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Early Hum Dev. 2018 Mar;118:8-14. doi: 10.1016/j.earlhumdev.2018.01.020. Epub 2018 Feb 7.

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

Author information

1
Boston Children's Hospital, Harvard Medical School, Boston, MA, USA. Electronic address: alan.leviton@childrens.harvard.edu.
2
Boston University School of Medicine, Boston, MA, USA.
3
Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
4
University of North Carolina School of Medicine, Chapel Hill, NC, USA.
5
Boston Medical Center, Boston University School of Medicine, Boston, MA, USA.

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.

KEYWORDS:

Extremely preterm; Learning disabilities; Mathematics; Reading; School performance; Special educational needs

PMID:
29425911
PMCID:
PMC5869147
DOI:
10.1016/j.earlhumdev.2018.01.020
[Indexed for MEDLINE]
Free PMC Article

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