Intelligence and executive function of school-age preterm children in function of birth weight and perinatal complication.

AIM: Assessment of intelligence and executive function in 9-10-year-old preterm children as compared to a full-term comparison group and to reveal the background of the individual differences in the outcomes by analyzing the effects of perinatal and social-economic factors. METHOD: Seventy-two preterm children (divided into two groups: 32 extremely low birth weight, 40 very low birth weight) and a matched group of 33 healthy full-term children, aged 9-10 years, were tested using the Wechsler Intelligence Scales for Children (WISC-IV) and digital versions of tasks measuring executive function. As background information perinatal variables and maternal education were entered in the analysis. RESULTS: In the WISC-IV all three groups performed in the normal range. The preterm children, particularly the ELBW subgroup, scored significantly lower than the full-term comparison group in several outcome measures. Behind the group means there were massive scatters of the individual scores. Lower maternal education, male gender, and bronchopulmonary dysplasia (BPD) increased the risk for performance deficits. CONCLUSION: Low-to-moderate risk preterm children as groups are disadvantaged in the development of intelligence and executive function as compared to healthy full-term children even until school-age. However, with appropriate protective factors they may have chances to develop comparably with their full-term, non-risk counterparts.

Reading and spelling skills of prematurely born children in light of the underlying cognitive factors.

Prematurity is a serious risk factor for learning difficulties. Within the academic skills reading has the greatest impact on the prospects of the students; therefore, studying the reading skills in the risk populations is very important. The aim of our study was to investigate reading and spelling skills of prematurely born children. Our target group consisted of 8-11-year-old children (n = 23) who were born preterm with very low birthweights (VLBW). For comparison 57 full-term children (27 good readers and 30 dyslexics) were included in the study sample. To assess the reading and spelling abilities the Hungarian version of the 3DM (Dyslexia Differential Diagnosis) was used. Cognitive abilities were tested using the Hungarian adaptation of the WISC-IV and the Rey Complex Figure Test. The data were analyzed with a novel statistical approach using the R program. In the cognitive measures the mean performances of all three groups fell within the normal range. In the WISC-IV Full-scale IQ as well as in some other cognitive measures the good readers significantly outperformed both the dyslexics and the preterms. The findings of the study did not confirm our expectation that VLBW prematurity should lead to developmental disadvantages in the acquisition of reading and spelling skills since in the reading and spelling performances of the good readers and the preterms did not differ, while both the good readers and the preterms scored higher than the dyslexics. The results suggest that the cognitive assets of the preterm children contributing to their reading and spelling performances were their good spatial-visual memory, working memory, and processing speed. The identification of the cognitive mechanisms underlying reading and spelling abilities is of crucial importance for designing intervention for children with deficits in these academic skills.

[Follow-up study of extremely low birth weight preterm infants to preschool age in the light of perinatal complications]. / Az extrém kis születési súlyú koraszülöttek fejlodésének követése az óvodáskor végéig a perinatalis szövodmények tükrében.

INTRODUCTION: Owing to the rapid progress of the medical science and technology, the chances of survival of the extremely low birth weight (<1000 g) preterm babies have dramatically improved. Nevertheless, the research findings on their long-term developmental outcome are inconsistent. AIM: Our study has attempted to contribute to the understanding of the developmental mechanisms in the extremely low birth weight preterm infants and to the prediction of the developmental outcomes taking into account of the risk factors of development. METHOD: 34 preterm children who were free of any major central nervous system injury were followed up from one to 5-6 years of age. The psychomotor development of the infants was assessed at 1 and 2 years of age and, at 5-6 years of age, intelligence tests were administered to the children. Perinatal and environmental factors were included in the data analysis. RESULTS: The extremely low birth weight preterm children as a group displayed no developmental delay at any of the measurement points. The mean developmental quotients were 98.6 and 106.6 at ages 1 and 2 years, respectively. At 5-6 years of age, the mean verbal IQ was 101.4, while the mean performance IQ was 92.9. Behind the group means there was a wide range of individual variations. The most powerful contributors to the developmental outcomes were birth weight, bronchopulmonary dysplasia, intra-uterine growth retardation, gender, and maternal education. The girls had a significant advantage over the boys in language development. Verbal intelligence was hampered by intracranial hemorrhage, while intrauterine growth restriction had a similar effect on the performance IQ. CONCLUSIONS: Our results suggest that even the extremely preterm infants may have rather good chances of satisfactory mental development. However, the individual developmental prospects are influenced by a great number of domain-specific risk- and protective factors. Although at a group-level, infant psychomotor development is a significant predictor of later intelligence quotient, the rate of development may change at any age. The phenomenon of "moving risk" underscores the importance of the long-term follow-up of preterm infants. Orv Hetil. 2018; 159(41): 1672-1679.

Comparative Network Analysis of Preterm vs. Full-Term Infant-Mother Interactions.

Several studies have reported that interactions of mothers with preterm infants show differential characteristics compared to that of mothers with full-term infants. Interaction of preterm dyads is often reported as less harmonious. However, observations and explanations concerning the underlying mechanisms are inconsistent. In this work 30 preterm and 42 full-term mother-infant dyads were observed at one year of age. Free play interactions were videotaped and coded using a micro-analytic coding system. The video records were coded at one second resolution and studied by a novel approach using network analysis tools. The advantage of our approach is that it reveals the patterns of behavioral transitions in the interactions. We found that the most frequent behavioral transitions are the same in the two groups. However, we have identified several high and lower frequency transitions which occur significantly more often in the preterm or full-term group. Our analysis also suggests that the variability of behavioral transitions is significantly higher in the preterm group. This higher variability is mostly resulted from the diversity of transitions involving non-harmonious behaviors. We have identified a maladaptive pattern in the maternal behavior in the preterm group, involving intrusiveness and disengagement. Application of the approach reported in this paper to longitudinal data could elucidate whether these maladaptive maternal behavioral changes place the infant at risk for later emotional, cognitive and behavioral disturbance.