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February 12, 2003

Cognitive Function in Preterm Infants: No Simple Answers

Author Affiliations

Author Affiliation: Division of Developmental and Behavioral Pediatrics, Southern Illinois University School of Medicine, Springfield.

JAMA. 2003;289(6):752-753. doi:10.1001/jama.289.6.752

Improved survival rates have heightened emphasis on the long-term outcome of infants born at very low-birth-weight (VLBW) and extremely low-birth-weight (ELBW). Medical or physical, neurological, cognitive, academic, neuropsychological, motor, social, emotional or behavioral, functional, and health-related quality of life are all outcomes of interest.1,2 Previously, the incidence of major disabilities, such as moderate or severe mental retardation, cerebral palsy, epilepsy, blindness, and sensorineural hearing loss, was the greatest concern because of the severity of developmental morbidity. Over the last decade, the incidence of these disabilities has remained constant, ranging from 15% to 20%, with higher incidence corresponding to lower birth weight and gestational age.3 In addition, more subtle cognitive impairments have been detected in survivors without major disabilities. These high-prevalence/low-severity dysfunctions include learning disabilities, borderline intellectual functioning, attention-deficit/hyperactivity disorders, specific neuropsychological deficits, and behavioral problems,4 and reportedly occur in 50% to 70% of VLBW infants.5,6