This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (89)  • Contact me when this article is cited  Related Content  • Related letter  • Related articles  • Similar articles in JAMA  Topic Collections  • Neurology  • Cognitive Disorders  • Pediatrics  • Child Development  • Alert me on articles by topic  Social Bookmarking   What's this?

Laura R. Ment, MD; Betty Vohr, MD; Walter Allan, MD; Karol H. Katz, MS; Karen C. Schneider, MPH; Michael Westerveld, PhD; Charles C. Duncan, MD; Robert W. Makuch, PhD

JAMA. 2003;289:705-711.

Context  Preterm very low-birth-weight (VLBW) infants have a high prevalence of neurodevelopmental disability when evaluated during the first several years of life. However, recent experimental data suggest that the developing brain may recover from or compensate for injury.

Objective  To determine if there is cognitive improvement throughout early and middle childhood following VLBW birth.

Design, Setting, and Participants  Follow-up data of 296 infants born weighing 600 to 1250 g who participated in a prospective, randomized, placebo-controlled intraventricular hemorrhage (IVH) prevention study performed at 3 northeastern US hospitals between September 1989 and August 1992 and who were serially evaluated at 36, 54, 72, and 96 months of corrected age (CA).

Main Outcome Measures  The age-normed Peabody Picture Vocabulary Test–Revised (PPVT-R) score and measures of intelligence.

Results  Overall, the median PPVT-R score increased from 88 at 36 months of CA to 99 at 96 months of CA; when data from 36 and 96 months of CA were compared, 45% of children gained 10 points or more and 12.5% showed a 5- to 9-point increase in test scores. Similar findings were noted for full-scale and verbal IQ scores. Multivariate analyses demonstrated that increasing age, residence in a 2-parent household, and higher levels of maternal education were all significantly associated with higher PPVT-R scores (for each, P<.001). In addition, early intervention led to greater increases over time in PPVT-R scores among children whose mothers had less than a high school education compared with those with a high school education level or greater (P = .03 by test for interaction). Although most children showed improvement in PPVT-R scores with increasing CA, children with early-onset IVH and subsequent significant central nervous system injury had the lowest PPVT-R scores initially and the scores declined over time (P = .009 by test for interaction).

Conclusions  The majority of VLBW children had improvement in verbal and IQ test scores over time. Only children with early-onset IVH followed by significant central nervous system injury had low PPVT-R scores that declined over time.

Author Affiliations: Departments of Pediatrics (Dr Ment and Ms Schneider), Neurology (Dr Ment), Epidemiology and Public Health (Ms Katz and Dr Makuch), and Neurosurgery (Drs Westerveld and Duncan), Yale University School of Medicine, New Haven, Conn; Department of Pediatrics, Brown University School of Medicine, Providence, RI (Dr Vohr); and Department of Neurology, Maine Medical Center, Portland (Dr Allan).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED LETTER

Long-term Cognitive Function in Very Low-Birth-Weight Infants
Lane Strathearn
JAMA. 2003;289(17):2209.
EXTRACT | FULL TEXT  

RELATED ARTICLES

Cognitive Function in Preterm Infants: No Simple Answers
Glen P. Aylward
JAMA. 2003;289(6):752-753.
EXTRACT | FULL TEXT  

Care of Premature Infants
Janet M. Torpy, Cassio Lynm, and Richard M. Glass
JAMA. 2003;289(6):796.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Clinical and Economic Effects of iNO in Premature Newborns With Respiratory Failure at 1 Year
Watson et al.
Pediatrics 2009;124:1333-1343.
ABSTRACT | FULL TEXT  

Risk Factors Affecting School Readiness in Premature Infants With Respiratory Distress Syndrome
Patrianakos-Hoobler et al.
Pediatrics 2009;124:258-267.
ABSTRACT | FULL TEXT  

Trajectories of Receptive Language Development From 3 to 12 Years of Age for Very Preterm Children
Luu et al.
Pediatrics 2009;124:333-341.
ABSTRACT | FULL TEXT  

Parental Education and Late-life Dementia in the United States
Rogers et al.
J Geriatr Psychiatry Neurol 2009;22:71-80.
ABSTRACT  

Alterations in functional connectivity for language in prematurely born adolescents
Schafer et al.
Brain 2009;132:661-670.
ABSTRACT | FULL TEXT  

