This paper focuses on the aspects of the lexicon in 66 prematurely born very-low-birth-weight and 87 full-term Finnish children at 2;0, studied using the Finnish version of the MacArthur Communicative Developmental Inventory. The groups did not differ in vocabulary size. Furthermore, the female advantage in vocabulary size was not seen in preterm children. The overall shapes of the trajectories for the main lexical categories as a function of vocabulary size were highly similar in both groups and followed those described in the literature. However, there were significant differences in the percentage of nouns and grammatical function words between the two groups. The results suggest that prematurity ‘cuts off’ the female advantage in vocabulary development. Furthermore, it also seems that there are differences between prematurely born and full-term children in the composition of the lexicon at 2;0. The findings support the universal sequence in the development of lexical categories.
BackgroundPreterm birth is a risk for cognitive development. This study assessed the cognitive profile of children born very preterm at the age of 11 years as well as the associated risk factors.MethodsA total of 128 children born very preterm were included. Magnetic resonance imaging was performed at term age. Cognitive development was assessed using the full-scale intelligence quotient (IQ) and four domains of the Wechsler Intelligence Scale for Children, fourth edition (WISC-IV), Finnish translation. The results were compared with test norms.ResultsMost study children performed at average (51%) or low average (21%) levels in the full-scale IQ assessment. The correlation between 5- and 11-year full-scale IQ was 0.73 (P<0.001). Compared with the normative data, children born very preterm performed poorer in all domains of the cognitive profile. The only significant risk factor for poor general cognition was major brain pathology. When considering all four domains of WISC-IV, low paternal education, male gender, and low birth weight z score were also found to be significant risk factors.ConclusionsLess than one-third of the children born very preterm performed below the low average cognitive level at 11 years of age. Specific neonatal and sociodemographic risk factors were identified as affecting the cognitive profile.
Objective To study neurodevelopmental outcome at 2 years of corrected age in very-low-birth-weight (VLBW) (≤ 1500 g) preterm infants with abnormal fetoplacental flow.
Methods
Aim The aim of this study was to analyse the relation between ventricular dilatation at term and neurodevelopmental outcome at 2 years corrected age in infants of very low birthweight (VLBW) or very low gestational age (VLGA).
Method A total of 225 VLBW or VLGA infants (121 males, 104 female; mean birthweight 1133g, SD 333g; mean gestational age 29wks, SD 2wks 5d) born in Turku University Hospital were included. Ventricular–brain ratio and the widths of each lateral ventricular horn were determined using ultrasonography, and the volume of the ventricles was measured by magnetic resonance imaging at term. The 2‐year outcome measures included scores for the Hammersmith Infant Neurological Examination, the presence of cerebral palsy (CP), the Mental Developmental Index (MDI) of the Bayley Scales of Infant Development (2nd edition), and the presence of severe hearing or vision impairments or any neurodevelopmental impairment (NDI).
Results CP was diagnosed in 15 participants (6.7%) and severe hearing deficit in 12 participants (5.3%). No severe vision impairment was found. Mild and severe cognitive delay was found in 24 (10.7%) and 8 (3.6%) of the VLBW or VLGA infants respectively. Isolated ventricular dilatation did not increase the risk for developmental impairments. However, ventricular dilatation with additional brain pathology was significantly associated with CP, MDI score below 70, and NDI. A ventricular–brain ratio above 0.35 was a sensitive measure of developmental impairment.
Interpretation Ventricular dilatation at term increases the risk of poor developmental outcome only when associated with other brain pathology. The ventricular–brain ratio is a useful clinical tool for determining the prognosis in VLBW and VLGA infants.
Cognitive development of VLBW infants seemed to have improved in comparison with earlier publications, but it differed from the FT controls. Neonatal factors affected cognitive development. Therefore, updated regional follow-up data are important for clinicians.
Good stability of cognitive development over time was found in VLBW children and in term children between the ages of 2 and 5 years. This conclusion stresses the value and clinical significance of early assessment at 2 years of corrected age. However, we also emphasize the importance of a long-term follow-up covering a detailed neuropsychological profile of these at-risk children.
Even if the fathers of VLBW infants experienced depressive symptoms less often than the mothers, the ability of the fathers to cope was significantly associated with the cognitive development of the infant. In addition, the fathers reported more parenting stress if the infant had a cognitive delay. The mothers reported more parenting stress related to accepting the VLBW infant with cognitive delay.
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