Psychosocial and Academic Characteristics of Extremely Low Birth Weight (≤800 g) Adolescents Who Are Free of Major Impairment Compared With Term-Born Control Subjects

Birth Weight Children Meta-Analysis of Neurobehavioral Outcomes in Very Preterm and/or Very Lowhttp://www.pediatrics.org/cgi/content/full/124/2/717 located on the World Wide Web at:The online version of this article, along with updated information and services, is Meta-Analysis of Neurobehavioral Outcomes in Very Preterm and/or Very Low Birth Weight Children abstract OBJECTIVE: Sequelae of academic underachievement, behavioral problems, and poor executive function (EF) have been extensively reported for very preterm (Յ33 weeks' gestation) and/or very low birth weight (VLBW) (Յ1500 g) children. Great variability in the published results, however, hinders the field in studying underlying dysfunctions and developing intervention strategies. We conducted a quantitative meta-analysis of studies published between 1998 and 2008 on academic achievement, behavioral functioning, and EF with the aim of providing aggregated measures of effect size for these outcome domains.METHODS: Suitable for inclusion were 14 studies on academic achievement, 9 studies on behavioral problems, and 12 studies on EF, which compared a total of 4125 very preterm and/or VLBW children with 3197 term-born controls. Combined effect sizes for the 3 outcome domains were calculated in terms of Cohen's d. Q-test statistics were performed to test homogeneity among the obtained effect sizes. Pearson's correlation coefficients were calculated to examine the impact of mean birth weight and mean gestational age, as well as the influence of mean age at assessment on the effect sizes for academic achievement, behavioral problems, and EF. RESULTS:Combined effect sizes show that very preterm and/or VLBW children score 0.60 SD lower on mathematics tests, 0.48 SD on reading tests, and 0.76 SD on spelling tests than term-born peers. Of all behavioral problems stacked, attention problems were most pronounced in very preterm and/or VLBW children, with teacher and parent ratings being 0.43 to 0.59 SD higher than for controls, respectively. Combined effect sizes for parent and teacher ratings of internalizing behavior problems were small (Ͻ0.28) and for externalizing behavior problems negligible (Ͻ0.09) and not significant. Combined effect sizes for EF revealed a decrement of 0.57 SD for verbal fluency, 0.36 SD for working memory, and 0.49 SD for cognitive flexibility in comparison to controls. Mean age at assessment was not correlated with the strength of the effect sizes. Mathematics and reading performance, parent ratings of internalizing problems, teacher ratings of externalizing behavior, and attention problems, showed strong and positive correlations with mean birth weight and mean gestational age (all r values Ͼ 0.51). CONCLUSIONS:Very preterm and/or VLBW children have moderate-toseveredeficitsinacademicachievement,attentionproblems,andinternalizing behavioral problems and poor EF, which are adverse outcomes that were strongly correlated to their immaturity at birth. During transition to young adulthood these children continue to lag behind term-born peers.

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“…Details on the studies included are provided in Table 1. [21][22][23][24][25][26][27][28][29][30][31][32][33][34] …”

Section: Academic Achievementmentioning

confidence: 99%

Meta-Analysis of Neurobehavioral Outcomes in Very Preterm and/or Very Low Birth Weight Children

et al. 2009

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“…Some studies of children with VLBW/VPTM suggest more MD and MLD in males than in females (O'Callaghan et al, 1996;Johnson and Breslau, 2000), though other investigations have not found sex differences in this population (e.g., Saigal et al, 2000;Taylor et al, 2000;Grunau et al, 2004). With respect to potential age differences in MD, impairments on tests of mathematics achievement in VLBW/ VPTB cohorts are evident from the early school-age years and persist into adolescence and young adulthood (Saigal et al, 1990;Taylor et al, 1995;Botting et al, 1998;Saigal et al, 2000;Rickards et al, 2001;Hack et al, 2002).…”

Section: Sex and Age Differences In Mathematics Outcomesmentioning

confidence: 99%

Mathematics deficiencies in children with very low birth weight or very preterm birth

