Neuropsychological Outcomes at 19 Years of Age following Extremely Preterm Birth

BACKGROUND & OBJECTIVES: Children born extremely preterm (<26 weeks of gestation) have lower cognitive scores and an increased rate of cognitive impairment compared to their term-born peers. However, the neuropsychological presentation of these extremely preterm individuals in adulthood has not been described. The aim of this study was to examine neuropsychological outcomes in early adulthood following extremely preterm birth in the 1995 EPICure cohort, and to investigate if the rate of intellectual impairment changed longitudinally.

METHODS: 127 young adults born extremely preterm and 64 term-born controls had a neuropsychological assessment at 19 years of age examining general cognitive abilities (IQ), visuo-motor abilities, prospective memory and aspects of executive functions and language.

RESULTS: Adults born extremely preterm scored significantly lower than term-born controls across all neuropsychological tests with effect sizes (Cohen’s d) of 0.7-1.2. Sixty percent of adults born extremely preterm had impairment in at least one neuropsychological domain; deficits in general cognitive functioning and visuo-motor abilities were most frequent. The proportion of extremely preterm participants with an intellectual impairment (IQ<70) increased by 6.7% between 11 and 19 years of age (p=0.02). Visuospatial functioning in childhood predicted visuo-motor functioning at 19 years.

CONCLUSIONS: Adults born extremely preterm continue to perform lower than their term-born peers in general cognitive abilities as well as across a range of neuropsychological functions, indicating that these young adults do not show improvement overtime. The prevalence of intellectual impairment increased from 11 years into adulthood.