Impact of family structure and stability on academic outcome in preterm children at 10 years of age. The Relation between Neonatal Thyroxine Levels and Neurodevelopmental Outcome at Age 5 and 9 Years in a National Cohort of Very Preterm and/or Very Low Birth Weight Infants Neurobehavioral outcomes of school-age children born extremely low birth weight or very preterm in the 1990s. Functional impairments at school age of preterm born children with late-onset sepsis. Neurologic Outcomes at School Age in Very Preterm Infants Born With Severe or Mild Growth Restriction Effect of neonatal surfactant therapy on lung function at school age in children born very preterm. High Prevalence/Low Severity Language Delay in Preschool Children Born Very Preterm Pulmonary function in children with initial low birth weight. Early school-based learning difficulties in children born very preterm. Randomized Trial of Early Versus Late Enteral Iron Supplementation in Infants With a Birth Weight of Less Than 1301 Grams: Neurocognitive Development at 5.3 Years' Corrected Age Protocol for systematic reviews of determinants/correlates of obesity-related dietary and physical activity behaviors in young children (preschool 0 to 6 years): evidence mapping and syntheses Effect of recombinant human erythropoietin on the switchover from fetal to adult hemoglobin synthesis in preterm infants. Perinatal Risk Factors Associated with the Obstructive Sleep Apnea Syndrome in School-Aged Children Born Preterm. Factors Influencing Childbearing Decisions and Knowledge of Perinatal Risks among Canadian Men and Women Neurodevelopmental pathways to preterm children's specific and general mathematic abilities. Growth in 10- to 12-Year-Old Children Born at 23 to 25 Weeks' Gestation in the 1990s: A Swedish National Prospective Follow-up Study Trajectories of Receptive Language Development From 3 to 12 Years of Age for Very Preterm Children Long-term cognition, achievement, socioemotional, and behavioral development of healthy late-preterm infants. Neurocognitive profiles of preterm infants randomly assigned to lower or higher hematocrit thresholds for transfusion Psychoeducational outcome at school age of preterm infants with bronchopulmonary dysplasia. Serial reaction time learning in preschool- and school-age children. The role of grandparents in childhood obesity in China - evidence from a mixed methods study Does Additional Prenatal Care in the Home Improve Birth Outcomes for Women with a Prior Preterm Delivery? A Randomized Clinical Trial
OBJECTIVE To compare school performance at age 10 years in a cohort of extremely preterm children and term control subjects and to examine the impact of family composition and stability on performance . STUDY DESIGN Prospect i ve , longitudinal follow-up from birth to 10 years of age of a regional cohort of children born at 24 to 31 weeks of gestational age and sociodemographically matched term control subjects .  Family composition , extent of parental care giving , and family moves were tracked sequentially . At 10 years , academic achievement and school performance were ascertained for 118 of 125 ( 94 % ) preterm survivors and 119 of 125 ( 95 % ) term children . RESULTS Term children were more likely to demonstrate optimal school outcome ( appropriate grade level without additional classroom assistance ) than were preterm children ( odds ratio 3.4 , 95 % CI 1.9 - 6.0 ) . Medical complications related to prematurity had little impact on school outcome . Among preterm children , optimal school outcome was significantly associated with increased parental education , child rearing by 2 parents ( regardless of marital status ) , and stability in family composition and geographic residence over 10 years . These environmental influences were less pronounced among term control subjects . CONCLUSION Although preterm children performed less well in school than term children , family factors were stronger predictors of school performance than were perinatal complications Transient neonatal hypothyroxinemia is very common in preterm infants . The literature on the effect of this hypothyroxinemia is , however , controversial , and large or long-term follow-up studies are not available . In a nationwide prospect i ve follow-up study on very preterm and ( or ) very low birth weight infants ( n = 717 ) , we studied the relationship between thyroxine levels in the 1st wk of life and neurodevelopmental outcome at 5 y of age and school performance at 9 y of age .  Thyroxine concentrations from filter paper eluates were determined in 717 infants : 32 % had levels of more than 3 SD below the mean ( < 60 nmol/L ) . The percentage of infants with such low levels increased with decreasing gestational age . At the age of 5 y , 96 % of survivors(n = 640 ) were available for extensive neurodevelopmental examination : 85 ( 13.3 % ) had a disability and 92 ( 14.3 % ) a h and icap . At the age of 9 y , 83 % of survivors ( n = 552 ) answered a question naire on school performance : 300 ( 54.3 % ) were in mainstream education in a grade appropriate for age , 151 ( 27 % ) were in mainstream education with grade retention , and 101 ( 18.3 % ) were in special education . Both neurologic dysfunction at age 5 y and school failure at age 9 y were significantly related to lower neonatal thyroxine