Taylor

Espy

Anderson

2009

Dev Disabil Res Revs

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Children with very low birth weight (VLBW, <1500 g) or very preterm birth (VPTB, <32 weeks gestational age or GA) have more mathematics disabilities or deficiencies (MD) and higher rates of mathematics learning disabilities (MLD) than normal birth weight term‐born children (NBW, >2500 g and >36 weeks GA). MD are found even in children without global disorders in cognition or neurosensory status and when IQ is controlled, and they are associated with other learning problems and weaknesses in perceptual motor abilities and executive function. Factors related to poorer mathematics outcomes include lower birth weight and GA, neonatal complications, and possible abnormalities in brain structure. While little is known about the nature of MD in these children, studies of MLD in other neurodevelopmental disorders and in children with learning disabilities provide useful models for further investigation. Further investigation of the neuropsychological and neuropathological correlates of distinct types of mathematics difficulties is also needed. Studies along these lines will yield information about the unique features of MD in children with VLBW/VPTB and about the nature and origins of poor mathematics achievement more generally. © 2009 Wiley‐Liss, Inc. Dev Disabil Res Rev 2009;15:52–59.

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“…Despite an attrition rate of 23% with the known selection bias that may result (ie, underestimation of impairment), 45 this rate is comparable to other long-term follow-up studies. 3,8,9,12 The study large sample size has allowed assessment of the impact of multiple relevant neonatal and demographic factors on outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…[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.…”

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confidence: 99%

Executive and Memory Function in Adolescents Born Very Preterm

2011

PEDIATRICS

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WHAT'S KNOWN ON THIS SUBJECT:Very preterm children display significant school problems that persist into adolescence. Executive functioning and memory play important roles in learning and school attainment. WHAT THIS STUDY ADDS:This study confirms that adolescents born very preterm exhibit deficits in executive functioning and memory in a large contemporary sample. Severe brain injury and maternal education are strong predictors of performance on executive function and memory tasks. abstract BACKGROUND: Many preterm children display school difficulties, which may be mediated by impairment in executive function and memory. OBJECTIVE:To evaluate executive and memory function among adolescents born preterm compared with term controls at 16 years. METHODS:A total of 337 of 437 (77%) adolescents born in 1989 to 1992 with a birth weight Ͻ 1250 g and 102 term controls were assessed with a battery of executive function and memory tasks. Multiple regression analyses were used to compare groups and to identify associations between selected factors and outcomes among preterm subjects. RESULTS:Adolescents born preterm, compared with term controls, showed deficits in executive function in the order of 0.4 to 0.6 SD on tasks of verbal fluency, inhibition, cognitive flexibility, planning/organization, and working memory as well as verbal and visuospatial memory. After exclusion of adolescents with neurosensory disabilities and full-scale IQ Ͻ 70, significant group differences persisted on most tests. Preterm subjects, compared with term controls, were at increased risk of exhibiting problems related to executive dysfunction, as measured with the Behavior Rating Inventory of Executive Function, on the Metacognition Index (odds ratio [OR]: 2.5 [95% confidence interval (CI): 1.2-5.1]) and the Global Executive Composite (OR: 4.2 [95% CI: 1.6 -10.9]), but not on the Behavioral Regulation index (OR: 1.5 [95% CI: 0.7-3.5]). Among adolescents born preterm, severe brain injury on neonatal ultrasound and lower maternal education were the most consistent factors associated with poor outcomes. CONCLUSIONS:Even after exclusion of preterm subjects with significant disabilities, adolescents born preterm in the early 1990s were at increased risk of deficits in executive function and memory. Pediatrics 2011;127:e639-e646

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Psychosocial and Academic Characteristics of Extremely Low Birth Weight (≤800 g) Adolescents Who Are Free of Major Impairment Compared With Term-Born Control Subjects

Cited by 241 publications

References 58 publications

Meta-Analysis of Neurobehavioral Outcomes in Very Preterm and/or Very Low Birth Weight Children

Meta-Analysis of Neurobehavioral Outcomes in Very Preterm and/or Very Low Birth Weight Children

Mathematics deficiencies in children with very low birth weight or very preterm birth

Executive and Memory Function in Adolescents Born Very Preterm

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