Low Birth Weight Preschoolers Research Articles

Internalizing symptoms in very low birth weight preschoolers: Symptom level and risk factors from four rating perspectives in a controlled multicenter study.

Preterm births rates of infants with very low birth weight (VLBW < 1500 g) are increasing. Prematurity poses several risks for emotional child development, e.g., internalizing symptoms. Our understanding of this condition in young children is limited, for at preschool age, symptoms have mostly been assessed from the mother's perspective only. As part of the longitudinal HaFEn cohort-study in Hamburg, Germany, we measured the level of internalizing symptoms in VLBW and term preschoolers as well as predictors from four informants' perspectives: mother, father, teacher, and child. A multilevel model was constructed to examine predictors of internalizing symptoms. n = 104 VLBW and n = 79 term children were included. From both their parents' perspective, children with VLBW had a significantly higher level of internalizing symptoms. From the teacher's and child's own perspectives, there were no significant mean group differences. In the multilevel analyses, the results were different regarding the four perspectives. VLBW did not predict internalizing symptoms. From mother's perspective, her own postpartum psychological distress, and from father's perspective, his postpartum and current psychological distress predicted a higher level of internalizing symptoms in their offspring. From teacher's perspective, socio-economic status predicted internalizing symptoms. The sample size was relatively small. Exclusion criteria and drop out of families could have created some selection bias. Our findings point to the importance of early identification of parental postpartum psychological distress given the potential for later internalizing symptoms in their children or the perception of their offspring as vulnerable and symptomatic, which may also impact the child's development.

Computerized working memory training has positive long-term effect in very low birthweight preschool children.

Working memory deficits are frequently found in children born preterm and have been linked to learning disabilities, and cognitive and behavioural problems. Our aim was to evaluate if a computerized working memory training program has long-term positive effects on memory, learning, and behaviour in very-low-birthweight (VLBW) children at age 5 to 6 years. This prospective, intervention study included 20 VLBW preschool children in the intervention group and 17 age-matched, non-training VLBW children in the comparison group. The intervention group trained with the Cogmed JM working memory training program daily for 5 weeks (25 training sessions). Extensive neuropsychological assessment and parental questionnaires were performed 4 weeks after intervention and at follow-up 7 months later. For most of the statistical analyses, general linear models were applied. At follow-up, higher scores and increased or equal performance gain were found in the intervention group than the comparison group on memory for faces (p=0.012), narrative memory (p=0.002), and spatial span (p=0.003). No group differences in performance gain were found for attention and behaviour. Computerized working memory training seems to have positive and persisting effects on working memory, and visual and verbal learning, at 7-month follow-up in VLBW preschool children. We speculate that such training is beneficial by improving the ability to learn from the teaching at school and for further cognitive development.

Executive Function in Low Birth Weight Preschoolers: The Moderating Effect of Parenting.

Previous meta-analyses have identified moderate deficits in executive function (EF) in children born low birth weight (birth weight < 2500 g; LBW). The current study tests the joint contribution of LBW and parenting quality on trajectories of executive function in 1121 preschoolers (50 % boys). We estimated latent growth curve models to represent linear change in EF from 3 to 5 years of age, and tested the impact of LBW, parenting, and their interaction, on the estimated trajectory parameters. Although LBW was related to lower EF ability at all three time points (Cohen's d = 0.43-0.55), LBW children who experienced high levels of sensitive parenting in toddlerhood exhibited faster rates of improvement in EF, and were virtually indistinguishable from their normal birth weight peers by age 5. On the other hand, LBW children who experienced below average levels of sensitive parenting showed lasting deficits in EF ability. These findings suggest that sensitive parenting may buffer LBW children from lasting deficits in EF. Implications of these findings for future interventions are discussed.

Visual Sensory and Perceptive Functions in Very Low Birth Weight Preschoolers

Visual Sensory and Perceptive Functions in Very Low Birth Weight Preschoolers

325 Attention Problems in Very Low Birth Weight Preschoolers

AimsTo compare very low birth weight (VLBW) children’s performance on attention measurements at preschool age to term-born peers, and to assess associated risk factors.MethodsAttention was assessed in 151 VLBW preschoolers...