levels even after adjustment for other perinatal factors ( odds ratio , 1.3 ) . Whether this relationship is causal should be investigated . If a causal relationship exists , substitution therapy may at least partially prevent neurologic dysfunction and learning disabilities , both common sequelae of very preterm birth CONTEXT The outcome into school age of regional cohorts of children born in the 1990s with birth weights less than 1000 g ( extremely low birth weight , ELBW ) or earlier than 28 weeks ' gestation ( very preterm ) is not known . OBJECTIVE To determine the cognitive , educational , and behavioral outcome of ELBW or very preterm infants born in the 1990s compared with normal birth weight ( NBW ) controls . DESIGN Regional cohort study . SETTING Victoria , Australia . PARTICIPANTS The ELBW or very preterm cohort was composed of 298 consecutive survivors born during 1991 - 1992 . The NBW cohort was composed of 262 r and omly selected children with birth weights of more than 2499 g. MAIN OUTCOME MEASURES Cognitive ability , educational progress , and behavioral problems . RESULTS The follow-up rates from birth to 8 years of age for survivors were 92.3 % ( 275/298 ) for the ELBW or very preterm cohort and 85.1 % ( 223/262 ) for the NBW cohort . The ELBW or very preterm children scored significantly below NBW controls on full-scale IQ ( mean difference , -9.4 ; 95 % confidence interval [ CI ] , -12.1 to -6.7 ; P<.001 ) and indices of verbal comprehension ( mean difference , -6.8 ; 95 % CI , -9.5 to -4.2 ; P<.001 ) , perceptual organization ( mean difference , -9.9 ; 95 % CI , -12.7 to -7.2 ; P<.001 ) , freedom from distractibility ( mean difference , -8.1 ; 95 % CI , -10.8 to -5.5 ; P<.001 ) , and processing speed ( mean difference , -6.7 ; 95 % CI , -9.4 to -4.0 ; P<.001 ) . The ELBW or very preterm children performed significantly worse than the NBW cohort on tests of reading ( mean difference , -6.7 ; 95 % CI , -9.5 to -3.9 ; P<.001 ) , spelling ( mean difference , -5.6 ; 95 % CI , -8.0 to -3.3 ; P<.001 ) , and arithmetic ( mean difference , -8.8 ; 95 % CI , -11.3 to -6.2 ; P<.001 ) . Attentional difficulties , internalizing behavior problems , and immature adaptive skills were more prevalent in the ELBW or very preterm cohort . CONCLUSION School-aged ELBW or very preterm children born in the 1990s continue to display cognitive , educational , and behavioral impairments BACKGROUND Late-onset sepsis is a relatively common complication particularly of preterm birth that affects approximately a quarter of very low birth weight infants . AIM We aim ed to determine the motor , cognitive , and behavioural outcome at school age of preterm children with late-onset sepsis compared to matched controls . STUDY DESIGN AND SUBJECTS A prospect i ve case-control study that included preterm infants ( gestational age<32weeks and /or birth weight<1500 g ) admitted to our Neonatal Intensive Care Unit in 2000 - 2001 with a culture-proven late-onset sepsis , and controls matched for gestational age . OUTCOME MEASURES At school age we assessed motor skills , intelligence , visual perception , visuomotor integration , verbal memory , attention , executive functioning , and behaviour . RESULTS At 6 - 9years , 21 of 32 children with late-onset sepsis ( 68 % ) had borderline or abnormal motor outcome with most problems in fine motor skills . Their total IQ was 89 compared to 98 in controls . In addition , verbal memory and attention were affected compared to controls ( 0.61 st and ard deviations ( SD ) , 95 % confidence interval ( CI ) 0.04 - 1.17 , p=0.033 and 0.94 SD , 95 % CI 0.32 - 1.62 , p=0.011 , respectively ) . Multiple episodes of sepsis and gram-negative sepsis were risk factors for worse cognitive outcome . CONCLUSIONS At school age , a majority of preterm children with late-onset sepsis had motor problems . Their IQ was considerably lower than matched controls , and memory and attention were specifically impaired . Outcome at school age of preterm children with late-onset sepsis was worse than previously thought OBJECTIVE : To determine whether mild and severe growth restriction at birth among preterm infants is associated with neonatal mortality and cerebral palsy and cognitive performance at 5 years of age and school performance at 8 years of age . METHODS : All 2846 live births between 24 and 32 weeks ' gestation from 9 regions in France in 1997 were included in a prospect i ve observational study ( the EPIPAGE [ Étude Epidémiologique sur les Petits Ages Gestationnels ] study ) and followed until 8 years of age . Infants were classified as “ small-for-gestational-age ” ( SGA ) if their birth weight for gestational age was at the < 10th centile , “ mildly-small-for-gestational-age ” ( M-SGA ) if birth weight was at the ≥10th centile and < 20th centile , and “ appropriate-for-gestational-age ” ( AGA ) if birth weight was at the ≥20th centile . RESULTS : Among the children born between 24 and 28 weeks ' gestation  , the mortality rate increased from 30 % in the AGA group to 42 % in the M-SGA group and to 62 % in the SGA group ( P < .01 ) . Birth weight was not significantly associated with any cognitive , behavioral , or motor outcomes at the age of 5 or any school performance outcomes at 8 years . For the children born between 29 and 32 weeks ' gestation , SGA children had a higher risk for mortality ( adjusted odds ratio [ aOR ] : 2.79 [ 95 % confidence interval ( CI ) : 1.50–5.20 ] ) , minor cognitive difficulties ( aOR : 1.73 [ 95 % CI : 1.12–2.69 ] ) , inattention-hyperactivity symptoms ( aOR : 1.78 [ 95 % CI : 1.10–2.89 ] ) , and school difficulties ( aOR : 1.74 [ 1.07–2.82 ] ) compared with AGA children . Being born M-SGA was associated with an increased risk for minor cognitive difficulties ( aOR : 1.87 [ 95 % CI : 1.24–2.82 ] ) and behavioral difficulties ( aOR : 1.66 [ 95 % CI : 1.04–2.62 ] ) . CONCLUSIONS : In preterm children , growth restriction was associated with mortality , cognitive and behavioral outcomes , as well as school difficulties Our aim was to evaluate long-term effects of exogenous surfactant therapy on pulmonary functional outcome in children born very preterm . We examined 40 children aged 7 - 12 years who were born before 30 weeks of gestation with an immature surfactant system , and were r and omized to one of three treatment groups : human surfactant given at birth ( prophylactic ) , human surfactant given after development of neonatal respiratory distress syndrome ( rescue ) , and placebo ( air ) treatment .  Spirometric parameters of preterm born children were compared with those of 20 children born at term . In addition , spirometric parameters were monitored twice daily for 4 weeks using a home spirometer . All spirometric parameters were significantly lower in the preterm groups than in the controls , except for the forced vital capacity ( FVC ) in the prophylactically treated group . Bronchial obstruction was found in 53 % of the prophylactically treated group , in 36 % of the rescue group , in 67 % of the placebo group , and in 0 % of the control group . Peak expiratory flow ( PEF ) and FVC values were higher in those children who received surfactant compared with the placebo group ( P < 0.05 ) . In 16 children ( 40 % ) born preterm , a beta2-agonist induced an increase in PEF > or = 15 % at least three times during 2 weeks of home monitoring ; eight children ( 20 % ) had abnormal diurnal PEF variation . Multiple regression analysis indicated that the independent variables associated with favorable outcomes in spirometric parameters were  surfactant therapy ( P = 0.012 - 0.045 ) and short intubation time after birth ( P = 0.0009 - 0.0044 ) . Bronchial obstruction , responsiveness to a beta2-agonist , and high diurnal PEF variation are common in children born before 30 gestational weeks . Surfactant supplementation reducing the need for mechanical ventilation or supplementary oxygen after birth may decrease the severity of immaturity related bronchial obstruction in childhood Objective : To examine the language development at corrected age 4 years of a regionally representative cohort of children born very preterm ( VPT ) . Of particular interest was the identification of biological and socioenvironmental risk and protective factors that influence  VPT children 's early language development . Method : Data were collected as part of a prospect i ve longitudinal study of 110 VPT ( VPT : ≤33 weeks gestation ) and 113 full-term children ( full term : 37–41 weeks gestation ) born in Canterbury , New Zeal and from 1998 to 2000 . At corrected age 4 years , all children were assessed with the preschool version of the Clinical Evaluation of Language Fundamentals . Extensive information was also collected about children 's family social background , perinatal health , childrearing environment , education/intervention exposures , and neurodevelopmental progress from birth to age 4 . Results : At the age of 4 years , VPT children were characterized by poorer receptive and expressive language development than full-term children . These differences persisted after exclusion of children with neurosensory impairment as well as statistical adjustment for the effects of social risk . Within the VPT group , the key predictors of children 's overall language development were family social risk at birth ( p = .05 ) , severity of white matter abnormalities on neonatal magnetic resonance imaging ( p = .49 ) , observed parent-child synchrony ( p = .001 ) , and concurrent child cognitive ability ( p = .001 ) . Together , these factors accounted for 45 % of the variance in children 's total Clinical Evaluation of Language Fundamentals — Preschool scores . Conclusion : By preschool age , children born VPT  show early emerging mild to moderate language delays that are likely to affect their school success and longer-term developmental progress . Findings highlight the importance of potentially modifiable factors such as early brain injury and parenting quality in predicting the language outcomes of children born VPT The objective of this analysis was to examine the effect of low birth weight and prematurity on bronchial air-flow , bronchial reactivity , airway symptoms and asthma diagnosis at school age . A cross-sectional epidemiological study was performed in three small towns in the eastern part of Germany on 2470 school children aged 5 - 14 ( 89.1 % of eligible children ) . A 78 item question naire to determine risk factors at birth and in early childhood was employed . 7.8 % of the children were born before completing 38 gestational weeks ; 6.6 % had a birth weight less than 2500 g.  