Neuropsychological effect of extreme preterm birth persists into young adulthood

  • Pediatrics
  • 10.01.2020

  • von Susan London
  • Clinical Essentials
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Takeaway

  • A cohort of infants born extremely preterm still had neuropsychological deficits vs term peers at the age of 19 years.
  • Prevalence of intellectual impairment had increased since age 11 years.

Why this matters

  • Understanding long-term outcomes helps inform counseling, planning, intervention.
  • Commentary authors note study limitations, including treating the cohort as homogeneous: "All survivors of prematurity are not alike," they write. 

Key results

  • Relative to term-born peers, young adults born extremely preterm had significantly poorer scores on 15 neuropsychological measures.
  • Effect size (Cohen’s d) ranged from 0.69 (short-term memory) to 1.21 (full-scale intelligence quotient [IQ]).
  • Impairment in ≥1 neuropsychological domain:
    • 60% of extremely preterm group, and
    • 21% of term group.
  • Domains most commonly affected in adults born extremely preterm: general cognitive functioning, visuomotor abilities.
  • In extremely preterm group, increases seen between ages 11 and 19 years in proportion having intellectual impairment:
    • IQ less than 70 (from 8.4% to 15.1%; P=.021),
    • IQ less than –2 SD vs controls (from 35.3% to 44.5%; P=.028).
  • Status at age 11 years predicted status at age 19 years for cognitive impairment (P<.001 and visuospatial functioning>

Study design

  • UK and Irish longitudinal cohort study of 127 young adults born extremely preterm (
  • Main outcomes: neuropsychological measures at 19 years of age.
  • Funding: Medical Research Council United Kingdom.

Limitations

  • Assessment not blinded for most participants.
  • Uncertain generalizability.