Alice C Burnett1, Shannon E Scratch2, Katherine J Lee3, Jeanie Cheong4, Karissa Searle5, Esther Hutchinson6, Cinzia De Luca7, Mary-Ann Davey8, Gehan Roberts9, Lex W Doyle10, Peter J Anderson3. 1. Premature Infant Follow-Up Programme and Victorian Infant Brain Studies and alice.burnett@mcri.edu.au. 2. Victorian Infant Brain Studies and. 3. Victorian Infant Brain Studies and Departments of Paediatrics. 4. Victorian Infant Brain Studies and Neonatal Services, Royal Women's Hospital, Parkville, Victoria, Australia; Obstetrics and Gynaecology, and. 5. Psychiatry, University of Melbourne, Parkville, Victoria, Australia; 6. Premature Infant Follow-Up Programme and Neonatal Medicine and. 7. Premature Infant Follow-Up Programme and. 8. Judith Lumley Centre, LaTrobe University, Melbourne, Victoria, Australia. 9. Departments of Paediatrics, Centre for Community Child Health, Royal Children's Hospital, Victoria, Australia; and Population Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia; 10. Premature Infant Follow-Up Programme and Victorian Infant Brain Studies and Departments of Paediatrics, Obstetrics and Gynaecology, and.
Abstract
BACKGROUND AND OBJECTIVES: Extremely preterm (EP; <28 weeks) birth and extremely low birth weight (ELBW; <1000 g) are risk factors for poor cognitive outcomes, including in executive function (EF; higher-order cognitive skills necessary for goal-directed, adaptive functioning and important for academic and behavioral-emotional outcomes). We aimed to (1) extend the limited data on EF in EP/ELBW survivors in adolescence compared with normal birth weight controls, and (2) determine changes in EF between ages 8 and 17 years in both groups. METHODS: Two hundred twenty-eight EP/ELBW and 166 control adolescents (mean age, 17 years) from a prospective geographical cohort were assessed with multiple EF tasks, and parent- and self-ratings of behavioral EF. The Rey Complex Figure and Behavior Rating Inventory of Executive Function parent report were also administered at age 8 years, enabling examination of change in scores between childhood and adolescence. RESULTS: EP/ELBW adolescents performed more poorly than controls in verbal processing speed, attentional control, cognitive flexibility, and goal-setting (effect sizes, -0.7 to -0.2 SD), but not psychomotor reaction time. Group differences were of similar magnitude across tasks. From childhood to late adolescence, EP/ELBW children improved their accuracy of the Rey Complex Figure copy more than controls. According to parents, executive behaviors were largely stable over time in both groups. CONCLUSIONS: Adolescents born EP/ELBW have poorer EF skills across multiple domains than controls. From childhood to late adolescence, different aspects of EF improved, but others did not, underscoring the need for multidomain, longitudinal assessments in this high-risk population.
BACKGROUND AND OBJECTIVES: Extremely preterm (EP; <28 weeks) birth and extremely low birth weight (ELBW; <1000 g) are risk factors for poor cognitive outcomes, including in executive function (EF; higher-order cognitive skills necessary for goal-directed, adaptive functioning and important for academic and behavioral-emotional outcomes). We aimed to (1) extend the limited data on EF in EP/ELBW survivors in adolescence compared with normal birth weight controls, and (2) determine changes in EF between ages 8 and 17 years in both groups. METHODS: Two hundred twenty-eight EP/ELBW and 166 control adolescents (mean age, 17 years) from a prospective geographical cohort were assessed with multiple EF tasks, and parent- and self-ratings of behavioral EF. The Rey Complex Figure and Behavior Rating Inventory of Executive Function parent report were also administered at age 8 years, enabling examination of change in scores between childhood and adolescence. RESULTS: EP/ELBW adolescents performed more poorly than controls in verbal processing speed, attentional control, cognitive flexibility, and goal-setting (effect sizes, -0.7 to -0.2 SD), but not psychomotor reaction time. Group differences were of similar magnitude across tasks. From childhood to late adolescence, EP/ELBW children improved their accuracy of the Rey Complex Figure copy more than controls. According to parents, executive behaviors were largely stable over time in both groups. CONCLUSIONS: Adolescents born EP/ELBW have poorer EF skills across multiple domains than controls. From childhood to late adolescence, different aspects of EF improved, but others did not, underscoring the need for multidomain, longitudinal assessments in this high-risk population.
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