title: Neurocognitive and Academic Outcomes at Age 10 Years of Extremely Preterm Newborns.
abstract: OBJECTIVE
  Despite reductions in mortality and morbidity among children born extremely preterm, they remain at high risk of neurocognitive deficits, with up to 40% having significant cognitive deficits at school age. We assessed the rate of neurocognitive impairment in a contemporary US cohort of 873 children aged 10 years who were born <28 weeks' gestation.
  
  
  METHODS
  The families of 889 of 966 (92%) children enrolled from 2002 to 2004 at 14 sites in 5 states returned at age 10 years for a comprehensive assessment of IQ, language, attention, executive function, processing speed, visual perception, visual-motor function, and academic achievement.
  
  
  RESULTS
  A total of 873 children were assessed with well-validated tests of cognitive and academic function. Distributions of test scores were consistently and markedly shifted below normative expectation, with one-third to two-thirds of children performing >1 SD below age expectation. The most extreme downward shifts were on measures of executive control and processing speed. Multivariate analyses, adjusted for socioeconomic status, growth restriction, and other potential confounders, revealed that the risk of poor outcome was highest at the lowest gestational age across all 18 measures.
  
  
  CONCLUSIONS
  More than half of our extremely preterm cohort exhibited moderate or severe neurocognitive deficits at age 10 years, with the most extensive impairments found among those born at the lowest gestational age. Children born extremely preterm continue to be at significant risk of persistent impairments in neurocognitive function and academic achievement, underscoring the need for monitoring and remediating such outcomes beginning in early childhood.
authors.affiliation: Departments of Anatomy and Neurobiology and rmjoseph@bu.edu.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Joseph
authors.affiliation: Department of Pediatrics, University of North Carolina, Chapel Hill, North Carolina;
authors.forename: Thomas M
authors.initials: TM
authors.lastname: O'Shea
authors.affiliation: Department of Neurology, Harvard Medical School, Boston, Massachusetts; Neuroepidemiology Unit, Department of Neurology, Boston Children's Hospital, Boston, Massachusetts;
authors.forename: Elizabeth N
authors.initials: EN
authors.lastname: Allred
authors.affiliation: Department of Biostatistics, School of Public Health, Boston University, Boston, Massachusetts;
authors.forename: Tim
authors.initials: T
authors.lastname: Heeren
authors.affiliation: National Institute of Neurologic Disorders and Stroke, Bethesda, Maryland; and.
authors.forename: Deborah
authors.initials: D
authors.lastname: Hirtz
authors.affiliation: Radiology, School of Medicine, and.
authors.forename: Hernan
authors.initials: H
authors.lastname: Jara
authors.affiliation: Department of Neurology, Harvard Medical School, Boston, Massachusetts; Neuroepidemiology Unit, Department of Neurology, Boston Children's Hospital, Boston, Massachusetts;
authors.forename: Alan
authors.initials: A
authors.lastname: Leviton
authors.affiliation: Department of Pediatrics, Boston Medical Center, Boston, Massachusetts.
authors.forename: Karl C K
authors.initials: KC
authors.lastname: Kuban
mesh_terms: D002648:Child; D003072:Cognition Disorders; D015331:Cohort Studies; D004522:Educational Status; D056344:Executive Function; D005260:Female; D005865:Gestational Age; D006801:Humans; D062071:Infant, Extremely Premature / Q000523:psychology; D007360:Intelligence; D007805:Language Development Disorders; D008297:Male; D019957:Motor Skills Disorders; D011581:Psychological Tests; D014796:Visual Perception