Intrauterine Growth and Neuropsychological Performance in Very Low Birth Weight Preschoolers

In this study we examined the association between intrauterine growth, indexed either as a categorical variable or continuous dimension, and neuropsychological outcome, in a very low birth weight (VLBW) sample of 143 preschoolers. When the commonly used split at the 10th percentile rank was applied to classify intrauterine growth restriction (IUGR), we found that the growth restricted group (n = 25) exhibited significantly poorer performance in the global motor domain, but not on any other neuropsychological measure. In contrast, when adequacy of intrauterine growth was indexed by standardized birth weight, a continuous dimension, this early risk factor explained a unique portion of the variance in global cognitive abilities and visuospatial skills, as well as in global, fine, and gross motor skills. These findings are consistent with recent magnetic resonance imaging data disclosing global neurodevelopmental changes in the brains of preterm infants with IUGR. When cases classified with IUGR (<10th percentile) were excluded, the relationship between adequacy of intrauterine growth and global cognitive abilities remained significant despite range restriction. Hence, an association between appropriateness of intrauterine growth and global intellectual outcome may be observed even within the population of VLBW preschoolers with adequate standardized birth weight.

Attention regulation in low‐risk very low birth weight preschoolers: the influence of child temperament and parental sensitivity

Even in the absence of major disabilities, children born prematurely are at high risk for academic delays and deficits. Research suggests that some differences in outcomes may relate to problems with self‐regulation, especially attention regulation. Previous research has demonstrated that individual differences in attention regulation is associated with both child and parent factors. This study examines the role of child temperament and parental sensitivity for attention regulation in preschool‐age children (n = 95) born with very low birth weights (VLBW) by using both questionnaire and observational data. Regression analyses demonstrate differential effects of specific child temperament characteristics and specific aspects of parental sensitivity on attention regulation. Early assessment of temperament and individualised parent sensitivity training may be important for improving outcomes for VLBW children.

Attention Problems in Very Low Birth Weight Preschoolers: Are New Screening Measures Needed for This Special Population?

Children born prematurely have been shown to have a range of problems that often result in delayed academic achievement. The current study assessed both attention problem scores (Child Behavior Checklist) and actual performance on tasks tapping three attention networks in a sample of children (n = 94) born with very low birth weights (VLBW; < or = 1500 grams). Attention problem scores were extremely low and did not predict children's actual attention performance. A body of research is developing that suggests VLBW children may have specific, yet subtle, attention problems that may differ from those of other children.

Spatial Working Memory Deficits in Children at Ages 3-4 Who Were Low Birth Weight, Preterm Infants.

The aim of this study was to investigate attention and perceptual and spatial working memory abilities in preterm, low birth weight preschool children without evident brain disorders as determined by normal cerebral ultrasound findings and normal motor development. The authors evaluated 19 preterm and 19 typically developing children who were matched for IQ and chronological age. Results indicated that children born prematurely without major neurological deficits and with a normal cognitive level may have specific difficulty in sustained attention, visuospatial processing, and spatial working memory when evaluated at ages 3-4. This finding is relevant for understanding the qualitative aspects of cognitive development in preterm children and the neurobiological substrate underlying this development.

Perceptual-motor, visual and cognitive ability in very low birthweight preschool children without neonatal ultrasound abnormalities.

Thirty-six children born preterm with very low birth weight without neonatal brain disorders and normal cerebral ultrasound findings were examined at pre-school age: visual, perceptual motor, attention, behaviour and cognitive assessments were performed in the study group as well as in a control group of term children matched for age, sex and parental educational and occupational status. The results showed a significant lower scoring in perceptual motor skills in the study group, associated with a defect of accuracy in spatial attention and a higher incidence of stereopsis impairment related with perceptual motor disabilities. Behavioural disorders, in terms of emotional maturation and hyperactivity, were significantly more frequent in the study group. To prevent behavioural and learning problems at school, a complete longitudinal assessment including visual functions and perceptual motor abilities seems mandatory in preterm born children, even in the absence of neonatal brain disorders including abnormal cerebral ultrasound findings.

Neuropsychological performance in low birth weight preschoolers: a population-based, controlled study.