Pulmonary function analysis were done by a mobile plethysmography at the school . There were only weak restrictions in lung volume in term low birth weight ( LBW ) children ( 100 ml lower TLC , p = 0.107 ) , and flow ( 257 ml lower PEFR , p = 0.108 ) , were low . However , bronchial hyper-responsiveness indicated by 292 ml lower FEV1.0 after cold air bronchial provocation , was significantly increased compared to term normal birth weight children ( p < 0.001 ) . The effect of LBW was less in older children , only slightly stronger in girls and increased in children mechanically ventilated during the postnatal period . Correspondingly , there was a higher prevalence of diagnosed asthma in term LBW children ( OR 1.6 , 95%-confidence interval 1.0 - 2.6 ) , however these were without an increased risk for any allergic sensitization . LBW , therefore , seems to be a risk factor for smaller lungs and hyperreactive airways primarily in term born children , whereas in preterm children the immature bronchial system seems to be recover by school age BACKGROUND Educational underachievement is a major morbidity associated with very preterm ( VPT ) birth . However , few studies have examined early school outcomes with most employing global , clinic based measures . OBJECTIVE To examine the early school achievement in a cohort of children born VPT and studied to age 6 years . METHODS A regional cohort of 102 VPT children ( < /=33 weeks GA ) were followed prospect ively alongside a comparison group of 108 full term ( FT ) children born during the same period ( 1998 - 2000 ) . At 6 years corrected age , all children underwent a comprehensive neurodevelopmental evaluation that included the Woodcock-Johnson Tests of Achievement ( WJ-III ) , teacher report and national numeracy and literacy test results . Rates of specific learning disabilities ( LD ) were also examined . RESULTS VPT children performed less well than FT children on WJ-III subtests ( ps<.05 ) , national tests ( ps<.01 ) , and in all curricular areas rated by teachers ( ps<.01 ) except expressive language . Even VPT children without severe neurodevelopmental impairment scored lower on the WJ-III math , national tests ( ps<.05 ) and were 2 - 3 times more likely to show delays ( ps<.02 ) in math ( 43 % vs. 19 % ) , written language ( 36 % vs. 22 % ) , language comprehension ( 26 % vs. 14 % ) , h and writing ( 36 % vs. 17 % ) , spelling ( 38 % vs. 30 % ) and physical education ( 33 % vs. 11 % ) . They were also twice as likely as FT children to have math LD ( 47 % vs. 21 % ) . CONCLUSIONS By age 6 , a substantial proportion of VPT children are lagging behind their FT peers across multiple curriculum areas , with difficulties being most prominent in math . Findings highlight the need for early identification and educational supports to help maximise VPT children 's learning opportunities during the transition to school BACKGROUND . Iron deficiency in early childhood may impair neurodevelopment . In a masked , r and omized , controlled trial of early versus late enteral iron supplementation in preterm infants with birth weights of < 1301 g , early iron supplementation reduced the incidence of iron deficiency and the number of blood transfusions . OBJECTIVE . We sought to examine whether early enteral iron supplementation improves neurocognitive and motor development in these infants . METHODS . Children who participated in the above mentioned trial were evaluated by applying the Kaufmann Assessment Battery for Children and the Gross Motor Function Classification Scale at the age of school entry . RESULTS . Of the 204 infants initially r and omized , 10 died and 30 were lost to follow-up . A total of 164 ( 85 % of the survivors ) were evaluated at a median corrected age of 5.3 years . In this population ( n = 164 ) , the mean ( ±SD ) mental processing composite in the early iron group was 92 ( ±17 ) versus 89 ( ±16 ) in the late iron group . An abnormal neurologic examination was found in 17 of 90 versus 26 of 74 , and a Gross Motor Function Classification Scale score of > 1 was found in 2 of 90 versus 5 of 74 , respectively . Fifty-nine of 90 children in the early iron group were without disability , compared with 40 of 74 in the late iron group . Severe disability was found in 5 of 90 versus 6 of 74 children and 67 of 90 versus 49 of 74 qualified for regular schooling , respectively . CONCLUSIONS . Early enteral iron supplementation showed a trend toward a beneficial effect on long-term neurocognitive and psychomotor development and showed no evidence for any adverse effect . Because the initial study was not design ed to evaluate effects on neurocognitive development , the power was insufficient to detect small but potentially clinical ly relevant improvements . Additional studies are required to confirm the trend towards a better outcome observed in the early iron group Background The aim of these review s is to inform the design and content of interventions to reduce obesity in young children . The behaviors that are associated with obesity/overweight have been studied extensively ; however , the factors associated with these behaviors in young children ( 0 to 6 years ) have not been systematic ally review ed . Over the past few years the focus of obesity prevention has shifted to preschool children because