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Intelligence of very preterm or very low birthweight infants in young adulthood

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Author: Weisglas-Kuperus, N. · Hille, E.T.M. · Duivenvoorden, H.J. · Finken, M.J.J. · Wit, J.M. · Buuren, S. van · Goudoever, J.B. van · Verloove-Vanhorick, S.P.
Type:article
Date:2009
Institution: TNO Kwaliteit van Leven
Source:Archives of Disease in Childhood : Fetal and Neonatal Edition, 3, 94, F196-F200
Identifier: 241506
doi: doi:10.1136/adc.2007.135095
Keywords: Health · Leefomgeving en gezondheid · Cognitive defect · Disability · Disease severity · Education · Environmental factor · Intrauterine growth retardation · Parent · Postnatal growth · Prematurity · Prenatal growth · Risk assessment · Sex difference · Survival rate · Child Development · Cohort Studies · Educational Status · Fetal Growth Retardation · Gestational Age · Humans · Infant, Newborn · Infant, Very Low Birth Weight · Intelligence · Maternal Age · Netherlands · Risk Factors · Young Adult

Abstract

Objective: To examine the effect of intrauterine and neonatal growth, prematurity and personal and environmental risk factors on intelligence in adulthood in survivors of the early neonatal intensive care era. Methods: A large geographically based cohort comprised 94% of all babies born alive in the Netherlands in 1983 with a gestational age below 32 weeks and/or a birth weight >1500 g (POPS study). Intelligence was assessed in 596 participants at 19 years of age. Intrauterine and neonatal growth were assessed at birth and 3 months of corrected age. Environmental and personal risk factors were maternal age, education of the parent, sex and origin. Results: The mean (SD) IQ of the cohort was 97.8 (15.6). In multiple regression analysis, participants with highly educated parents had a 14.2-point higher IQ than those with less well-educated parents. A 1 SD increase in birth weight was associated with a 2.6-point higher IQ, and a 1-week increase in gestational age was associated with a 1.3-point higher IQ. Participants born to young mothers (<25 years) had a 2.7-point lower IQ, and men had a 2.1-point higher IQ than women. The effect on intelligence after early (symmetric) intrauterine growth retardation was more pronounced than after later (asymmetric) intrauterine or neonatal growth retardation. These differences in mean IQ remained when participants with overt handicaps were excluded. Conclusions: Prematurity as well as the timing of growth retardation are important for later intelligence. Parental education, however, best predicted later intelligence in very preterm or very low birthweight infants.