High Prevalence/Low Severity Language Delay in Preschool Children Born Very Preterm Attention problems in very preterm children from childhood to adulthood: the Bavarian Longitudinal Study. Cognitive development in low risk preterm infants at 3–4 years of life Brief parenting intervention for parents of NICU graduates: a randomized, clinical trial of Primary Care Triple P Trajectories of Receptive Language Development From 3 to 12 Years of Age for Very Preterm Children Language assessment of non-handicapped twins at 5 years of age. A functional magnetic resonance imaging study of language processing and its cognitive correlates in prematurely born children. Effect of neonatal surfactant therapy on lung function at school age in children born very preterm. Long-term cognition, achievement, socioemotional, and behavioral development of healthy late-preterm infants. Association between gestational age at birth, antenatal corticosteroids, and outcomes at 5 years: multiple courses of antenatal corticosteroids for preterm birth study at 5 years of age (MACS-5) Developmental coordination disorder at 8 years of age in a regional cohort of extremely‐low‐birthweight or very preterm infants Early school-based learning difficulties in children born very preterm. Habituation as Parameter for Prediction of Mental Development in Healthy Preterm Infants Maternal transdermal nitroglycerin use and early childhood development. Mental health and developmental outcomes for children born after ART: a comparative prospective study on child gender and treatment type. Children Born Preterm at the Turn of the Millennium Had Better Lung Function Than Children Born Similarly Preterm in the Early 1990s The stability of the diagnosis of developmental disability between ages 2 and 8 in a geographic cohort of very preterm children born in 1997 Neurobehavioral outcomes of school-age children born extremely low birth weight or very preterm in the 1990s. Associations between parental psychological well-being and socio-emotional development in 5-year-old preterm children. Neurophysiologic correlates of deficient phonological representations and object naming in prematurely born children Randomised trial of parental support for families with very preterm children: outcome at 5 years Preschool Assessment of Preterm Infants Treated With Darbepoetin and Erythropoietin Outcomes at age 2 years of infants < 28 weeks' gestational age born in Victoria in 2005.
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 BACKGROUND Very preterm ( VP ; gestational age < 32 weeks ) and very low birth weight ( VLBW ; < 1500 grams ) is related to attention problems in childhood and adulthood . The stability of these problems into adulthood is not known . METHODS The Bavarian Longitudinal Study is a prospect i ve cohort study that followed 260 VP/VLBW and 229 term-born individuals from birth to adulthood . Data on attention were collected at 6 , 8 , and 26 years of age , using parent reports , expert behavior observations , and clinical ADHD diagnoses . RESULTS At each assessment , VP/VLBW individuals had significantly more attention problems , shorter attention span , and were more frequently diagnosed with ADHD than term-born comparisons . In both VP/VLBW and term-born individuals , overall , attention span increased and attention problems decreased from childhood to adulthood . Attention problems and attention span were more stable over time for VP/VLBW than term-born individuals . Similarly , ADHD diagnoses showed moderate stability from childhood to adulthood in VP/VLBW , but not in term-born individuals . However , when those with severe disabilities were excluded , differences between VP/VLBW and term-born individuals reduced . CONCLUSIONS Despite improvement in attention regulation from childhood to adulthood , children born very preterm remained at increased risk for attention problems in adulthood . In contrast , term-born children with clinical attention problems outgrew these by adulthood . As inattentive behavior of VP/VLBW children may be overlooked by teachers , it may be necessary to raise awareness for school intervention programs that reduce attention problems in VP/VLBW children Background : Major neurological h and icaps and neuropsychological disturbances are more common in ex-preterm children than their counterparts born at term . Objective : To establish in a prospect i ve study whether a characteristic neuropsychological profile exists in ex-preterm children who do not exhibit neurodevelopmental deficits on routine clinical examination . Methods : Thirty intellectually normal children born preterm ( 30–34 weeks gestation ) without major neurological disabilities and a control group of term children matched for age , sex , and parental educational and occupational status were assessed at 3–4 years of age to obtain a complete neuropsychological