Background and aims Despite the dramatically increased survival rates for very preterm (gestational age ≤ 30 weeks) infants, these children’s developmental outcomes remain of significant concern. A majority of non-disabled very preterm children with IQs in the average range have substantial academic and behavior problems, of which deficits in mathematics and symptoms of inattention are the most pronounced. Executive function may be an important mechanism underlying these problems, an issue only scarcely examined and aim of this study.
Methods Two-hundred non-disabled very preterm (mean age = 8.2±2.5) and 230 term children (mean age = 8.3±2.3), all born between 1996 and 2004, were assessed with measures of mathematics/arithmetic (Dutch Pupil Monitoring System), and executive function in preschool and in primary school. Parents and teachers reported on attention problems using the Achenbach behavior questionnaires and the Disruptive Behavior Disorders Rating scales.
Results Very preterm children had significantly more mathematical and attention problems than term children (SMD’s > 0.46). IQ significantly predicted mathematical problems (βs > 0.15, Ps < 0.04). Executive functioning, in particular spatial span and inhibitory control, was, over and above IQ, significantly predictive for mathematical problems (βs = 0.11, P=0.003) and attention problems (βs > 0.17, Ps < 0.001) in primary school. Associations were stronger for very preterm than for term children.
Conclusions Very preterm birth is associated with medium-sized deficits in mathematics and attention problems. Impaired executive function and IQ scores are important predictors for these adverse outcomes.