Ten-year follow-up of children born before 29 gestational weeks: health, cognitive development, behaviour and school achievement

Abstract

Since the mid-1990s several studies have reported poor school performance in extremely preterm infants. The necessity to provide a full picture of the child's situation has been indicated. In a southern Swedish population 32,120 infants were born during the 2-y period 1985-1986. In total, 121 infants (0.4%) were reported liveborn before the 29th gestational wk and 12 (0.04%) were reported stillborn. Only 65 infants (50%) survived to the age of 10 y. The aim of this study was to evaluate the situation of extremely preterm (EPT) children at school, compared with that of full-term (FT) control children, at the age of 10 y. Health, cognitive development, school achievement and behaviour were measured. Ninety-two percent of the preterm children had no major neurological disability and most were in good health. The EPT children had an IQ of 90 +/- 15 vs 106 +/- 15 (mean +/- SD) for the FT children (p <0.001), and on the test of Visual-Motor Integration, the EPT children had 93.3 +/- 12.2 vs 109.6 +/- 14.2 for FT peers (p < 0.001). On both tests the differences between the groups corresponded to approximately one standard deviation. Thirty-eight percent of the EPT children performed below grade level at school. Thirty-two percent had general behavioural problems and 20% had attention deficit hyperactivity disorder, compared with 10% and 8%, respectively, in the FT group. EPT children require interventions to support their development and reduce behavioural problems.

Dificuldade de aprendizagem em escolares de muito baixo peso ao nascer

“…17 In reality, despite apparently exhibiting intellectual function within normal limits when submitted to standardized tests, children born prematurely are at increased risk of academic performance disabilities. [18][19][20][21][22][23][24][25][26][27][28][29][30] This risk appears to increase in line with reductions in birth weight. 16,19 The academic difficulties exhibited by extremely low birth weight children reflect their vulnerabilities in terms of visuospatial, visuomotor and verbal abilities.…”

The development of potentially better practices to support the neurodevelopment of infants in the NICU

“…435,[437][438][439][440][441][442][443][444][445] Of these infants, only 3 to 5% are diagnosed with classic cystic periventricular leucomalacia. 446 Follow-up studies of premature infants demonstrate that there are many infants without ultrasound evidence of abnormality who continue to demonstrate significant cognitive and behavioral deficits.…”

Early diagnosis of abnormal development of preterm newborns: assessment instruments

“…Vários estudos têm demonstrado que não somente as crianças consideradas de alto risco são afetadas futuramente. Crianças prematuras com baixo risco para anormalidades demonstram dificuldades ligadas a outras áreas do desenvolvimento além da área motora 5,[8][9][10][11] .…”