Neonatal predictors of cognitive ability in adults born very preterm: a prospective cohort study

Abstract

Aim To identify neonatal predictors to allow a developmental prognosis of the cognitive abilities of survivors born very preterm/very low birthweight (VLBW) into adult life. Method The Bavarian Longitudinal Study is a prospective whole‐population study that followed 260 infants born very preterm/VLBW from birth to adulthood. Regression analyses examined which neonatal factors predicted adult IQ. Results Neonatal morbidity, neonatal treatment, and early social environment of infants born very preterm/VLBW explained 37.6% of the variance in adult IQ. Seven unique early‐life predictors of lower adulthood IQ were found: respiratory distress syndrome, intraventricular haemorrhage, problems with mobility, mechanical ventilation, less parenteral nutrition, low/middle socioeconomic status, and poor early parent–infant relationships. Specifically, modifiable factors such as mechanical ventilation predicted a drop of 0.43 IQ points for each day of treatment, adjusted for initial respiratory problems. Good early parent–infant relationships predicted an approximately 5‐point increase in adult IQ, adjusted for other significant predictors such as socioeconomic status. Interpretation Mechanical ventilation, parenteral feeding, and early parenting were identified as significant modifiable factors that were strongly related to adult IQ. Mechanical ventilation policies have changed but there is scope for early interventions that focus on positive parenting, which may reduce the adverse effects of very preterm/VLBW birth on cognitive abilities.

Predictors of early motor trajectories from birth to 5 years in neonatal at‐risk and control children

“…Further, previous findings have shown that early parent-infant relationships predict long-term cognitive outcomes. 33 Our findings support future research to investigate whether targeted intervention programmes to improve early parent-infant relationships and to provide parent support in the NICU can lead to significant and long-term improvements in children's motor development. Given the evidence from previous studies that early motor deficits do not diminish over time, 34 and that poor motor skills in adulthood are associated with mental health problems and lower health-related quality of life, 35 the early motor trajectories identified in this current study may help to predict whether children with high degree of motor difficulties over the first 5 years of life are more likely to have additional problems in other developmental domains across the life span.…”

Cognitive outcomes in children and adolescents born very preterm: a meta‐analysis

“…First, it is possible that owing to advances in medical research, a cohort effect may be evident in our selected studies. 96 However, socio-economic status was not included as a covariate in the current meta-analysis because there is a severe lack of consistency in terms of reporting socio-economic variables across studies. As such, it may follow that cognitive outcomes have also improved in the same time period.…”

Developmental cascades of social inhibition and friendships in preterm and full‐term children

“…Early parent–infant relationship quality was assessed with the Parent–Infant Relationship Index (PIRI) from birth to 5 months (Breeman, Jaekel, Baumann, Bartmann, & Wolke, ; Wolke, Schmid, Schreier, & Meyer, ). The instrument consists of eight “yes” or “no” items obtained by trained nurses' observations and a standardized interview with the children's parents, assessing attachment‐related parental concerns, feelings, and behaviours.…”

“…Early parent-infant relationship quality was assessed with the Parent-Infant Relationship Index (PIRI) from birth to 5 months (Breeman, Jaekel, Baumann, Bartmann, & Wolke, 2017;Wolke, Schmid, Schreier, & Meyer, 2009).…”