Antenatal and Neonatal Antecedents of Executive Dysfunctions in Extremely Preterm Children

J Child Neurol. 2018 Mar;33(3):198-208. doi: 10.1177/0883073817750499. Epub 2018 Jan 11.

Abstract

To find out why children born extremely preterm are at heightened risk of executive dysfunctions, the authors assessed 716 children who were 10 years old born extremely preterm whose IQ was ≥ 70. A working memory dysfunction (n = 169), an inhibition dysfunction (n = 360), a switching dysfunction (355), and all 3 (executive dysfunction; n = 107) were defined on the basis of Z-scores ≤ -1 on the Differential Ability Scales-II Working Memory composite, and/or on the NEPSY-II Inhibition-Inhibition and Inhibition-Switching subtests. All risk profiles include an indicator of socioeconomic disadvantage. The risk profile of each of the 3 individual dysfunctions includes an indicator of the newborn's immaturity, and the risk profiles of the inhibition dysfunction and switching dysfunction also include an indicator of inflammation. Only the switching dysfunction was associated with fetal growth restriction. The risk factors for executive dysfunction can be subsumed under the 4 themes of socioeconomic disadvantage, immaturity/vulnerability, inflammation, and fetal growth restriction.

Keywords: extremely preterm; learning disabilities; mathematics; reading; school performance; special educational needs.

Publication types

  • Multicenter Study
  • Observational Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Child
  • Executive Function*
  • Fetal Growth Retardation / epidemiology
  • Fetal Growth Retardation / immunology
  • Follow-Up Studies
  • Humans
  • Infant, Extremely Premature / immunology
  • Infant, Extremely Premature / psychology*
  • Inflammation / epidemiology
  • Inflammation / immunology
  • Learning Disabilities / epidemiology*
  • Learning Disabilities / immunology
  • Neuropsychological Tests
  • Prevalence
  • Prospective Studies
  • Risk Factors
  • Socioeconomic Factors