Abstract
BACKGROUND: Improved survival rates for preterm and very low birthweight infants have increased attention towards their long-time neuro-developmental outcome, and particularly cognitive performances. To discriminate the effects of preterm birth from those of its neurological and sensorial consequences, we studied the cognitive function of a sample of healthy preterm children (no IVH stage 3–4; PLV; ROP grade 3–4) at pre-school age.METHODS: Thirty-five healthy preterm children (gestational age less than 33 weeks) were assessed at mean age of 4.4 years (SD 0.3) together with 50 controls born at term and matched for age and gender. Cases were selected from patients attending follow up at a large tertiary Pediatric Hospital. Griffiths scales were used to measure cognitive development. Multivariate regression analysis was adopted to simultaneously explore the effects of preterm birth and socio-demographic factors on cognitive score: parent age and education.RESULTS: Ninty-six % of global developmental Griffiths scores of both cases and controls were within 83–116, corresponding to the scale range of low to high average. However, global mean scores were lower for cases (97) than controls (103) and the difference was statistically significant (p<0.05). In particular, scores of preterm infants were significantly lower in four subscales: locomotor, hand and eye co-ordination, performance, practical reasoning. After adjusting for socio-demographic variables in multivariate analysis, the difference in global scores remained statistically significant (p<0.01). Maternal education was also significant predictor of cognitive development (p<0.05) with higher educational level corresponding to better children performances.CONCLUSIONS: These findings suggest that healthy preterm children at pre-school age, despite a global developmental score in the normal range, still show a lower developmental profile than their term peers, and maternal education also exerts a significant effect. Lower subscale scores point to specific areas of difficulty. These findings have implication for subsequent school performance and therapeutic interventions.
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