of the high prevalence of obesity at school entry and recognition that habits formed in early life could track into adulthood . In order to develop effective interventions and change behavior , it is important to underst and the factors that are associated with those behaviors . For example , we need to underst and whether it would be more important to target the family , childcare setting s or the wider environment and identify the most effective way of changing these energy balance related behaviors . Methods / Design Quantitative ( intervention and observational ) and qualitative literature on determinants/correlates of fruit and vegetable intake , sugar sweetened beverage and other unhealthy diet intake , and physical activity and sedentary behaviors in young children will be systematic ally identified , mapped and review ed . A common search strategy ( no language or period restrictions ) will be used to identify papers from eight electronic data bases and this will be supplemented by h and - search ing . Next , studies in developed countries that examine the factors associated with these behaviors in children aged 0 to 6 years ( at baseline ) will be screened and mapped descriptively followed by in-depth data extraction , quality assessment and synthesis . Data from quantitative studies will be summarized using either forest plots or harvest plots and narrative synthesis , and qualitative studies using thematic analysis . Qualitative evidence will be integrated with the quantitative evidence , using a parallel synthesis approach , to provide a deeper underst and ing of effective strategies to influence these energy balance related behaviors . Discussion In addition to updating and mapping current research , these review s will be the first to comprehensively synthesize and integrate both the quantitative and qualitative evidence pertaining to determinants/correlates/barriers/facilitators of obesity related behaviors in this young age group ( 0 to 6 years ) with the aim of informing future interventions . Systematic review registration International Prospect i ve Register for Systematic Review s ( PROSPERO ) Registration number : To determine whether recombinant erythropoietin ( r-HuEpo ) administered to very low birth weight infants could increase hemoglobin F synthesis , or delay its developmentally programmed decline , we determined serially the synthesis of hemoglobins A and F in 15 preterm infants receiving either a placebo or r-HuEpo .  There was no difference between the two groups in the proportion of hemoglobin F being synthesized in relation to postconceptional age STUDY OBJECTIVES The obstructive sleep apnea syndrome ( OSAS ) is more prevalent in ex-preterm children compared to the general pediatric population . However , it is unknown whether OSAS in ex-preterm children is associated with specific perinatal risk factors . This multicenter cohort study aim ed to determine perinatal factors associated with OSAS at school age . METHODS 197 ex-preterm ( 500 - 1,250 g ) children aged 5 - 12 y who participated as neonates in a double-blind , r and omized clinical trial of caffeine versus placebo ( Caffeine for Apnea of Prematurity ) underwent comprehensive ambulatory polysomnography .  A negative binomial regression model was used to identify perinatal risk factors associated with OSAS . RESULTS 19 children had OSAS ( 9.6 % ) . Chorioamnionitis and multiple gestation were positively associated with OSAS with P values of 0.014 and 0.03 , respectively . Maternal white race ( P = 0.047 ) and maternal age ( P = 0.002 ) were negatively associated with OSAS . Other risk factors , such as birth weight , Apgar score at 5 min , antenatal corticosteroids , delivery route , and sex were not significant . CONCLUSIONS OSAS is very frequent , and is associated with chorioamnionitis and multiple gestation in ex-preterm children . Those born to older white mothers appear to be protected . We speculate that the former may be due to systemic inflammation and the latter to a higher socio-economic status . COMMENTARY A commentary on this article appears in this issue on page 721 BACKGROUND Women age 35 and older account for an increasing proportion of births and are at increased risk of having difficulties conceiving and of delivering a multiple birth , low birth weight infant , and /or preterm infant . Little is known about men 's and women 's underst and ing of the maternal age related risks to pregnancy . OBJECTIVES 1 ) To determine the factors influencing the timing of childbearing for  non-parenting men and women , 2 ) to determine knowledge among non-parenting men and women about maternal age-related reproductive risks , the consequences of low birth weight and multiple birth , and issues related to infertility , and 3 ) to determine characteristics associated with limited knowledge of these reproductive risks . METHODS An age-stratified r and om sample of individuals , aged 20 - 45 years and without children , completed a computer-assisted telephone interview from two urban regions of Alberta , Canada ( 1006 women and 500 men ) . RESULTS Factors that influenced timing of childbearing for both men and women included : financial security ( 85.8 % ) and partner suitability to parent ( 80.2 % ) . Over 70 % of men and women recognized the direct relationship