Functioning at School Age of Moderately Preterm Children Born at 32 to 36 Weeks' Gestational Age

• Published in: Pediatrics (Evanston) 2009-07, Vol.124 (1), p.251-257
• Main Authors: van Baar, Anneloes L, Vermaas, John, Knots, Edwin, de Kleine, Martin J. K, Soons, Paul
• Format: Article
• Language: English
• Subjects: Attention Deficit Disorder with Hyperactivity - epidemiology; Attention Deficit Hyperactivity Disorder; Biological and medical sciences; Child; Child Behavior Disorders - epidemiology; Child development; Children & youth; Cognition & reasoning; Cognition Disorders - epidemiology; Comparative analysis; Developmental Disabilities - epidemiology; Education, Special - statistics & numerical data; Educational aspects; Elementary school students; Emotions; Female; Follow-Up Studies; General aspects; Gestational Age; Health aspects; Humans; Infant, Newborn; Infant, Premature; Infants (Premature); Intelligence; Logistic Models; Male; Medical sciences; Netherlands - epidemiology; Patient outcomes; Pediatrics; Premature birth; Premature infants; Surveys and Questionnaires
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.2008-2315

To study outcome of low-risk moderately preterm birth between 32 and 36/7 weeks' gestation. 377 Moderately preterm children (M: 34.7, SD: 1.2 complete weeks), without need for neonatal intensive care and without dysmaturity or congenital malformations, were compared with 182 term children and assessed at eight years (M: 8.9, SD: 0.54). School situation, IQ, sustained attention, behavior problems, and attention-deficit/hyperactivity characteristics were studied. Special education was attended by 7.7% of the moderately preterm children, more than twice the rate of 2.8% in the general Dutch population of this age. Additional exploration for two preterm subgroups of 32 to 33 versus 34 to 36 weeks' gestation showed a need for special education in 9.7% versus 7.3% and a significant difference in grade retention for 30% versus 17%, respectively. Of the children attending mainstream primary schools, grade retention was found in 19% of the preterm versus 8% of the comparison children. Adjusting for maternal education, a group difference of 3 points was found in IQ. The preterm children needed more time for the sustained attention task. The preterm children had more behavior problems (specifically internalizing problems with 27% scoring above the borderline cut-off), as well as more attention-deficit/hyperactivity disorder characteristics (specifically attention deficits). Cognitive and emotional regulation difficulties affect functioning of moderately preterm children, as school problems, a slightly lower IQ, attention and behavioral problems are found when they are compared with term-born children. Identification and monitoring of precursors of these problems at younger age is needed in view of prevention purposes.