profile . Intellectual ability , language comprehension and expression , perceptual and visual motor function , working memory , and attention and behavioural problems were investigated . Results : Even in the absence of major neurological signs , children born preterm achieved lower mean scores than controls on the Stanford-Binet intelligence scale ( 110.8 v 121 , p<0.001 ) , visual perception test ( 33.8 v 42.7 , p<0.001 ) , visual motor integration test ( 42.6 v 47.4 , p = 0.049 ) , memory for location test ( 8.4 v 9.5 , p = 0.007 ) , sustained attention test ( 41.6 v 51.5 , p = 0.009 ) , and the picture vocabulary test ( 33.3 v 44.7 , p = 0.021 ) . Conclusions : Neuropsychological abnormalities can be detected early in childhood in apparently normal ex-preterm children and are consistent with a growing body of evidence that prematurity may be associated with long term neuropsychological morbidity in childhood and adolescence Background Preterm-born or asphyxiated term-born children who received neonatal intensive care show more emotional and behavioral problems than term-born children without a medical condition . It is uncertain whether regular parenting intervention programs to which the parents of these children are usually referred , are effective in reducing child problem behavior in this specific population . Our objective was to investigate whether a regular , brief parenting intervention , Primary Care Triple P , is effective in decreasing emotional and behavioral problems in preterm-born or asphyxiated term-born preschoolers . Methods For this pragmatic , open r and omized clinical trial , participants were recruited from a cohort of infants admitted to the neonatal intensive care units ( NICU ) of two Dutch hospitals . Children born with a gestational age < 32 weeks or birth weight < 1500 g and children born at a gestational age 37–42 weeks with perinatal asphyxia were included . After screening for a t-score ≥60 on the Child Behavior Checklist ( CBCL ) , children were r and omly assigned to Primary Care Triple P ( n = 34 ) or a wait-list control group ( n = 33 ) . The primary outcome was child emotional and behavioral problems reported by parents on the CBCL , 6 months after the start of the trial . Results There was no effect of the intervention on the CBCL at the trial endpoint ( t64 = 0.54 , P = .30 ) . On secondary measurements of child problem behavior , parenting style , parenting stress , and parent perceived child vulnerability , groups either did not differ significantly or the intervention group showed more problems . In both the intervention and control group there was a significant decrease in emotional and behavioral problems during the trial . Conclusions Primary Care Triple P , a brief parenting intervention , is not effective in reducing child emotional and behavioral problems in preterm-born children or term-born children with perinatal asphyxia . Trial registration Netherl and s National Trial Register ( NTR ) : 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 BACKGROUND The aim of the present study was to determine language levels in twins and singletons born after at least 34 weeks gestation and without identifiable neurological abnormality and to evaluate whether in vitro fertilization ( IVF ) affects language development in twin pregnancies . METHODS A prospect i ve study of a large cohort of all children born between 1 January 2001 and 31 December 2003 was carried out at Gazi University Hospital . All live-born twin pairs in which both twins survived were identified , and a comparable sample of families with pairs of singletons were chosen . The  Stanford-Binet Intelligence Scale Form and the translated Turkish form of the Peabody Picture Vocabulary Test  were completed at 60 months . RESULTS Even after excluding the most premature twins and those with diagnosable neurological damage , twins performed worse than singletons on language development tests . Twin girls had better scores than twin boys . A statistically significant difference was found between the scores of term and preterm twins . No significant difference was noted when compared according to birth order . Appropriate for gestational age ( AGA ) twins did better than small for gestational age ( SGA ) twins in the test scores . All twin girls did not differ from singleton girls , but all twin boys performed worse than singleton boys . Term twins had similar results with term singletons , but preterm twins had lower scores than preterm singletons . SGA singletons had better scores than SGA twins , while AGA twins and singletons did not differ . When the children were compared with regard to method of conception , IVF children had significantly lower scores on the tests than those in the spontaneous conception group . CONCLUSION It is hoped that the present findings could lead to a more precise assessment