Change in cognitive abilities over time during preschool age in low risk preterm children

Background: More information is needed on 'low-risk' preterm infants' neurological outcome so that they can be included in follow-up programs at least until school age.

Objective: To examine the neuropsychological outcome in a group of low-risk low birth weight (LBW) children without neurological impairment followed from birth to 5 years of age.

Patients: 26 intellectually normal children born preterm (30-34 weeks gestation) without major neurological disabilities and 23 control children born at term and matched for age, sex, and parental educational and occupational status.

Methods: Subjects already evaluated at 3 years of age underwent assessment again at 5 years using as neuropsychological outcome measures a wide range of tests including perceptual and visual-motor function, language comprehension and expression, and attention skills.

Results: When tested at 5 years, children born preterm still obtained significantly lower mean scores than controls on visual motor integration test (57 vs 64, p=0.01), visual perception test (41 vs 43, p=0.002) and a trend toward a lower score in the picture vocabulary test (81 vs 85.5, p=0.07). The group of premature infants and controls improved their performance over time in the neuropsychological abilities investigated and, in some skills such as visual perception. Children born preterm took longer than those born at term to reach similar performance levels, 5 versus 3 years.

Conclusion: Ex low-risk children born preterm achieve lower scores over time in visual-motor and perceptual ability scales and in some language tests than children born at term. Like high-risk premature infants even those at low risk deserve regular follow-up with long-term programs.