between older maternal age and conception difficulties . Less than half knew that advanced maternal age increased the risk of stillbirth , caesarean delivery , multiple birth and preterm delivery . CONCLUSIONS Poor underst and ing of the links between childbearing after age 35 , pregnancy complications and increased risk of adverse infant outcomes limits adults ' ability to make informed decisions about timing of childbearing BACKGROUND Preterm children have problems with mathematics but knowledge about the predictors of specific mathematic abilities in preterm population s is scarce . AIMS This study investigated neurodevelopmental pathways to children 's general and specific mathematic abilities across the full gestational age range . STUDY DESIGN Prospect i ve geographically defined longitudinal investigation in Germany . SUBJECTS 947 children across the full gestational age range ( 23 - 41 weeks ) . Outcome measures . At 8 years , children 's cognitive and mathematic abilities were measured and residuals of a regression predicting mathematic scores by IQ were used to identify specific mathematic abilities . RESULTS Neurodevelopmental cascade models revealed that adverse effects of preterm birth on mathematic abilities were mediated by neonatal risk . Specific mathematic abilities were uniquely predicted by the duration of hospitalization and ventilation . CONCLUSIONS Prolonged neonatal medical treatment and , in particular , mechanical ventilation may lead to specific impairments in mathematic tasks . These findings have implication s for the mode of respiratory support in neonates , routine follow-up and intervention planning as well as research about brain reorganization after preterm birth BACKGROUND . Knowledge of long-term growth of extremely preterm infants in relation to gestational age is incomplete , and there are concerns regarding their poor growth in early childhood . As part of a longitudinal study of a national cohort of infants born at < 26 weeks ' gestation ( extremely immature ) , growth development from birth to the age of 11 years was examined , and correlates of growth attainment were analyzed . METHODS . Two hundred forty-seven extremely immature children were born alive from April 1990 through March 1992 in the whole of Sweden , and 89 ( 36 % ) survived .  Growth and neurosensory outcomes of all extremely immature survivors were evaluated at 36 months of age . Eighty-six ( 97 % ) extremely immature children were identified and assessed at 11 years of age . In this growth study , 83 extremely immature infants ( mean [ SD ] : birth weight , 772 g [ 110 g ] ; gestational age , 24.6 weeks [ 0.6 weeks ] ) without severe motor disability were followed up prospect ively from birth to 11 years old and compared with a matched group of 83 children born at term .  z scores for weight , height , head circumference , and BMI were computed for all children . We also examined gender-specific longitudinal growth measures . Predictors of 11-year growth were studied by multivariate analyses . RESULTS . Extremely immature children were significantly smaller in all 3 growth parameters than the controls at 11 years . Extremely immature children showed a sharp decline in weight and height z scores up to 3 months ' corrected age , followed by catch-up growth in both weight and height up to 11 years . In contrast to weight and height , extremely immature children did not exhibit catch-up growth in head circumference after the first 6 months of life . The mean BMI z scores increased significantly from 1 to 11 years in both groups . The mean BMI change between 1 and 11 years of age was significantly larger in extremely immature than in control participants . Extremely immature girls showed a faster weight increase than extremely immature boys , whereas catch-up growth in height and head circumference was similar in these groups . Multiple-regression analyses revealed that preterm birth and parental height were significant predictors of 11-year height , and group status ( prematurity ) correlated strongly with head circumference . CONCLUSIONS . Children born at the limit of viability attain poor growth in early childhood , followed by catch-up growth to age 11 years , but remain smaller than their term-born peers . Strategies that improve early growth might improve the outcome OBJECTIVES : The goal was to examine whether indomethacin use , gender , neonatal , and sociodemographic factors predict patterns of receptive language development from 3 to 12 years of age in preterm children . METHODS : A total of 355 children born in 1989–1992 with birth weights of 600 to 1250 g were evaluated at 3 , 4.5 , 6 , 8 , and 12 years with the Peabody Picture Vocabulary Test-Revised  . Hierarchical growth modeling was used to explore differences in language trajectories . RESULTS : From 3 to 12 years , preterm children displayed catch-up gains on the Peabody Picture Vocabulary Test-Revised . Preterm children started with an average st and ardized score of 84.1 at 3 years and gained 1.2 points per year across the age period studied . Growth-curve analyses of Peabody Picture Vocabulary Test-Revised raw scores revealed an indomethacin-gender effect on initial scores at 3 years , with preterm boys assigned r and omly to receive indomethacin scoring , on average , 4.2 