of children for speech impairment and , above all , to more efficient preventive intervention . Whatever mechanisms are involved , the present results indicate that twins born as a result of IVF , are at a disadvantage in terms of language development in comparison with spontaneously conceived twins OBJECTIVE Abnormalities in brain structure , cognition , and behavior have been described in children born prematurely . However , no direct in vivo evidence has yet demonstrated abnormal neural processing in these children . Our aim was to compare brain activity associated with phonologic and semantic processing of language between term and preterm children using functional magnetic resonance imaging ( fMRI ) . METHODS fMRI scans were acquired during a passive language comprehension task in 26 preterm children at 8 years of age and in 13 term community control children who were comparable in age , sex , maternal education , and minority status . IQ was assessed using a st and ard measure of intelligence . RESULTS The pattern of brain activity identified in a semantic processing task in the preterm children closely resembled the pattern of brain activity identified in a phonologic processing task in term controls . The greater this resemblance in the preterm children , the lower their verbal comprehension IQ scores and the poorer their language comprehension during the scanning task . CONCLUSIONS Preterm children with the poorest language comprehension seemed not to fully engage normal semantic processing pathways in a language comprehension task . These children instead engaged pathways that normal term children used to process meaningless phonologic sounds . Aberrant processing of semantic content in these preterm children may account in part for their lower verbal IQ scores 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 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 Background The Multiple Courses of Antenatal Corticosteroids for Preterm Birth Study ( MACS ) showed no benefit in the reduction of major neonatal mortality/morbidity or neurodevelopment at 2 and 5 years of age . Using the data from the r and omized controlled trial and its follow-up , the aim of this study was to evaluate the association between gestational ages at birth in children exposed to single versus multiple courses of antenatal corticosteroid ( ACS ) therapy  in utero and outcomes at 5 years of age . Method A total of 1719 children , with the breakdown into groupings of < 30 , 30–36 , and ≥ 37 weeks gestation at birth , contributed to the primary outcome : death or survival with a disability in one of the following domains : neuromotor , neurosensory , and neurobehavioral/emotional disability and were included in this analysis . Results Gestational age at birth was strongly associated with the primary outcome , p < 0.001 . Overall , the interaction between ACS groups and gestational age at birth was not significant , p = 0.064 . Specifically , in the 2 preterm categories , there was no difference in the primary outcome between single vs. multiple ACS therapy . However , for infants born ≥37 weeks gestation , there was a statistically significant increase in the risk of the primary outcome  in multiple ACS therapy , 48/213 ( 22.5 % ) compared to 38/249 ( 15.3 % ) in the single ACS therapy ; OR = 1.69 [ 95 % CI : 1.04 , 2.77 ] ; p = 0.037 . Conclusion Preterm birth ( < 37 weeks gestation ) remained the primary factor contributing to an adverse outcome regardless of the number of courses of ACS therapy . Children born ≥ 37 weeks and exposed to multiple ACS therapy may have an increased risk of neurodevelopmental/neurosensory impairment by 5 years of age . To optimize outcomes for infants/children , efforts in reducing the incidence of preterm birth should remain the primary focus in perinatal research .Trial registration This study has been registered at ( identifier NCT00187382 The aims of this study were to determine the motor outcome of extremely‐low‐birthweight ( ELBW ; < 1000 g ) or very preterm ( < 28wks ) children compared with normal birthweight ( NBW ) children , to establish the perinatal associations of developmental coordination disorder ( DCD ) and its cognitive and behavioural consequences . Participants were consecutive surviving ELBW or very preterm children and r and omly selected NBW(>2499 g ) children born in the state of Victoria , Australia , in 1991 or 1992 . Main outcomes were : ( 1 ) results of the Movement Assessment Battery for Children ( MABC ) at 8 years of age ; ( 2 ) cognitive function ; ( 3 ) academic progress ; and ( 4 ) behaviour .  