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

作者：Leviton Alan^*; Joseph Robert M; Allred Elizabeth N; O'Shea T Michael; Kuban Karl K C

来源：Early Human Development, 2018, 118: 8-14.

DOI：10.1016/j.earlhumdev.2018.01.020

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

Bacicground: 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.

• 出版日期2018-3