Babies born before 26 weeks of gestation have a high rate of cognitive and neurological impairment that may be more extensive than previously recognized, say researchers from the University of Nottingham, the University of Bristol, and the University of Hertfordshire in the United Kingdom.
Researchers followed 241 British and Irish children born before 26 weeks of gestation from birth until 6 years of age. The children underwent physical exams, intelligence and cognitive tests, and psychological assessments. Children who had disabilities were divided into the following groups:
- severe disability (children who were highly dependent on caregivers and had cerebral palsy severe enough to prevent walking, low intelligence quotient (IQ) score, hearing loss, or blindness)
- moderate disability (children who could someday be independent and had cerebral palsy that allowed them to walk, lower-than-normal IQ scores, correctable hearing loss, and impaired vision but not blindness)
- mild disability (children with minimal physical problems or other impairments, like squinting or refractive vision problems)
At 6 years of age, the children born extremely prematurely were compared to classmates of a similar age who were born after a full-term pregnancy.
At age 6, 22% of the children born extremely prematurely were severely disabled; 24% were moderately disabled; and 34% were mildly disabled. In contrast, only 1% of the children born at full term had a moderate disability. Some additional findings:
- Twelve percent of the children born extremely prematurely had disabling cerebral palsy; none of the full-term children had cerebral palsy.
- Four of the extremely premature children were blind, and two could only see light.
One quarter of the children born extremely prematurely had a squint; one quarter wore glasses.
- Seven kids born extremely prematurely had profound hearing loss that a hearing aid couldn't correct, and 17 kids had less severe hearing loss. Seven of these kids wore a hearing aid, compared to only one kid who was born at full term.
- Children who were born prematurely also scored significantly lower on cognitive tests than their full-term classmates. Almost twice as many extremely preterm children had general cognitive deficits.
What This Means to You: Although it's been well-documented that extremely premature children are at higher risk for physical disabilities, the results of this study also indicate that the level of cognitive impairment in children born extremely prematurely may be underrecognized, especially when the children are compared to their classmates born at full term.
If your child was born extremely prematurely and has been diagnosed with a physical or cognitive disability, he or she may be eligible for developmental or educational intervention services. For more information about these intervention services or your child's physical growth, emotional development, or school performance, talk to your child's doctor.
Source: Neil Marlow, DM; Dieter Wolke, PhD; Melanie A. Bracewell, MD; Muthanna Samar, MSc; New England Journal of Medicine, January 6, 2005
Reviewed by: Steven Dowshen, MD
Date reviewed: February 2005
