Early school outcomes for extremely preterm infants with transient neurological abnormalities

Abstract

AIM To determine if transient neurological abnormalities (TNA) at 9 months corrected age predict cognitive, behavioral, and motor outcomes at 6 years of age in extremely preterm infants. METHOD A cohort of 124 extremely preterm infants (mean gestational age 25.5wk; 55 males, 69 females), admitted to our unit between 2001 and 2003, were classified based on the Amiel-Tison Neurological Assessment at 9 months and 20 months corrected age as having TNA (n=17), normal neurological assessment (n=89), or neurologically abnormal assessment (n=18). The children were assessed at a mean age of 5 years 11 months (SD 4mo) on cognition, academic achievement, motor ability, and behavior. RESULTS Compared with children with a normal neurological assessment, children with TNA had higher postnatal exposure to steroids (35% vs 9%) and lower adjusted mean scores on spatial relations (84 [standard error {SE} 5] vs 98 [SE 2]), visual matching (79 [SE 5] vs 91 [SE 2]), letter–word identification (97 [SE 4] vs 108 [SE 1]), and spelling (76 [SE 4] vs 96 [SE 2]) (all p<0.05). INTERPRETATION Despite a normalized neurological assessment, extremely preterm children with a history TNA are at higher risk for lower cognitive and academic skills than those with normal neurological findings during their first year of school.

Motor Evoked Potentials as Potential Biomarkers of Early Atypical Corticospinal Tract Development in Infants with Perinatal Stroke

“…An analysis of CP diagnosis outcome in our full sample of 10 infants was not possible at this time due to variable length of follow-up and inconsistent identification of diagnosis (definition and timing). Physicians commonly wait to provide a diagnosis of CP to ensure abnormal motor findings are not transient and watch to determine whether they will resolve [39]. As such, it is possible that infants in our sample not yet diagnosed with CP to date may be diagnosed later in life.…”

Reading and math abilities of Finnish school beginners born very preterm or with very low birth weight

“…However, gross measures such as these are conceptually remote to foundational reading and math skills. The only study directly bearing on this issue appears to be that of Harmon et al (2015). The authors found that at six years of age, extremely preterm born children with either transient or persistent neonatal abnormalities showed an impairment in letter and word identification, spelling and applied math problems, compared to peers with a normal neurological assessment.…”

“…Support has come from recent studies suggesting that extremely preterm children need increased teacher support to compensate for their poor ability to focus on classroom activities (Wong et al, 2014). Moreover, persistent neurological abnormalities during the first year of life predict poorer kindergarten performance in letter-word identification, spelling, and math among extremely preterm children at six years of age (Harmon, Taylor, Minich, Wilson-Costello, & Hack, 2015). However, contrary to research in school-age achievement, studies on the school readiness skills of preterm born children are still scarce.…”

Altered resting-state functional connectivity in emotion-processing brain regions in adults who were born very preterm

“…Very preterm birth (VPT, <32 weeks’ gestation) has been associated with a higher risk of neurological and cognitive deficits (Bos & Roze, 2011; Burnett et al 2013), behavioural problems and learning difficulties (Johnson & Marlow, 2011; Harmon et al 2015). Individuals who were born VPT are vulnerable to socio-emotional impairments, including social isolation, peer rejection, poor social competence and shyness (Rickards et al 2001; Dahl et al 2006; Schmidt et al 2008; Healy et al 2013; Williamson & Jakobson, 2014), as well as impairments in the ability to recognize facial emotions (Potharst et al 2013; Witt et al 2014).…”