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Antenatal and neonatal antecedents of learning limitations in 10-year old children born extremely preterm.

ABSTRACT: BACKGROUND:Children born extremely preterm are at increased risk of learning limitations. AIM:To identify the antecedents of learning limitations of children born extremely preterm. STUDY DESIGN:Prospective observational study from birth to age 10?years. Variables entered into the multinomial logistic regression analyses were ordered temporally, with the earliest occurring predictors/covariates of each learning limitation risk entered first and not displaced by later occurring covariates. SUBJECTS:874 children who were born before the 28th week of gestation. OUTCOME MEASURES:A reading limitation was defined as a score one or more standard deviations below the expected mean on the WIAT-III Word Reading and a mathematics limitation was defined as a similarly low score on the Numerical Operations component. RESULTS:56 children had a "reading ONLY" limitation, 132 children had a "math ONLY" limitation and 89 children had "reading AND math" limitations. All risk profiles included an indicator of socioeconomic disadvantage (e.g., mother's "racial" identity and eligibility for government-provided health care insurance), an indicator of newborn's immaturity/vulnerability (e.g., high illness severity score, receipt of hydrocortisone, and/or ventilator-dependence at 36?weeks post-menstruation), and all but the math only limitation included an indicator of fetal growth restriction and inflammation (i.e., pregnancy urinary tract infection or late ventilator-dependence). CONCLUSIONS:The themes of socioeconomic disadvantage and immaturity/vulnerability characterize all three risk profiles, while the themes of fetal growth restriction and inflammation are characteristic of a reading limitation only, and the reading and math limitations entity.

SUBMITTER: Leviton A

PROVIDER: S-EPMC5869147 | biostudies-literature | 2018 Mar

REPOSITORIES: biostudies-literature

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Antenatal and neonatal antecedents of learning limitations in 10-year old children born extremely preterm.

Leviton Alan A Joseph Robert M RM Allred Elizabeth N EN O'Shea T Michael TM Kuban Karl K C KKC

Early human development 20180207

<h4>Background</h4>Children born extremely preterm are at increased risk of learning limitations.<h4>Aim</h4>To identify the antecedents of learning limitations of children born extremely preterm.<h4>Study design</h4>Prospective observational study from birth to age 10 years. Variables entered into the multinomial logistic regression analyses were ordered temporally, with the earliest occurring predictors/covariates of each learning limitation risk entered first and not displaced by later occurr ...[more]

PMID: 29425911

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Project description:BackgroundThe incidence of attention deficit hyperactivity disorder is higher among children born very preterm than among children who are mature at birth.MethodsWe studied 583 ten-year-old children who were born before 28 weeks of gestation whose IQ was above 84 and had a parent-completed Child Symptom Inventory-4, which allowed classification of the child as having or not having symptoms of attention deficit hyperactivity disorder. For 422 children, we also had a teacher report, and for 583 children, we also had a parent report of whether or not a physician made an attention deficit hyperactivity disorder diagnosis.ResultsThe risk profile of screening positive for attention deficit hyperactivity disorder based on a parent's report differed from the risk profile based on the teacher's report, whereas the risk profile according to a physician and according to any two observers closely resembled the parent-reported profile. Among the statistically significant risk factors were young maternal age (parent, physician, and two observers), maternal obesity (parent, physician, and two observers), maternal smoking (parent, physician, and two observers), magnesium given at delivery for seizure prophylaxis (parent and two observers), recovery of Mycoplasma sp. from the placenta (teacher and two observers), low gestational age (parent and two observers), low birth weight (teacher and physician), singleton (parent, physician, and two observers), male (parent, teacher, physician, and two observers), mechanical ventilation on postnatal day seven (physician), receipt of a sedative (parent and two observers), retinopathy of prematurity (parent), necrotizing enterocolitis (physician), antibiotic receipt (physician and two observers), and ventriculomegaly on brain scan (parent and two observers).ConclusionsThe multiplicity of risk factors identified can be subsumed as components of four broad themes: low socioeconomic state, immaturity or vulnerability, inflammation, and epigenetic phenomena.

Dataset Information

Antenatal and neonatal antecedents of learning limitations in 10-year old children born extremely preterm.

Publications

Antenatal and neonatal antecedents of learning limitations in 10-year old children born extremely preterm.

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