Seven Years Cognitive Functioning and Early Assessment in Extremely Low Birth Weight Children

Abstract

Infants born preterm are at high risk for the onset of cognitive dysfunctions at school age. The aim of this study was to investigate the association between early neurodevelopmental assessment and the risk of adverse cognitive outcome in extremely low birth weight children. We enrolled all newborns (January 2002 – April 2007) consecutively admitted to our Institution, with a birthweight < 1000 g. Exclusion criteria were genetic abnormalities, severe neurofunctional impairment, and/or neurosensory disabilities. Ninety-nine children were assessed at 1 year of corrected age using the Griffiths Mental Development Scales Revised. The same children were re-assessed at school age through the Wechsler Intelligence Scale for Children. Children with impaired Griffiths General Quotient (i.e., <1 SD) at 1 year of corrected age showed a significantly lower Full Scale Intelligence Quotient at 7 years of chronological age when compared to children who scored in the normal range at 1 year (p < 0.01). Considering the Griffiths Sub-quotients separately, a poor score in the Performance or in the Personal-Social Sub-quotients at 1 year was associated with significantly worse cognitive outcomes both in the Verbal and in the Performance Intelligence Quotients at 7 years (p < 0.01 and p < 0.05, respectively). A score <1 SD in the Locomotor or in the Eye and Hand Coordination Sub-quotients were specifically associated with poorer Performance or Verbal Intelligence Quotients, respectively (p < 0.05). Our findings suggest that a poor score on the Griffiths Scales at 1 year is associated with a higher risk of cognitive impairment at school age. Larger confirmation studies are needed.

<p>Comparison Of The Children Neuropsychological And Behavior Scale And The Griffiths Mental Development Scales When Assessing The Development Of Children With Autism</p>

“…Some research has been performed on the value of the GMDS for predicting later developmental problems. Squarza et al conducted a study on early developmental level and cognitive outcomes in 99 children with an extremely low birth weight, and the results showed that the lower the GMDS score was at 1 year, the more severe the cognitive impairment was at school age, indicating a high predictive power of the GMDS 29. This predictive power increased with increasing age at assessment 17,18.…”

Early Intervention in preterm infants modulates LINE-1 promoter methylation and neurodevelopment

“…The clinical relevance of these short-term results needs to be confirmed later in childhood when neurobehavioral and cognitive impairments become more obvious, although studies on the neurodevelopmental trajectories of preterm infants have suggested the predictive value of the 12 months' assessment on long-term outcomes (69).…”

“…We further demonstrate that the Early Intervention program enhances neurodevelopment at 12 months corrected age compared to Standard Care, albeit scores are within the normal range for both groups. The clinical relevance of these short-term results needs to be confirmed later in childhood when neurobehavioral and cognitive impairments become more obvious, although studies on the neurodevelopmental trajectories of preterm infants have suggested the predictive value of the 12 months’ assessment on long-term outcomes (69).…”

Early detection of general movements trajectories in very low birth weight infants

“…mild cognitive delay, learning disabilities) and behavioral (i.e. autism, hyperactivity) impairments 3,4 .…”