The Course of Intellectual Development in Preterm and Fullterm Children: An 8-year Longitudinal Study

Abstract

A total of 55 preterm children born at low to moderate risk and a comparison group of 100 healthy fullterm children were studied until they reached 8 years of age. Perinatal biomedical data and environmental data were considered as potential contributors to developmental outcome. The Budapest Binet intelligence quotients (IQs) were used as outcome measures. The mean IQs for both groups fell within the normal range at each measuremen t point. However, the differential patterns of IQ development in the preterm and term group underscore the signi cance of the age variable. Instead of a gradually declining impact of prematurity, the age effect resulted in a complex pattern. The considerable intra-group variability within the preterm group and the correlates of outcome suggest that biological hazards related to birth may have subtle long-term in uences. Variables tapping the quality of home environment, however, clearly outweighed the perinatal risk factors in their ability to predict long-term outcomes. The results suggest a transaction between the two spheres of contributing factors. Long-term follow-up studies with multiple measuremen t points are essential if we are to understand the developmental implications of premature birth.

Prenatal and family risks of children born to mothers with epilepsy: effects on cognitive development

“…Results suggest that children born with risks are more susceptible to external influences -positive or negative -over a longer period of their lifetime than healthy children. 22 These results raise the question of the appropriateness of merely 'eliminating' family influences in early risk studies by methodological techniques. It appears to be crucial to account for those interactive and differential long-term effects on the psychological outcome of affected children.…”

Desenvolvimento psicológico na fase escolar de crianças nascidas pré-termo em comparação com crianças nascidas a termo

“…Por outro lado, Mutch, Leyland e McGee (1993), Kalmar (1996) e Sansavini, Rizzard, Alessandroni e Giovanelli (1996) encontraram resultados mais otimistas em relação a essas crianças vulneráveis. Esses autores enfatizaram que não é só a condição de baixo peso e prematuridade que determina o desempenho cognitivo da criança.…”

“…Devese salientar a influência potencial das variáveis proximais do ambiente familiar no desenvolvimento da criança, como por exemplo, as interações e mediações sociais, embora neste estudo não tenha sido objeto de análise. Kalmar (1996) e Bradley e colaboradores (1993) demonstraram que crianças pré-termo e muito baixo peso vivendo em condições de pobreza, mas experimentando um ambiente familiar com três ou mais fatores protetores (variedade da estimulação, suporte emocional, responsividade parental e aceitação do comportamento infantil) são mais propensas a apresentar sinais de resiliência do que crianças que não contam com esses mecanismos protetores. O ambiente assume, então, um papel importante e decisivo, na medida em que recursos externos podem ser mobilizados no sentido de promoverem mediação adequada a essas crianças, dando-lhes condições para a ativação de recursos que lhes permitirão um funcionamento cognitivo dentro dos parâmetros normativos satisfatórios.…”

Health status development in a cohort of preterm children

“…Older mothers may have obtained the maturity and the responsiveness that are important for adequate rearing of preterm children, in spite of low SES. 22,24,25 Another explanation for the ambiguous impact of SES may be the relatively small class differences with regard to exposure to health service created by the health security system in The Netherlands. 21 The relative importance of HS problems in the cohort of preterm born children appears to change with age.…”

“…Problems in basic functioning decrease, whereas concentration problems and negative moods increase. Although there are many longitudinal HS studies in preterm born children, [19][20][21][22][23][24][25][26][27][28][29][30] for several reasons comparison with the results of these studies is complicated. First, these previous studies had small samples of preterm children (range, , with diverse selection criteria (with or without handicaps and with various cut-off points for gestational age).…”