Psychological stress of parents of preterm infants enrolled in an early discharge programme from the neonatal intensive care unit: a prospective randomised trial
Saenz et al.
Arch. Dis. Child. Fetal Neonatal Ed. 2009;94:F98-F104.
ABSTRACT | FULL TEXT  

Fgfr1 Is Required for Cortical Regeneration and Repair after Perinatal Hypoxia
Fagel et al.
J. Neurosci. 2009;29:1202-1211.
ABSTRACT | FULL TEXT  

Management and Outcomes of Very Low Birth Weight
Eichenwald and Stark
NEJM 2008;358:1700-1711.
FULL TEXT  

Ametropia, Preschoolers' Cognitive Abilities, and Effects of Spectacle Correction
Roch-Levecq et al.
Arch Ophthalmol 2008;126:252-258.
ABSTRACT | FULL TEXT  

Improved Neurodevelopmental Outcomes for Extremely Low Birth Weight Infants in 2000-2002
Wilson-Costello et al.
Pediatrics 2007;119:37-45.
ABSTRACT | FULL TEXT  

A Longitudinal Study of Reading Skills Among Very-Low-Birthweight Children: Is There a Catch-up?
Samuelsson et al.
J Pediatr Psychol 2006;31:967-977.
ABSTRACT | FULL TEXT  

Associations of Maternal Age- and Parity-Related Factors With Trends in Low-Birthweight Rates: United States, 1980 Through 2000
Yang et al.
AJPH 2006;96:856-861.
ABSTRACT | FULL TEXT  

Reducing the Incidence of Low Birth Weight in Low-Income Countries Has Substantial Economic Benefits
Alderman and Behrman
WORLD BANK RES OBS 2006;21:25-48.
ABSTRACT | FULL TEXT  

Grade 3 to 4 Intraventricular Hemorrhage and Bayley Scores Predict Outcome
Ment et al.
Pediatrics 2005;116:1597-1598.
FULL TEXT  

Cognitive development in low risk preterm infants at 3-4 years of life
Caravale et al.
Arch. Dis. Child. Fetal Neonatal Ed. 2005;90:F474-F479.
ABSTRACT | FULL TEXT  

Ensuring Accurate Knowledge of Prematurity Outcomes for Prenatal Counseling
MacKendrick and Caplan
Pediatrics 2005;116:1053-1054.
FULL TEXT  

Poor Predictive Validity of the Bayley Scales of Infant Development for Cognitive Function of Extremely Low Birth Weight Children at School Age
Hack et al.
Pediatrics 2005;116:333-341.
ABSTRACT | FULL TEXT  

Structural and Functional Brain Development After Hydrocortisone Treatment for Neonatal Chronic Lung Disease
Lodygensky et al.
Pediatrics 2005;116:1-7.
ABSTRACT | FULL TEXT  

Changes in Neurodevelopmental Outcomes at 18 to 22 Months' Corrected Age Among Infants of Less Than 25 Weeks' Gestational Age Born in 1993-1999
Hintz et al.
Pediatrics 2005;115:1645-1651.
ABSTRACT | FULL TEXT  

Improved Survival Rates With Increased Neurodevelopmental Disability for Extremely Low Birth Weight Infants in the 1990s
Wilson-Costello et al.
Pediatrics 2005;115:997-1003.
ABSTRACT | FULL TEXT  

Adverse Neurodevelopmental Outcomes Among Extremely Low Birth Weight Infants With a Normal Head Ultrasound: Prevalence and Antecedents
Laptook et al.
Pediatrics 2005;115:673-680.
ABSTRACT | FULL TEXT  

Abnormal Cerebral Structure Is Present at Term in Premature Infants
Inder et al.
Pediatrics 2005;115:286-294.
ABSTRACT | FULL TEXT  

Follow-up Care of High-Risk Infants
Pediatrics 2004;114:1377-1397.
ABSTRACT | FULL TEXT  

Long-term Cognitive Function in Very Low-Birth-Weight Infants
Strathearn
JAMA 2003;289:2209-2209.
FULL TEXT  

Cognitive Improvement in Some Very-Low-Birthweight Children
JWatch Psychiatry 2003;2003:7-7.
FULL TEXT  

Cognitive Ability Increases Over Time in VLBW Babies
JWatch Pediatrics 2003;2003:8-8.
FULL TEXT  

Cognitive Function in Preterm Infants: No Simple Answers
Aylward
JAMA 2003;289:752-753.
FULL TEXT