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Perinatal and postnatal factors in very preterm infants and subsequent cognitive and motor abilities

Department of Child Health, University of Liverpool, Neonatal Unit, Liverpool Maternity Hospital, Liverpool, UK

Correspondence to:
Correspondence to:
Professor Cooke
Department of Child Health, University of Liverpool, Neonatal Unit, Liverpool Maternity Hospital, Liverpool L8 7SS, UK; mc19{at}liv.ac.uk

Background: Many children born very preterm have cognitive and minor motor problems later, even if attending mainstream schools.

Objective: To examine associations between this suboptimal performance and perinatal and postnatal clinical factors.

Participants and methods: A geographically determined cohort of 280 infants born at less than 32 weeks gestation in 1991–92 in Liverpool, free of major disability and attending mainstream school at 7 years of age. A perinatal and postnatal data set were obtained from the clinical records retrospectively. Measurements of height, weight, and head circumference at 7 years were made, together with assessments of intelligence (Wechsler intelligence scale for children, IQ) and motor impairment (Movement assessment battery for children, MABC).

Results: Multiple regression analysis showed IQ at 7 years to be independently significantly related to gestation, persistence of the arterial duct (PDA), and head circumference at 7 years. MABC was only significantly related to gestation. PDA was related to periventricular haemorrhage (OR 2.7, 95% confidence interval (CI) 1.3 to 5.8) and parenchymal lesions including ventriculomegaly (OR 4.1, 95% CI 1.5 to 11.4).

Conclusion: Cognitive ability in children born preterm is significantly related to gestation, but may also be related to the effects of PDA on early brain development, through either periventricular haemorrhage/ventriculomegaly or other disturbance of early brain growth.

Abbreviations: IQ, intelligence quotient; MABC, Movement assessment battery for children; PDA, patent ductus arteriosus

Keywords: cognitive ability; motor impairment; outcome; persistent arterial duct; preterm

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