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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 ,
H. Gerry Taylor ,
Kimberly Andrews Espy ,
Nori Minich ,
Nancy Klein ,
Tiffany Sheffield  and
Maureen Hack
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: [email protected]
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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)

Keywords

Premature birthNeuropsychological testsRisk factorsCognitionExecutive functionChild
Type
Regular Articles
Information
Journal of the International Neuropsychological Society , Volume 17 , Issue 6 , November 2011 , pp. 1067 - 1079
Copyright
Copyright © The International Neuropsychological Society 2011

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