Karl C K Kuban1, Robert M Joseph2, Thomas M O'Shea3, Elizabeth N Allred4, Timothy Heeren5, Laurie Douglass6, Carl E Stafstrom7, Hernan Jara8, Jean A Frazier9, Deborah Hirtz10, Alan Leviton4. 1. Department of Pediatrics, Boston Medical Center, Boston, MA. Electronic address: karl.kuban@bmc.org. 2. Department of Anatomy and Neuroanatomy, Boston University, Boston, MA. 3. Department of Pediatrics, Division of Neonatal-Perinatal Medicine, University of North Carolina, Chapel Hill, NC. 4. Department of Neurology, Harvard Medical School, Boston, MA; Department of Neurology, Neuroepidemiology Unit, Boston Children's Hospital, Boston, MA. 5. Department of Biostatistics, Boston University School of Public Health, Boston, MA. 6. Department of Pediatrics, Boston Medical Center, Boston, MA. 7. Division of Pediatric Neurology, Department of Neurology, Johns Hopkins Hospital, Baltimore, MD. 8. Department of Radiology, Boston Medical Center, Boston University, Boston, MA. 9. Department of Psychiatry, University of Massachusetts Medical School/University of Massachusetts Memorial Health Care, Worcester, MA. 10. National Institute of Neurological Disorders and Stroke, Bethesda, MD.
Abstract
OBJECTIVES: 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. STUDY DESIGN: 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.
OBJECTIVES: 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. STUDY DESIGN: 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: Karl C K Kuban; T Michael O'Shea; Elizabeth N Allred; Nigel Paneth; Deborah Hirtz; Raina N Fichorova; Alan Leviton Journal: J Child Neurol Date: 2014-03-18 Impact factor: 1.987
Authors: Rachel G Hirschberger; Karl C K Kuban; Thomas M O'Shea; Robert M Joseph; Tim Heeren; Laurie M Douglass; Carl E Stafstrom; Hernan Jara; Jean A Frazier; Deborah Hirtz; Julie V Rollins; Nigel Paneth Journal: Pediatr Neurol Date: 2017-11-13 Impact factor: 3.372
Authors: Laurie M Douglass; Timothy C Heeren; Carl E Stafstrom; William DeBassio; Elizabeth N Allred; Alan Leviton; T Michael O'Shea; Deborah Hirtz; Julie Rollins; Karl Kuban Journal: Pediatr Neurol Date: 2017-05-18 Impact factor: 3.372
Authors: Qi Li; Michael Michaud; Chan Park; Yan Huang; Rachael Couture; Frank Girodano; Michael L Schwartz; Joseph A Madri Journal: Lab Invest Date: 2017-01-16 Impact factor: 5.662
Authors: Shenandoah Robinson; Christopher J Corbett; Jesse L Winer; Lindsay A S Chan; Jessie R Maxwell; Christopher V Anstine; Tracylyn R Yellowhair; Nicholas A Andrews; Yirong Yang; Laurel O Sillerud; Lauren L Jantzie Journal: Exp Neurol Date: 2017-12-26 Impact factor: 5.330
Authors: Steven J Korzeniewski; Elizabeth N Allred; Robert M Joseph; Tim Heeren; Karl C K Kuban; T Michael O'Shea; Alan Leviton Journal: Pediatrics Date: 2017-10-13 Impact factor: 7.124
Authors: Jean R Lowe; Janell F Fuller; Barbara T Do; Betty R Vohr; Abhik Das; Susan R Hintz; Kristi L Watterberg; Rosemary D Higgins Journal: Early Hum Dev Date: 2018-12-04 Impact factor: 2.079
Authors: Jacqueline T Bangma; Evan Kwiatkowski; Matthew Psioda; Hudson P Santos; Stephen R Hooper; Laurie Douglass; Robert M Joseph; Jean A Frazier; Karl C K Kuban; Thomas M O'Shea; Rebecca C Fry Journal: J Pediatr Date: 2018-08-02 Impact factor: 4.406
Authors: C J Meakin; E M Martin; H P Santos; I Mokrova; K Kuban; T M O'Shea; R M Joseph; L Smeester; R C Fry Journal: Horm Behav Date: 2018-03-05 Impact factor: 3.587