Barbara Schnider1, Vera Disselhoff1, Ulrike Held2, Beatrice Latal3, Cornelia F Hagmann1, Flavia M Wehrle4. 1. University Children's Hospital Zurich, Department of Neonatology and Pediatric Intensive Care, Zurich, Switzerland; University Children's Hospital Zurich, Children's Research Center, Zurich, Switzerland. 2. University of Zurich, Epidemiology, Biostatistics and Prevention Institute, Zurich, Switzerland. 3. University Children's Hospital Zurich, Children's Research Center, Zurich, Switzerland; Child Development Center, University Children's Hospital Zurich, Switzerland. 4. University Children's Hospital Zurich, Department of Neonatology and Pediatric Intensive Care, Zurich, Switzerland; University Children's Hospital Zurich, Children's Research Center, Zurich, Switzerland; Child Development Center, University Children's Hospital Zurich, Switzerland. Electronic address: flavia.wehrle@kispi.uzh.ch.
Abstract
BACKGROUND & AIMS: Children and adolescents born very preterm are at increased risk to develop executive function deficits and to suffer from social, emotional and attentional problems. This study investigated whether executive function deficits contribute to behavioral problems in children and adolescents born very preterm at school-age. STUDY DESIGN: Thirty-eight children and adolescents born very preterm and 41 age-matched term-born peers were assessed at a mean age of 12.9 (±1.8) years with a comprehensive battery of executive function tests, including working memory, planning, cognitive flexibility, and verbal fluency. A composite score was calculated to reflect overall executive function abilities. To assess behavioral problems, parents completed the Strengths and Difficulties Questionnaire (SDQ). Mediation analysis was applied to quantify the effect of preterm birth on behavioral problems with executive function abilities as a mediating variable. RESULTS: Executive function abilities were poorer in the very preterm compared to the term-born group (d = 0.62, p = .005) and the parents of very preterm children reported more behavioral problems on the SDQ Total Difficulties Score (d = 0.54, p = .01). The effect of birth status on behavioral problems was significantly mediated by executive function abilities while adjusting for age at assessment, sex, and socioeconomic status (F(2, 76) = 6.42, p = .002, R2 = 0.14). CONCLUSION: Results from this study suggest that the increase in behavioral symptoms in very preterm children at school-age compared to term-born peers may partly be explained by their executive function deficits. These findings highlight the importance of continuously monitoring the development of children born very preterm to provide optimal care as they grow up.
BACKGROUND & AIMS:Children and adolescents born very preterm are at increased risk to develop executive function deficits and to suffer from social, emotional and attentional problems. This study investigated whether executive function deficits contribute to behavioral problems in children and adolescents born very preterm at school-age. STUDY DESIGN: Thirty-eight children and adolescents born very preterm and 41 age-matched term-born peers were assessed at a mean age of 12.9 (±1.8) years with a comprehensive battery of executive function tests, including working memory, planning, cognitive flexibility, and verbal fluency. A composite score was calculated to reflect overall executive function abilities. To assess behavioral problems, parents completed the Strengths and Difficulties Questionnaire (SDQ). Mediation analysis was applied to quantify the effect of preterm birth on behavioral problems with executive function abilities as a mediating variable. RESULTS: Executive function abilities were poorer in the very preterm compared to the term-born group (d = 0.62, p = .005) and the parents of very preterm children reported more behavioral problems on the SDQ Total Difficulties Score (d = 0.54, p = .01). The effect of birth status on behavioral problems was significantly mediated by executive function abilities while adjusting for age at assessment, sex, and socioeconomic status (F(2, 76) = 6.42, p = .002, R2 = 0.14). CONCLUSION: Results from this study suggest that the increase in behavioral symptoms in very preterm children at school-age compared to term-born peers may partly be explained by their executive function deficits. These findings highlight the importance of continuously monitoring the development of children born very preterm to provide optimal care as they grow up.
Authors: Hyun Min Kim; L John Horwood; Sarah L Harris; Samudragupta Bora; Brian A Darlow; Lianne J Woodward Journal: Paediatr Perinat Epidemiol Date: 2022-05-23 Impact factor: 3.103