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Clin Exp Pediatr > Accepted Articles
DOI: https://doi.org/10.3345/kjp.2019.00647    [Accepted]
Published online September 25, 2019.
Long-term Cognitive, Executive and Behavioral Outcomes of Moderate and Late Preterm at School Age
Ju Hyun Jin1  , Shin Won Yoon1  , Jungeun Song2  , Seong Woo Kim3  , Hee Jung Chung1 
1Department of Pediatrics, National Health Insurance Service Ilsan Hospital, Goyang-si, Korea
2Department of Psychiatry, National Health Insurance Service Ilsan Hospital, Goyang-si, Korea
3Department of Physical Medicine and Rehabilitation, National Health Insurance Service Ilsan Hospital, Goyang-si, Korea
Correspondence: 
Hee Jung Chung, Tel: +82-31-900-0520, Fax: +82-31-900-0343, Email: agathac@nhimc.or.kr
Received: 14 June 2019   • Revised: 11 September 2019   • Accepted: 23 September 2019
Abstract
Background
There is increasing concern that moderate preterm (32–33 weeks’ gestation) and late preterm (34–36 weeks’ gestation) birth may be associated with minor neurodevelopmental problems affecting poor school performance.
Purpose
We explored cognitive function, cognitive visual function, executive function, and behavioral problems at school age in moderate to late preterm infants.
Methods
Children aged 7–10 years who had been born at 32+0 – 36+6 weeks of gestation and admitted to neonatal intensive care unit from August 2006 to July 2011 at the National Health Insurance Service Ilsan Hospital were eligible. We excluded the children with severe neurologic impairment, congenital malformations, and chromosomal abnormalities. Neuropsychological assessments consisted of 5 neuropsychological tests and 3 questionnaires.
Results
A total of 37 children (mean age 9.1 ± 1.2 years) participated in this study. The mean gestational age at birth was 34.6 ± 7.5 weeks and the mean birth weight was 2229.2 ± 472.8 g. The mean full-scale intelligence quotient was 92.89 ± 11.90, and 24.3% scored between 70 and 85 (borderline intelligence function). 65% of children had abnormal scores for at least one of the variables on the attention deficit hyperactivity disorder diagnostic system. Scores below borderline function for executive quotient and memory quotient were 32.4% and 24.3%, respectively. On the Child Behavior Check List, borderline or clinically relevant internalizing problems were noted in 13.5%. There were no significant associations between perinatal factors or socioeconomic status and cognitive, visual perception, executive function, or behavior outcomes.
Conclusion
Moderate to late preterm infants are at risk of developing borderline intelligence function and attention problems at early school age. Cognitive and executive functions that are important for academic performance need to be carefully monitored and continuously followed up in moderate to late preterm infants.
Key Words: Moderate preterm, Late preterm, Cognitive function, Executive function, Long-term outcome




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