Of 298 consecutive ELBW/very preterm survivors , 255 ( 85.6 % ; 117 males , 138 females ) had the  MABC  at a mean age of 8 years 8 months . More ELBW/very preterm children ( 9.5 % ) had DCD than the NBW group ( 2 % , p=0.001 ) . Only male sex increased the likelihood of DCD in ELBW/very preterm children ( p=0.017 ) . ELBW/very preterm children with DCD had worse cognitive function and academic test scores ( up to 1SD below those without DCD ) ; they also had more adaptive behaviour and externalizing problems , but not internalizing problems . DCD is more common in ELBW/very preterm children , has few perinatal correlates , and is associated with poor cognitive and academic performance as well as increased behaviour problems 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 The aim of this prospect i ve pilot study was to evaluate the predictive value of discrimination and habituation , which was measured by mismatch negativity in 17 healthy very preterm ( mean gestational age 27.4 weeks ; range 25.0 - 31.3 ) and 16 term ( mean gestational age 40.3 weeks ; range 37.9 - 41.7 ) born infants at term equivalent age .  Developmental outcome was measured by Bayley Scales of Infant Development – I in 13 preterm and 13 term-born children at a mean age of 21.7 months ( ±2.18 ) and 18.5 months ( ±1.9 ) , respectively . No differences in amplitude and latency of the mismatch negativity were found between both groups at term equivalent age . Within the preterm group habituation capacity was positively correlated with the Mental Developmental Index ( r = .654 , P = .008 ) and Performance Developmental Index ( r = .482 , P = .048 ) at 21 months . Early learning capability , as measured by habituation , may be associated with a better prognosis for early mental development in healthy preterm infants OBJECTIVE Our r and omized , double-blind , placebo-controlled trial of transdermal nitroglycerin ( GTN ) for preterm labour demonstrated a significant reduction in neonatal morbidity and mortality . The objective of this study was to evaluate developmental performance in the children born to women who participated in the GTN trial after one year and two years of follow-up . METHODS The Ages and Stages Question naires ( ASQ ) were used for the assessment s , and five domains of child development ( communication , gross motor skills , fine motor skills , problem-solving , and personal social skills ) were evaluated . Supplementary analyses were performed after stratifying study subjects by gestational age at birth ( < 28 , 28 to 32 , 33 to 36 , ≥ 37 weeks ) or by defining study subjects as normal or abnormal using st and ard cut-offs . RESULTS A total of 153 infants born to women who participated in the GTN trial were included in the initial follow-up . Among them , 111 ( 72.5 % ) children ( 55 in the GTN  arm and 56 in the placebo arm ) at 12 months of age and 83 ( 54.2 % ) children ( 42 in the GTN arm and 41 in the placebo arm ) at 24 months of age completed the full ASQ . There were no differences in ASQ total score and five subscores between the GTN arm and the placebo arm at the one-year and two-year follow-up evaluations , in overall study subjects , or after stratifying study subjects by gestational age . A trend towards reduced abnormalities in the GTN arm at the two-year follow-up was observed , although there was no statistical significance . CONCLUSION Maternal GTN use for preterm labour had no impact on children 's long-term development , but larger studies are needed to confirm the preliminary findings of this study STUDY QUESTION Do children born after assisted reproductive techniques ( ART ; IVF/ICSI )  display more mental health issues or social and cognitive developmental problems at 7 - 8 years than naturally conceived ( NC ) controls , and does child gender play a role ? SUMMARY ANSWER ART children do not differ with regard to mental health or social and cognitive developmental problems when compared with controls , but some gender-specific differences do exist . WHAT IS KNOWN ALREADY Systematic review s have not found any evidence of delays in neurocognitive or sensorimotor development in ART children . However findings on the effect of the type of ART treatment ( IVF versus ICSI ) on the offspring 's physical and mental development have not been uniform . Knowledge of the role of child gender in ART research is scarce . STUDY DESIGN , SIZE , DURATION This prospect i ve follow-up study compares mental health and social and cognitive developmental problems between 7 - 8-year-old ART and NC children , controlling for the father 's age , length of the parents ' partnership , mother 's parity , child 's gestational age , and the need of neonatal intensive care unit ( NICU ) . Further , within the ART group , we analysed whether the treatment type ( IVF versus ICSI ) and the child 's gender are associated with the mental health and developmental outcomes . PARTICIPANTS / MATERIAL S , SETTING , METHODS In this study , 255 singleton ART children ( IVF and ICSI ) were compared with 278 NC children on parent-reported internalizing and externalizing symptoms , and social ( social skills and peer relations ) and cognitive development ( executive functioning , perception , memory , and language ) . Within the ART group , 164 IVF and 76 ICSI children were compared on the same outcomes . Statistics included analyses of covariates ( ANCOVA ) with group main effects , group and gender interaction effects , and Bonferroni post hoc tests . MAIN RESULTS AND THE ROLE OF CHANCE ART and NC children did not differ generally in terms of their internalizing and externalizing symptoms or in the number of social and cognitive developmental problems ( Group main effects , P > 0.05 ) , but gender-specific group differences existed . The ART boys showed lower levels of cognitive problems than the NC boys , whereas ART girls showed higher levels of cognitive problems than the NC girls ( Group × Gender-interaction effects with Bonferroni post hoc tests on mother-reports , P < 0.01 ) . Further , unlike in the NC group , where boys showed more externalizing symptoms and social and cognitive developmental problems than girls ( Group × Gender-interaction effects with Bonferroni post hoc tests for both parents ' reports , P < 0.05 ) , gender differences were not found in the ART group . Within the ART group , IVF and ICSI children did not differ in terms of mental health or developmental outcomes , and no significant gender differences emerged . LIMITATIONS , REASONS FOR CAUTION The information on children 's mental health and development was based on parental reports only . The dropout rate between the child 's first year and the school age assessment s was very high for fathers ( 57.4 % ) and substantial for mothers ( 30.1 % ) , and the participating group was biased for older age of both parents and for better education of the fathers . WIDER IMPLICATION S OF THE FINDINGS The findings indicate the importance of considering child gender in learning about multiple developmental outcomes among children born after ART . STUDY FUNDING /COMPETING INTERESTS This study was supported by the Academy of Finl and ( # 11232276 ) , the Emil Aaltonen Foundation , The Family Federation of Finl and , Helsinki University Central Hospital Research Funds , and the National Graduate School of Psychology . None of authors has any competing interests to declare Objective Compare respiratory health in children born extremely preterm ( EP ) or with extremely low birthweight ( ELBW ) nearly one decade apart , hypothesizing that better perinatal management has led to better outcome . Design Fifty-seven ( 93 % ) of 61 eligible 11-year old children born in Western Norway in 1999–2000 with gestational age ( GA ) < 28 weeks or birthweight < 1000 gram ( EP1999–2000 ) and matched term-controls were assessed with comprehensive lung function tests and st and ardized question naires . Outcome was compared with data obtained at 10 years of age from all ( n = 35 ) subjects born at GA < 29 weeks or birthweight < 1001 gram within a part of the same region in 1991–92 ( EP1991–1992 ) and their matched term-controls . Results EP1999–2000 had significantly reduced forced expiratory flow in 1 second ( FEV1 ) , FEV1 to forced vital capacity ( FEV1/FVC ) and forced expiratory flow between 25–75 % of FVC ( FEF25–75 ) , with z-scores respectively -0.34 , -0.50 and -0.61 below those of the term-control group , and more bronchial hyperresponsiveness to methacholine ( dose-response-slope 13.2 vs. 3.5 ; p<0.001 ) , whereas other outcomes did not differ . Low birthweight z-scores , but not neonatal bronchopulmonary dysplasia ( BPD ) or low GA , predicted poor outcome . For children with neonatal BPD , important lung-function variables were better in EP1999–2000 compared to EP1991–1992 . In regression models , improvements were related to more use of antenatal corticosteroids and surfactant treatment in the EP1999–2000 . Conclusions Small airway obstruction and bronchial hyperresponsiveness were still present in children born preterm in 1999–2000 , but outcome was better than for children born similarly preterm in 1991–92 , particularly after neonatal BPD . The findings suggest that better neonatal management not only improves survival , but also long-term pulmonary outcome Objective Studies reporting the developmental outcomes for very preterm ( VPT ) children often focus on development at age 2 years . The aim of this study was to assess the stability of the rates of diagnosis of developmental disability from age 2 to 8 years in a regional cohort of VPT and extremely low – birth weight ( ELBW ) children and compare these with term controls . Methods  VPT ( 22–27 completed weeks of gestation ) and ELBW ( birth weight 500–999 g ) children and matched term controls born in Victoria , Australia , in 1997 were enrolled at birth in a regional prospect i ve longitudinal study . Outcomes were assessed at ages 2 and 8 years . Results Of the 283 VPT/ELBW live