Neonatal predictors of cognitive ability in adults born very preterm: a prospective cohort study

Linda D. Breeman, Julia Jaekel, Nicole Baumann, Peter Bartmann, Dieter Wolke*

*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

45 Citationer (Scopus)

Abstract

Aim: To identify neonatal predictors to allow a developmental prognosis of the cognitive abilities of survivors born very preterm/very low birthweight (VLBW) into adult life. Method: The Bavarian Longitudinal Study is a prospective whole-population study that followed 260 infants born very preterm/VLBW from birth to adulthood. Regression analyses examined which neonatal factors predicted adult IQ. Results: Neonatal morbidity, neonatal treatment, and early social environment of infants born very preterm/VLBW explained 37.6% of the variance in adult IQ. Seven unique early-life predictors of lower adulthood IQ were found: respiratory distress syndrome, intraventricular haemorrhage, problems with mobility, mechanical ventilation, less parenteral nutrition, low/middle socioeconomic status, and poor early parent–infant relationships. Specifically, modifiable factors such as mechanical ventilation predicted a drop of 0.43 IQ points for each day of treatment, adjusted for initial respiratory problems. Good early parent–infant relationships predicted an approximately 5-point increase in adult IQ, adjusted for other significant predictors such as socioeconomic status. Interpretation: Mechanical ventilation, parenteral feeding, and early parenting were identified as significant modifiable factors that were strongly related to adult IQ. Mechanical ventilation policies have changed but there is scope for early interventions that focus on positive parenting, which may reduce the adverse effects of very preterm/VLBW birth on cognitive abilities.

OriginalsprogEngelsk
TidsskriftDevelopmental Medicine and Child Neurology
Vol/bind59
Udgave nummer5
Sider (fra-til)477-483
Antal sider7
ISSN0012-1622
DOI
StatusUdgivet - 1 maj 2017
Udgivet eksterntJa

Bibliografisk note

Funding Information:
We thank all current and former Bavarian Longitudinal Study group members, paediatricians, psychologists, and research nurses. Moreover, we thank those employed at the Department of Neonatology, University Hospital Bonn, who contributed to study organization, recruitment, data collection, and management at the 26-year assessment: Barbara Busch, Stephan Czeschka, Claudia Grünzinger, Christian Koch, Diana Kurze, Sonja Perk, Andrea Schreier, and Julia Trummer. Special thanks are due to the study participants and their families. This study was supported by grants PKE24, JUG14, 01EP9504, and 01ER0801 from the German Federal Ministry of Education and Science (BMBF). The authors have stated that they had no interests which might be perceived as posing a conflict or bias.

Publisher Copyright:
© 2017 Mac Keith Press

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