Effects of Gestational Age at Birth on Cognitive Performance: A Function of Cognitive Workload Demands

Abstract

ObjectiveCognitive deficits have been inconsistently described for late or moderately preterm children but are consistently found in very preterm children. This study investigates the association between cognitive workload demands of tasks and cognitive performance in relation to gestational age at birth.MethodsData were collected as part of a prospective geographically defined whole-population study of neonatal at-risk children in Southern Bavaria. At 8;5 years, n = 1326 children (gestation range: 23–41 weeks) were assessed with the K-ABC and a Mathematics Test.ResultsCognitive scores of preterm children decreased as cognitive workload demands of tasks increased. The relationship between gestation and task workload was curvilinear and more pronounced the higher the cognitive workload: GA2 (quadratic term) on low cognitive workload: R 2 = .02, p<0.001; moderate cognitive workload: R 2 = .09, p<0.001; and high cognitive workload tasks: R 2 = .14, p<0.001. Specifically, disproportionally lower scores were found for very (<32 weeks gestation) and moderately (32–33 weeks gestation) preterm children the higher the cognitive workload of the tasks. Early biological factors such as gestation and neonatal complications explained more of the variance in high (12.5%) compared with moderate (8.1%) and low cognitive workload tasks (1.7%).ConclusionsThe cognitive workload model may help to explain variations of findings on the relationship of gestational age with cognitive performance in the literature. The findings have implications for routine cognitive follow-up, educational intervention, and basic research into neuro-plasticity and brain reorganization after preterm birth.

Preterm Toddlers' Inhibitory Control Abilities Predict Attention Regulation and Academic Achievement at Age 8 Years

“…It has previously been reported that the relationship between gestational age and academic outcomes is not linear but curvilinear with increasingly stronger effects below 33-36 weeks [25,35,44, 45] thus we explored this possibility. Results, however, showed that effects of preterm birth on early inhibition and effects of inhibition on later outcomes were overall not stronger in the more preterm compared with the term groups.…”

“…Preterm individuals often have general cognitive impairments [35,44,46] and these are associated with their academic outcomes. Although the relationship between cognitive abilities and achievement was not the focus of this study, we explored whether the effects of early inhibitory control on childhood outcomes were explained by toddlers' cognitive abilities, assessed with the Griffiths Mental Development Scales [36] at 20 months of corrected age.…”

“…Spelling and writing were assessed with a standard diagnostic test (DRT 2) [34]. Test scores were z-standardized according to the healthy full-term control children's scores within the sample [35]. Subsequently, we explored whether the effects of early inhibitory control on childhood outcomes were explained by toddlers' cognitive abilities, assessed with the Griffiths Mental Development Scales [36] at 20 months of corrected age.…”

Attention problems in relation to gestational age at birth and smallness for gestational age

“…Healthy infants who were born in the same obstetric hospitals, cared for on normal postnatal wards were recruited as controls (N=916), resulting in a total study sample of 8421 newborns. Of the 8421 participants, 1513 children were selected for follow-up at 6 and 8 years of age according to the following criteria: 1. either very preterm (<32 weeks gestation) or very low birth weight (<1500g birth weight); 2. a subsample of children born at ≥32 weeks gestation randomly selected within the stratification factors gender, family SES (low, medium and high) and degree of neonatal risk (none, low, moderate, high and very high) (22).…”

Preterm Cognitive Function Into Adulthood

“…VP/VLBW children and adolescents have an increased prevalence of cognitive deficits [1][2][3] and recent evidence indicates that young VP/VLBW adults still have lower average IQ scores compared with those born at term. 1,2,[4][5][6] It is, however, not known whether the same children who had cognitive deficits in childhood continue to have deficits in adulthood, as developmental tests in early childhood rely strongly on sensorimotor skills and may not accurately measure core cognitive ability.…”