The association between perinatal and neonatal variables and neuropsychological development in very and extremely low-birth-weight preterm children at the beginning of primary school.

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Background: very low birth weight preterm infants show neuropsychological alterations in functions such as memory or visuospatial skills, although certain related functions, such as spatial orientation, have not been studied. Objectives: to compare children born preterm and at term between the ages of 5 and 7 years on egocentric and allocentric spatial orientation, and relate their performance to visuospatial skills, behavior, memory in daily environments, and perinatal risk factors. Study design: observational cross-sectional study Subjects: 88 very low birth weight children born preterm and 59 controls. Outcome measures: IQ (RIST), visuospatial skills (NEPSY II: Route Finding and Geometric Puzzles), spatial orientation (Egocentric and Allocentric Spatial Memory Test-Children's Version), behavior (BASC questionnaire for parents), memory in everyday environments (ECM-Q questionnaire for parents), and perinatal risk factors (collected from medical records). Results: Children born preterm obtain significantly lower scores than controls on the RIST, Route Finding, and Allocentric Spatial Memory Tests. Although spatial orientation is related to other neuropsychological variables in both premature and control children, there is no meaningful association with behavior or daily memory in children born preterm. The perinatal risk factors that are associated the most with visuospatial and orientation problems are surgical procedures and peri-and intraventricular hemorrhages. Conclusions: Children born preterm with low birth weight present difficulties in their spatial orientation, and for this reason, we propose including these types of tasks in the usual neuropsychological evaluation.

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<abstract> <p>Preterm-born children are at risk of slower psychomotor development. This risk may be associated with low birth weight and other perinatal factors and morbidities.</p> <p>We aimed to assess psychomotor development in school-aged preterm children, and to determine whether some early motor and perinatal variables could be related to and/or predict the later motor achievements.</p> <p>Parents of 54 very low-birth-weight preterm, 24 extremely low-birth-weight preterm and 96 control children completed the Movement Assessment Battery for Children (MABC-2-C) checklist and were interviewed about the motor milestones of their children.</p> <p>Significant differences were found between the preterm and control groups in the MABC-2-C results. MABC-2-C outcomes were significantly predicted by the age of crawling, the use of steroids, mechanical ventilation and intraventricular hemorrhage (IVH).</p> <p>The use of screening tools may allow the rapid identification of psychomotor development delays. The presence of some perinatal risk factors and some motor milestone attainments could be related to motor development in the later childhood of preterm children.</p> </abstract>

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