births , 71 % survived to age 8 years and 94 % were assessed . Of the 199 controls , 100 % survived to age 8 years and 86.9 % were assessed . At age 2 years , the rates of nil , mild , moderate and severe disabilities in the VPT/ELBW children were respectively 51.9 % , 20.9 % , 13.4 % and 13.9 % ; and at age 8 years , 43.9 % , 36.9 % , 10.7 % and 8.6 % . The Cohen κ statistic revealed poor agreement between disability status at ages 2 and 8 years for VPT/ELBW children ( 0.20 , p<0.001 ) but a higher level of agreement ( 0.37 , p<0.001 ) for the control children . This was primarily driven by differences in classification of cognitive disability between ages 2 and 8 years . Conclusions Developmental outcomes at age 2 years are only a moderate predictor of long-term outcome and are not a reliable end point for follow-up studies of VPT and ELBW children 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 Preterm children are at risk for developing behavioral and emotional problems , as well as being less socially competent . Premature birth causes chronic distress in the parents . AIMS The aim of the paper is to discover whether parental psychological well-being is associated with the social , behavioral , and functional development of very low birth weight ( VLBW , ≤1500 g ) children at 5years of age . STUDY DESIGN A longitudinal prospect i ve cohort study . SUBJECTS A cohort of 201 VLBW infants ( ≤1500 g , < 37weeks of gestation ) born during 2001 - 2006 in Turku University Hospital , Finl and was studied . OUTCOME MEASURES At 4-year chronological age of their child , parents independently completed vali date d question naires ( Beck Depression Inventory , Parenting Stress Index and Sense of Coherence Scale )  . At 5years , parents and day-care providers evaluated the development of the child by completing the Five to Fifteen question naire . RESULTS The parents of VLBW children reported significantly more problems in child development compared to the Finnish normative data . Depressive symptoms and weaker sense of coherence in mothers , but not in fathers , were associated with more problems in child development . Parenting stress , for both mothers and fathers , was associated with developmental problems in their child at 5years of age . CONCLUSIONS Maternal depressive symptoms and parenting stress of both parents may be risk factors for the social , behavioral , and functional development of 5-year-old preterm children . On the other h and , stronger maternal sense of coherence may be a protective factor OBJECTIVE The aim of this follow-up study was to evaluate the development of object naming ability and auditory processing in prematurely born children . Furthermore , we investigated whether the mismatch negativity ( MMN ) parameters at the age of 4 years correlate with the MMN parameters and naming ability at the age of 6 years . METHODS Twelve very low birth weight ( VLBW ) preterm children ( mean age 5 years 7 months ) and matched controls were studied . Object naming was measured by the Boston naming test  . Auditory event-related potentials ( ERPs ) , especially the MMN  , were recorded for Finnish syllables ( st and ard /taa/ ; deviants /ta/ and /kaa/ ) in an oddball paradigm . RESULTS VLBW preterm children scored significantly lower in the object naming test than their controls . The MMN amplitude for consonant change was significantly smaller in the preterm group compared to the controls . The MMN amplitude at the age of 4 years correlated with the MMN amplitude at the age of 6 years . Furthermore , absence of the MMN at the age of 4 years predicted naming difficulties at the age of 6 years . CONCLUSIONS VLBW preterm children with a difficulty to preattentively discriminate changes in syllables , as indexed by the diminished change detection response , MMN , seem to have sustained naming difficulty . Therefore , it is reasonable to record the MMN along with the language development from infancy , in order to identify the children at risk for language deficiencies and to provide appropriate rehabilitation Aims : To test the effectiveness of a home based developmental education intervention in improving outcome at 5 years for very preterm infants . Methods : The Avon Premature Infant Project ( APIP ) is a r and omised controlled trial in which the parents of 284 babies born <33 weeks gestational age received a developmental education programme , a social support intervention , or st and ard care .  