points higher than placebo-treated boys . However , the velocity of receptive vocabulary development from 3 to 12 years did not differ for the treatment groups . Children with severe brain injury demonstrated slower gains in skills over time , compared with those who did not suffer severe brain injury . Significant differences in language trajectories were predicted by maternal education and minority status . CONCLUSION : Although indomethacin yielded an initial benefit for preterm boys , this intervention did not alter the developmental trajectory of receptive language scores . Severe brain injury leads to long-term sequelae in language development , whereas a socioeconomically advantaged environment supports better language development among preterm children OBJECTIVE To compare healthy late-preterm infants with their full-term counterparts from age 4 through 15 years for numerous st and ard cognitive , achievement , socioemotional , and behavioral outcomes . DESIGN Prospect i ve cohort study . SETTING National Institute of Child Health and Development Study of Early Child Care and Youth Development , 1991 - 2007 . PARTICIPANTS A total of 1298 children ( 53 born at 34 - 36 weeks ' gestational age ) , and their families , observed from birth through age 15 years . None of the infants had major health problems before or immediately following birth , and all the infants were discharged from the hospital within 7 days . MAIN EXPOSURE Preterm status : children born late preterm ( 34 - 36 weeks ) vs those born full term ( 37 - 41 weeks ) . MAIN OUTCOME MEASURES Eleven st and ard outcomes measuring cognition , achievement , social skills , and behavioral/emotional problems using the Woodcock-Johnson Psycho-Educational Battery-Revised and the Child Behavior Checklist , administered repeatedly through age 15 years . RESULTS No consistent significant differences were found between late-preterm and full-term children for these st and ard measures from ages 4 to 15 years . Through age 15 years , the mean difference of most of these outcomes hovered around 0 , indicating , along with small confidence intervals around these differences , that it is unlikely that healthy late-preterm infants are at any meaningful disadvantage regarding these measures . CONCLUSION Late-preterm infants born otherwise healthy seem to have no real burdens regarding cognition , achievement , behavior , and socioemotional development throughout childhood Objective : Preterm infants are frequently transfused with red blood cells based on st and ardized guidelines or clinical concerns that anemia taxes infants ' physiological compensatory mechanisms and thereby threatens their health and well-being . The impact of various transfusion guidelines on long-term neurocognitive outcome is not known . The purpose of this study is to evaluate long-term neurocognitive outcome on children born prematurely and treated at birth with different transfusion guidelines . Methods : Neurocognitive outcomes were examined at school age for 56 preterm infants r and omly assigned to a liberal ( n = 33 ) or restrictive ( n = 23 ) transfusion strategy . Tests of intelligence , achievement , language , visual-spatial/motor , and memory skills were administered . Between-group differences were assessed . Results : Those in the liberal transfusion group performed more poorly than those in the restrictive group on measures of associative verbal fluency , visual memory , and reading . Conclusions : Findings highlight possible long-term neurodevelopmental consequences of maintaining higher hematocrit levels OBJECTIVE To investigate the cognitive performance and educational attainment at school-age of children with bronchopulmonary dysplasia ( BPD ) , compared with a preterm control group of children . METHODS Seventy preterm infants with BPD and 61 birth weight matched controls were prospect ively followed-up to school-age . The  Weschler Intelligence Scale for Children - III ( WISC ) , the Wide Range Achievement Test ( WRAT ) and the Developmental Test of Visual Motor Integration ( VMI ) were administered . The results were compared between the two groups and multiple regression analyses were performed to determine the effect of confounding variables . RESULTS The children in the BPD group performed less well on the Full Scale IQ ( mean 86.7 vs 93.5 ; 95 % CI , 1.9 - 11.7 ) , Verbal IQ ( mean 87.1 vs 94.1 ; 95 % CI , 2.0 - 12.0 ) and the Performance IQ ( mean 88.6 vs 95.2 ; 95 % CI , 2.0 - 11.2 ) of the WISC , the reading component of the WRAT ( mean 93.8 vs 98.9 ; 95 % CI , 0.3 - 9.8 ) and the VMI ( mean 88.9 vs 93.3 ; 95 % , CI 1.1 - 7.8 ) . Despite controlling for social and biological variables , statistical differences persisted for Full Scale and Verbal IQ and reading . A Verbal IQ > 1 SD below the mean was found in 41 % of BPD children compared to 21 % of controls , while on the reading component of the WRAT a greater proportion of BPD children also had scores>1 SD below the mean . CONCLUSION Impaired psychoeducational performance was found in preterm children with BPD compared to controls , especially in the areas of language abilities and reading skills . This supports a greater need for special educational services and counseling for parents for these children Visuomotor sequence learning was assessed in 4- to 10-year-old children using a serial reaction time ( SRT ) task with both r and om and sequenced trials . One-half of the children received exposure to the sequence prior to performing the  reaction time ( RT ) task .  