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Cited by 14Infant Development and Preterm CareNeonatal and fetal brain pathologyBirth, Development, and Health

Maternal social risk, gestational age at delivery, and cognitive outcomes among adolescents born extremely preterm

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Joseph, Robert M., Hooper, Stephen R., Heeren, Tim, Santos, Hudson P., Frazier, Jean A., Venuti, Lauren, Foley, Ann, Rollins, Caitlin K. +4 more·2022·Paediatric and Perinatal Epidemiology
DOI 10.1111/ppe.12893PMC PMC9754639
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Abstract

Background: Children born extremely preterm (EP) are at increased risk of cognitive deficits that persist into adulthood. Few large cohort studies have examined differential impairment of cognitive function in EP‐born adolescents in relation to early life risk factors, including maternal social disadvantage, gestational age at delivery, and neonatal morbidities prevalent among EP neonates. Objectives: To assess cognitive abilities in relation to early life risk factors in an EP‐born cohort at 15 years of age. Methods: 681 of 1198 surviving participants (57%) enrolled from 2002 to 2004 in the Extremely Low Gestational Age Newborn Study returned at age 15 years for an assessment of cognitive abilities with the Wechsler Abbreviated Scale of Intelligence‐II and the NIH Toolbox Cognition Battery (NTCB) verbal cognition and fluid processing composites, the latter of which measured executive functions and processing speed. Three cognitive outcomes, WASI‐II IQ, NTCB verbal cognition, and NTCB fluid processing, were analysed for associations with maternal social disadvantage and gestational age. Mediation of maternal social disadvantage by gestational age and mediation of gestational age by neonatal morbidities were also examined. Results: Test scores were lower for NTCB fluid processing relative to IQ and NTCB verbal abilities. Social disadvantage and gestational age were associated with all three cognitive outcomes. Mediation analyses indicated partial mediation of gestational age associations with all three outcomes by neonatal morbidities but did not support mediation by gestational age of social risk associations with cognitive outcomes. Conclusions: Greater maternal social disadvantage and lower gestational age are associated with less favourable cognitive outcomes among EP‐born adolescents at 15 years of age. Neonatal morbidities partially mediate associations between lower gestational age and cognitive outcomes. These findings highlight the need for improved medical and remedial interventions to mitigate the risk of poor cognitive outcomes among EP‐born adolescents.

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  • The NIHTB-CB has been used extensively to examine neuropsychological functioning of children and adolescents with diverse clinical conditions.

    “The NIHTB-CB has been used extensively to examine the neuropsychological functioning of children and adolescents with diverse characteristics and clinical conditions.”

    From Cognitive weaknesses or impairments on the NIH toolbox cognition battery in children and adolescents: base rates in a normative sample and proposed methods for classification (2025) · cites this paper as Joseph et al., 2022

    The Methods (Cognitive assessments; page not provided) say the NIH Toolbox Cognition Battery was used to assess cognitive abilities, and the Principal findings report its use among adolescents born extremely preterm. This supports an example of use in a clinical population, but the paper does not establish extensive use across children and adolescents with diverse characteristics and clinical conditions. (LLM, conf=0.85)

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Cited by

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Authors
Joseph, R. M., Hooper, S. R., Heeren, T., Santos, H. P., Frazier, J. A., Venuti, L., Foley, A., Rollins, C. K., Kuban, K. C. K., Fry, R. C., O’Shea, T. M., & for the ELGAN Study Investigators
Affiliations
  • Boston University (US)
  • University of North Carolina at Chapel Hill (US)
  • Department of Biostatistics Boston University School of Public Health Boston Massachusetts USA
  • School of Nursing University of North Carolina North USA
  • University of Massachusetts Chan Medical School (US)
  • Boston Children's Hospital (US)
  • Boston Medical Center (US)
Corresponding author
Joseph, Robert M.
ORCID
Venue
Paediatric and Perinatal Epidemiology
Publisher
Wiley
Published
2022-05-18
Volume
36
Issue
5
Pages
654-664
ISSN
  • 0269-5022 (ISSN-L)
  • 1365-3016
DOI
10.1111/ppe.12893
PMC
PMC9754639
OpenAlex
W4280602388
Cited by
14
References
5
Citations by year
2026: 2 · 2025: 6 · 2024: 2 · 2023: 3 · 2022: 1
FWCI
3.29
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Paediatric and Perinatal Epidemiology (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion)
  • UNC Libraries
Funders
  • Yale University
  • Tufts Medical Center
  • East Carolina University
  • National Institutes of Health (UG3OD023348, UH3OD023348)
  • University of North Carolina at Chapel Hill
  • NIH Office of the Director (5UH3OD023348)
  • National Institute of Nursing Research (R01NR019245)
  • National Institute of Neurological Disorders and Stroke (U01NS040069)
  • National Institute of Environmental Health Sciences (P30ES010126)
  • National Institute of Child Health and Human Development (2R01NS040069-06A2)
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD092374, P30HD018655, P50HD105351)
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Development and Preterm Care
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Neonatal and fetal brain pathology
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
Keywords
extremely preterm birth, adolescents, cognitive outcomes, gestational age, neonatal morbidity, verbal intelligence, executive function, processing speed, mediation analysis
MeSH terms
Adolescent, Adult, Child, Cognition, Gestational Age, Humans, Infant, Newborn, Intelligence, Thiocyanates, Infant, Extremely Premature

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