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Cognitive Outcomes for Extremely Preterm/Extremely Low Birth Weight Children in Kindergarten

Published online by Cambridge University Press:  19 September 2011

Leah J. Orchinik
Affiliation:
Department of Psychology, Case Western Reserve University, Cleveland, Ohio
H. Gerry Taylor*
Affiliation:
Department of Pediatrics, Case Western Reserve University, Rainbow Babies and Children's Hospital, Cleveland, Ohio
Kimberly Andrews Espy
Affiliation:
Developmental Neuroscience Laboratory, University of Nebraska-Lincoln, Lincoln, Nebraska
Nori Minich
Affiliation:
Department of Pediatrics, Case Western Reserve University, Rainbow Babies and Children's Hospital, Cleveland, Ohio
Nancy Klein
Affiliation:
Department of Education, Cleveland State University, Cleveland, Ohio
Tiffany Sheffield
Affiliation:
Developmental Neuroscience Laboratory, University of Nebraska-Lincoln, Lincoln, Nebraska
Maureen Hack
Affiliation:
Department of Pediatrics, Case Western Reserve University, Rainbow Babies and Children's Hospital, Cleveland, Ohio
*
Correspondence and reprint requests to: H. Gerry Taylor, W.O. Walker Building, Suite 3150, 10524 Euclid Ave., Cleveland, OH 44106. E-mail: hgt2@case.edu

Abstract

Our objectives were to examine cognitive outcomes for extremely preterm/extremely low birth weight (EPT/ELBW, gestational age <28 weeks and/or birth weight <1000 g) children in kindergarten and the associations of these outcomes with neonatal factors, early childhood neurodevelopmental impairment, and socioeconomic status (SES). The sample comprised a hospital-based 2001–2003 birth cohort of 148 EPT/ELBW children (mean birth weight 818 g; mean gestational age 26 weeks) and a comparison group of 111 term-born normal birth weight (NBW) classmate controls. Controlling for background factors, the EPT/ELBW group had pervasive deficits relative to the NBW group on a comprehensive test battery, with rates of cognitive deficits that were 3 to 6 times higher in the EPT/ELBW group. Deficits on a measure of response inhibition were found in 48% versus 10%, odds ratio (95% confidence interval) = 7.32 (3.32, 16.16), p < .001. Deficits on measures of executive function and motor and perceptual-motor abilities were found even when controlling for acquired verbal knowledge. Neonatal risk factors, early neurodevelopmental impairment, and lower SES were associated with higher rates of deficits within the EPT/ELBW group. The findings document both global and selective cognitive deficits in EPT/ELBW children at school entry and justify efforts at early identification and intervention. (JINS, 2011, 17, 1067–1079)

Type
Regular Articles
Copyright
Copyright © The International Neuropsychological Society 2011

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