A term reference population was also recruited . This study reports outcomes at 5 years ( mean age 58 months 15 days ) for 187 ( 66 % ) of these children without disability . Outcomes were assessed using the British Ability Scales II for cognitive development , the Movement ABC for motor impairment , and the Child Behavior Checklist for behavioural problems . Results : Preterm infants showed poorer cognitive performance than their term peers . Mean ( SD ) general conceptual ability ( GCA ) scores were : Portage 99.2 ( 15.7 ) ; parent adviser 100.3 ( 14.8 ) ; preterm control 101.1 ( 15.0 ) ; term reference 107.2 ( 13.4 ) . There were no significant differences between preterm groups in GCA scores indicating no effect of either intervention . Similarly , there was no significant effect of intervention on behavioural or motor outcomes . Further analyses , in which outcome data were adjusted for social factors , did not reveal any differences between the three preterm groups or by subgroups classified by a range of perinatal variables . Conclusion : The small advantage shown at 2 years of age is no longer detectable at 5 years . These results question the effectiveness of early intervention in enhancing cognitive , behavioural , and motor function at 5 years BACKGROUND : We previously reported improved neurodevelopmental outcomes at 2 years among infants treated with the erythropoiesis-stimulating agents ( ESAs ) darbepoetin alfa ( darbepoetin ) or erythropoietin . Here we characterize 4-year outcomes . METHODS : Former preterm infants r and omly assigned to receive darbepoetin ( 10 μg/kg , once per week ) , erythropoietin ( 400 U/kg , 3 times/week ) , or placebo through 35 weeks ’ postconceptual age were evaluated at 3.5 to 4 years of age . For comparison , healthy children formerly delivered full term ( term controls [ TCs ] ) were also recruited . All participants were assessed by using measures of full-scale IQ ( FSIQ ) and general language from the Wechsler Preschool and Primary Scale of Intelligence , Third Edition , and an overall measure of executive function , on the basis of tests evaluating inhibitory control and spatial working memory . Rates of neurodevelopmental impairment were compared across groups . RESULTS : Multivariate analysis of variance compared children r and omly assigned to ESAs ( n = 39 ) , placebo ( n = 14 ) , and TCs ( n = 24 ) . FSIQ and performance IQ were significantly higher in the ESA group than in the placebo group ( FSIQ : 91.1 ± 17.5 vs 79.2 ± 18.5 , P = .036 ; performance IQ : 93.0 ± 17.0 vs 79.5 ± 19.5 , P = .018 ) . Follow-up analyses revealed that the children receiving ESAs performed better than those who received placebo on executive function tasks . The ESA group ’s performance was below that of TCs , but the results did not reach significance on executive function . The incidence of neurodevelopmental impairment was greater in the placebo group than in the ESA group . CONCLUSIONS : ESA-treated infants had better cognitive outcomes and less developmental impairment at 3.5 to 4 years of age compared with placebo-treated infants . ESAs show promise in improving long-term cognitive outcomes of infants born prematurely OBJECTIVE To determine the survival rates and neurosensory outcomes of infants born at gestational age 22 - 27 weeks in the state of Victoria in 2005 and compare theses data with those for similar infants born in the 1990s . STUDY DESIGN This was a population -based study of all extremely preterm ( 22 - 27 weeks ' gestational age ) live births in Victoria in 2005 free of lethal anomalies and r and omly selected term controls .  Survival and quality -adjusted survival rates at age 2 years were determined relative to the controls , and results were compared with regional extremely preterm cohorts born in 1991 - 92 and 1997 . RESULTS Of 270 very preterm live births in 2005 , 172 ( 63.7 % ) survived to 2 years , not significantly different from the survival rate of 69.6 % for those born in 1997 . Rates of severe developmental delay and severe disability were lower than in the very preterm survivors born in 1997 . Quality -adjusted survival rates in the extremely preterm cohorts rose from 42.1 % in 1991 - 92 to 55.1 % in 1997 , but did not increase in 2005 ( 53.4 % ) . CONCLUSIONS Survival rates for infants born at 22 - 27 weeks ' gestational age have not increased since the late 1990s , but the neurosensory outcome in survivors has improved
RESULTS : Preterm-born children scored significantly lower compared with term-born children on simple ( d = –0.45 [ 95 % CI : –0.59 to –0.30 ] ; P < .001 ) and on complex ( d = –0.62 [ 95 % CI : –0.82 to –0.43 ] ; P < .001 ) language function tests , even in the absence of major disabilities and independent of social economic status .
: While growing up , preterm-born children have increasing difficulties with complex language function
BACKGROUND AND OBJECTIVE : Preterm-born children ( < 37 weeks ’ gestation ) have higher rates of language function problems compared with term-born children .
It is unknown whether these problems decrease , deteriorate , or remain stable over time .
The goal of this research was to determine the developmental course of language functions in preterm-born children from 3 to 12 years of age .