Abstract
ABSTRACTObjective: To evaluate the cognitive and academic profile of preterm newborns at school age and to determine the factors related to prematurity and sociodemographic profile that influence these results.Methods: Patients aged 6-14 years old that were assisted in the preterm follow-up clinic were recruited. The cognitive, academic, and neurological capacities were accessed through a detailed evaluation with a child neurologist, a neuropsychologist and a psychopedagogue. Neonatal data were collected from patient records.Results: 97 children were included and 14 were excluded from the study, resulting in 83 children. Gestational age (GA) was 30±3 weeks and weight at birth was 1138g (605 to 4185g). Poor performance was shown in 38.4% for writing, 57.5% for reading and 42.5% for mathematics. The mean total intelligence quotient (IQ) was 96±14.9 points, and 10.9% were considered altered. Children with unstructured families presented 78.3% of failure in reading tests (p=0.029). The multivariate analysis showed association between GA at birth and classic mini-mental score (p=0.043), total IQ (p=0.047), perceptual organization IQ (p=0.035), and processing speed IQ (p=0.036). There was also association between weight at birth and the classic (p=0.004) and adapted (p=0.007) mini-mental scores; invasive mechanic ventilation duration and classic mini-mental (p=0.049); and lower maternal age and processing speed IQ (p=0.033).Conclusions: Preterm infants at school age had high frequency of failure in cognitive and academic evaluation tests. Learning difficulties are high among them. Multiple neonatal variables are related with altered cognitive and students development.
Highlights
Despite the therapeutic advances in the past decades regarding premature infant (PI) care, the rates of long-term sequelae have remained high.[1]
We could contact 97 patients, and 5 did not accept the invitation to participate in the study; 2 died due to other intercurrences; and 4 were excluded for not matching the criteria
We expected a low incidence of major disabilities and sequelae, such as deafness, blindness, cerebral palsy and intellectual disability
Summary
Despite the therapeutic advances in the past decades regarding premature infant (PI) care, the rates of long-term sequelae have remained high.[1]. The factors that have the most negative impact on development and increase the risk of delay and disabilities, especially in terms of cognition, are low GA and low weight. Other perinatal factors that increase the risk of developing severe intellectual disabilities are severe peri-intraventricular hemorrhage (PIVH), cystic periventricular leukomalacia, use of corticoids after birth and going through major surgical procedures.[4] Factors such as being male, ethnicity (non-white), low income and low parental schooling are an influence.[5] The following can be listed as protective factors: breastfeeding, higher family income, insertion in programs of early stimulation and preventive educational support.[6,7]
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