Abstract
Late preterm children born between 340/7 and 366/7 weeks’ gestation account for ≈70% of prematurely born infants. There is growing concern about this population at risk of mild neurodevelopmental problems, learning disabilities and lower academic performance. Following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement, this paper analyzes recent published evidence from 16selected studies involving late preterm children and control group assessments at preschool and/or school age, mainly focusing on cognitive functioning, language learning and academic achievement. The review identifies the assessment tools used in these studies (standardized tests, parental questionnaires and laboratory tasks) and the areas being evaluated from preschool (age 3 years) to primary school levels. Results reveal the presence of mild difficulties, pointing to suboptimal outcomes in areas such as executive function, short term verbal memory, literacy skills, attention and processing speed. Some difficulties are transient, but others persist, possibly compromising academic achievement, as suggested by the few studies reporting on higher risk for poor school performance. Given the increasing number of late preterm children in our society the review highlights the need to implement screening strategies to facilitate early risk detection and minimize the negative effects of this morbidity in childhood.
Highlights
Infants born between 340/7 and 366/7 weeks’ gestation have for a long time been considered low-risk preterm infants, called near-term infants
The aim of the present review is to update the knowledge on late preterm learning outcomes and academic performance, focusing on evidence published in the last decade (2010–2019), from studies comparing healthy late preterm children and at term control groups, assessed at some point during preschool, kindergarten and early school years, and corresponding to cohorts of participants born not earlier than the late 90s
The selected studies, most of them reporting neuropsychological assessments including cognition and language measurements, and just a few of them centered on academic performance, have been grouped into a single table ordered according to assessment age
Summary
Infants born between 340/7 and 366/7 weeks’ gestation have for a long time been considered low-risk preterm infants, called near-term infants They usually receive no special healthcare and are being treated as equivalent to infants born beyond 37 weeks of gestation in terms of their biomedical risk. It was not until the last decade that the label near-term was gradually replaced by late preterm, as suggested by the National Institute of Child Health and Child Development (NICHD) after a workshop celebrated in 2005 in which the need for specific research on the outcomes of this group of preterm babies was emphasized: clinical practice guidelines for this population should be developed and the assimilation of late preterm to term-born infants had to be reconsidered [1]. The growing interest in this population arises from the fact that late preterm newborns represent the largest segment of the preterm neonatal population, accounting for approximately 70% of all prematurely born infants [18,19,20] so, even if it is just a percentage of them that will need some kind of developmental support or
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