Long-term neuropsychological outcomes of very low birth weight: Associations with early risks for periventricular brain insults

Abstract

Few follow-up studies of children with very low birth weight (VLBW, <1,500 g) have examined neuropsychological sequelae at later ages or neonatal risks as predictors of these outcomes. The present study assessed cognitive skills at mean age 16 years in 48 participants with <750 g birth weight, 47 with 750–1,499 g birth weight, and 52 term-born controls. Our major objectives were to delineate the long-term cognitive consequences of VLBW, and to determine if risks for periventricular brain insults accounted for variations in outcomes. Analysis revealed poorer outcomes for the <750 g group than for term-born controls on nearly all measures, with specific impairments in visual–motor skills, spatial memory, and executive function. Predictors of outcome for participants with VLBW included lower birth weight, lower weight for gestational age, and a longer period of oxygen requirement for chronic lung disease. The longer-term consequences of VLBW are consistent with expectations based on early brain pathology and suggest limitations to functional plasticity. (JINS, 2004,10, 987–1004.)

Pattern of daily weights among low birth weight neonates in the neonatal intensive care unit: data from a multihospital health-care system

“…It is clear that the risk of neurodevelopmental handicap is inversely related to birth weight. 21,22 It is also clear that undernutrition in early infancy can be a cause of neurodevelopmental delay. 6,22 On that basis it is tempting to speculate that divergence in the growth lines is due, at least in part, to progressive undernutrition of the lowest birth weight cohorts.…”

Persisting cognitive deficits in survivors of very low birthweight and their implications for adult functioning

“…The observation of pronounced weaknesses on the Wechsler Adult Intelligence Scale Perceptual Organization Index in the VLBW group compared with controls is consistent with previous literature. 8 However, the fact that there were group differences on all ability indices and on multiple verbal as well as performance subtests suggests that cognitive impairment in early adulthood is more pervasive than suggested by past studies using shortened versions of IQ testing batteries. Another important finding is the much higher rate of low IQ scores (>1SD below the mean of the controls) in the VLBW group, indicating that reduced IQ is a relatively common finding among survivors.…”

“…Although Løhaugen et al did not find that neonatal risk factors were related to IQ scores when individuals with cerebral palsy were excluded from analysis, past studies have documented associations of cognitive deficits with more extreme low birthweight, intrauterine growth retardation, and longer periods of oxygen treatment. 8 Assessment of VLBW-related brain abnormalities and environmental characteristics has the potential to yield more accurate predictions of individual outcomes. 9 Measures of executive function and other skills frequently impaired in survivors of VLBW (but not comprehensively probed by IQ tests) will also be useful in clarifying the cognitive implications of variations in brain status and environmental-genetic background.…”

Executive and Memory Function in Adolescents Born Very Preterm

“…[1][2][3][4][5][6][7][8][9][10][11][12] During teenage years, deficits in IQ scores for preterm children compared with term controls vary between 8 and 13 points. 13 However, preterm children with normal intelligence still face significant school difficulties.…”

“…Deficits in these domains have been observed in adolescents and young adults born preterm before the era of modern neonatology. 3,[15][16][17][18] These abilities depend on the integrity of the neural network that connects the prefrontal cortex to the brainstem, the cerebral lobes, and the limbic and subcortical regions. 19 Neuroimaging studies in preterm children have shown decreased white matter volumes and impaired white matter gains compared with term controls, which indicates their increased vulnerability for executive dysfunction.…”