The aim was to evaluate neuropsychological performance and its pre-, and perinatal predictors in low birth weight (LBW) preschool children. A population-based sample of 137 5-year-old children with birth weights less than 2000 g and without major handicaps was compared with a random sample of 152 normal birth weight term controls. Main assessment tools were all subscales from the Wechsler Preschool and Primary Scale of Intelligence Revised, subscales from the Illinois Test of Psycholinguistic Abilities and tests of manual dexterity and figure copying. The LBW children showed significantly lower mean scores compared to controls on tests of visuo-spatial and visuo-motor abilities, but were comparable to controls in other areas, confounding parental factors were controlled for. 14 of the LBW children, there were signs of maternal chorio-amnionitis. Twelve of these had premature rupture of membranes lasting more than 24 h. These 14 children had a mean performance IQ of 87 (SD 5) compared to 100 (SD 15) for the LBW children without maternal signs of chorio-amnionitis (P = 0.001). Having a small head circumference at birth was a less powerful, but statistically significant predictor of impaired performance. Low birth weight is associated with impaired performance on visuo-spatial and visuo-motor tasks. Signs of maternal chorio-amnionitis and a small head circumference at birth may be risk factors for such impairment.

Mother, Child, and Family Factors Related to Employment of Single Mothers With LBW Preschoolers

The purpose of this study was to identify maternal, child, and family factors related to the employment status and employment history of single mothers of low-birth-weight (LBW) and full-term preschoolers. A sample of 121 female-headed, single-parent families with 3-, 4-, and 5- year-old LBW and full-term children was recruited through admission records to three Level III neonatal intensive care units (NICUs) and birth records of two normal newborn nurseries. Results show that the birth of an LBW infant was not related to employment status, number of hours employed per week, or employment history for single mothers. Employed mothers had significantly more education and more positive attitudes toward employment. Controlling for other factors, never being married, and having more children, more federal income, and less positive employment attitudes were predictive of nonemployment. Both employed and nonemployed women expressed preference for employment.

Behavioral problems in low-birthweight preschoolers.

Preschool behavior of a population-based sample of 144 5-year-old children with birthweights less than 2000g (LBW) was compared with a random sample of 163 normal-birthweight term controls. The Personality Inventory for Children and the Yale Children's Inventory were completed by the mothers, and child behavior during psychometric testing was assessed. Nineteen per cent of the LBW children compared to 4% of controls had behavioral problems as defined by abnormal scores on more than three behavioral measures. The LBW children were more often socially insecure, anxious and difficult to manage, but inattention and hyperactivity were not prominent. The LBW children were not more sensitive to the negative impact of parental risk factors than normal-birthweight children.

Impact of Caretaker Stress On Behavioral Adjustment of Very Low Birth Weight Preschool Children

The impact of caretaker daily stress and life strain on the behavioral adjustment of very low birth weight (VLBW less than or equal to 1,500 grams) preschool children was investigated; the degree to which the caregiving environment contributes to the effects of caretaker stress on child outcome was also explored. Subjects were 39 VLBW children (mean birth weight = 1,208 grams) and their primary caretakers, the majority of whom were their biological mothers. Data on caretaker stress and life strain, the caregiving environment, and child behavior were gathered when the children were 60 months of age. The impact of caretaker daily stress and life strain on VLBW child adjustment was moderate and similar to that of normal birth weight (NBW) children. The impact of caretaker stress appeared to be affected by the quality of the caregiving environment. Analysis showed that more behavior problems were found in VLBW 5-year-olds than expected in the general preschool population. Caretakers of VLBW 5-year-olds experienced more intense daily stress than those of NBW children.

Temperament, Behavior Problems, and Learning Skills in Very Low Birth Weight Preschoolers

The relationship between temperament, behavior problems, and learning skill abilities in preschool children who were born with very low birth weight (VLBW) is described. Subjects were 37 4-year-olds who weighed less than 1,500 grams at birth, were appropriate for gestational age, and free from congenital anomalies (M birth weight = 1,201 grams). Data were gathered when the children were 48 months chronological age and analyzed using point biserial and Pearson product moment correlation, chi square, and MANOVA. Temperament characteristics of rhythmicity, intensity, and persistence were related to behavior problems and learning skill abilities. Mothers reported more children with behavior problems than expected in the general population. Children with four or more behavior problems had significantly lower skill achievement scores than children with fewer behavior problems.