In Experiment 1 , 7- and 10-year-old children demonstrated sequence-specific decreases in RT . As in the adult SRT literature , participants with explicit awareness of the sequence at the end of the session showed larger sequence-specific reaction time decrements than those without explicit awareness . Contrary to expectation , preexposure to the sequence did not reliably predict the level of awareness attained . Results from Experiment 2 indicate that 4-year-olds also demonstrate significant sequence learning on a variant of the SRT task . This article provides preliminary data regarding developmental changes in sequential learning and the development and use of implicit and explicit knowledge . Age-related differences emerged primarily in explicit rather than implicit knowledge Background The current literature on the influences of family environment on  childhood obesity is predominantly based on western population s and has focused on the role of parents . This study examined the influence of gr and parents on the development of obesity among Chinese primary school aged children . Methods A mixed methods study was conducted in four socioeconomically distinct primary school communities in two cities of southern China . The qualitative study ( 17 focus groups and four personal interviews ) involved parents , gr and parents , school staff , and food retailers in the vicinity of the schools ( n = 99 ) and explored perceived causes of childhood obesity . The cross-sectional study examined the association between children ’s objective ly measured weight status and reported health behaviours , and the presence and role of gr and parents in the household . It included children from three r and omly selected third grade ( 8 to 10 years ) classes from each school ( n = 497 ) . Results Gr and parents were commonly perceived to contribute to childhood obesity through inappropriate perception ( e.g. fat children are healthy and well cared for ) , knowledge ( e.g. obesity related diseases can only happen in adults ; the higher the dietary energy/fat content , the more nutritious the food ) , and behaviour ( e.g. overfeeding and indulging through excusing the children from household chores ) . Conflicting child care beliefs and practice s between gr and parents and parents , and between gr and parents and school teachers , were felt to undermine efforts to promote healthy behaviours in children . In the cross-sectional study , children who were mainly cared for by their gr and parents were more likely to be overweight/obese ( adjusted OR = 2.03 ; 95 % CI = 1.19 to 3.47 ) ; and to consume more sugar-added drinks and unhealthy snacks ( B = 2.13 , 95 % CI = 0.87 to 3.40 ) , than children who were mainly cared for by their parents or other adult . Children who lived with two or more gr and parents in the household were more likely to be overweight/obese than children who did not live with any gr and parent ( adjusted OR = 1.72 ; 95 % CI = 1.00 to 2.94 ) . Conclusions Involvement of gr and parents in childcare is an important factor contributing to childhood obesity in China . Future preventive interventions should include strategies that target gr and parents Women with a history of a prior preterm birth ( PTB ) have a high probability of a recurrent preterm birth . Some risk factors and health behaviors that contribute to PTB may be amenable to intervention . Home visitation is a promising method to deliver evidence based interventions . We evaluated a system of care design ed to reduce preterm births and hospital length of stay in a sample of pregnant women with a history of a PTB . Single site r and omized clinical trial . Eligibility : > 18 years with prior live birth ≥20–<37 weeks gestation ; < 24 weeks gestation at enrollment ; spoke and read English ; received care at regional medical center . All participants ( N = 211 ) received st and ard prenatal care .  Intervention participants ( N = 109 ) also received home visits by certified nurse-midwives guided by protocol s for specific risk factors ( e.g. , depressive symptoms , abuse , smoking ) . Data was collected via multiple methods and sources including intervention fidelity assessment s.  Average age 27.8 years ; mean gestational age at enrollment was 15 weeks . Racial breakdown mirrored local demographics . Most had a partner , high school education , and 62 % had Medicaid . No statistically significant group differences were found in gestational age at birth . Intervention participants had a shorter intrapartum length of stay . Enhanced prenatal care by nurse-midwife home visits may limit some risk factors and shorten intrapartum length of stay for women with a prior PTB . This study contributes to knowledge about evidence -based home visit interventions directed at risk factors associated with PTB
premature infants are more susceptible to motor development , behavior and academic performance impairment when compared to term infants .
OBJECTIVES to examine and synthesize the available knowledge in the literature about the effects of preterm birth on the development of school-age children .