unit, Boston Children's Hospital, Boston, MA.
authors.forename: Alan
authors.initials: A
authors.lastname: Leviton
mesh_terms: D000067877:Autism Spectrum Disorder / Q000453:epidemiology*; D002648:Child; D003072:Cognition Disorders / Q000453:epidemiology*; D004827:Epilepsy / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D008297:Male; D008831:Microcephaly / Q000453:epidemiology; D051346:Mobility Limitation; D065886:Neurodevelopmental Disorders / Q000453:epidemiology*; D009483:Neuropsychological Tests; D012640:Seizures / Q000453:epidemiology; D012656:Self-Help Devices / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D012737:Sex Factors; D014481:United States / Q000453:epidemiology
keywords: autism; cognition; executive function; extremely low gestational age newborns; late childhood; microcephaly; motor impairment; neurological follow-up