Moderately preterm birth—birth about seven or eight weeks early—is associated with cognitive problems in childhood, a study in JAMA Network Open suggests.
Samson Nivins, Ph.D., and colleagues at the Karolinska Institutet in Stockholm analyzed data from 5,946 children ages 9 to 10 years who were part of the Adolescent Brain and Cognitive Development Study. The researchers grouped the children according to gestational age: very preterm (28 to 31 weeks), moderately preterm (32 to 33 weeks), late preterm (34 to 36 weeks), early term (37 to 38 weeks), and full term (at least 39 weeks). The researchers then combined the children’s scores on various neurocognitive tasks such as picture vocabulary, oral reading recognition, list sorting, and picture sequence memory into a single composite cognitive score.
After adjusting for socioeconomic status, genetics, and other risk factors, the researchers found that children who were born moderately preterm had lower composite cognitive scores as well as lower scores in vocabulary, working memory, episodic memory, and delayed recall compared with children who were born full term. They did not find significant differences in composite cognitive scores among children born very preterm, late preterm, or early term compared with full-term children.
“Considering that cognitive impairment is often associated with lower academic achievement and reduced quality of life, our study emphasizes the importance of early screening and targeted interventions for these students,” the researchers wrote.
In addition, moderately preterm children had lower composite scores compared with those born very preterm. “This paradox may be explained by selective survival for which advances in neonatal care mean very preterm children in our study may represent a more resilient subgroup. Furthermore, very preterm children are often identified as high risk and receive targeted early interventions, potentially mitigating cognitive deficits,” Nivins and colleagues wrote. “In contrast, moderately preterm children may not be recognized as needing such support, leaving them more vulnerable to cognitive challenges over time.”
The researchers added that the smaller sample size in the very preterm group—less than 1% of children in the study—could limit the ability to detect differences between very preterm children and the children in the other groups.
(Image: Getty Images/iStock/NickyLloyd)
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