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      Comparison of cognitive and behavioural problems and psychiatric diagnoses in preterm born children between 6-13 years old Translated title: Comparación de problemas cognitivos y conductuales y diagnósticos psiquiátricos en niños prematuros entre 6 y 13 años

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          Abstract

          Abstract Introduction: Despite the increased survival rates follow up studies of preterm born children have documented increased prevalence of neurodevelopmental disabilities and cognitive deficits. By using psychiatric assessment, we aimed to evaluate cognitive functions by comparing preterm born babies according to the week of gestation by comparing the scores of the Wechsler Intelligence Scale for Children-Revised Form (WISC-R) in childhood. Material and methods: Children with a history of birth as preterm babies between 1998-2004 were included in the study. The children born between 27-36 weeks, currently 6-13 years old were admitted to the study. The controls consisted of healthy children chosen from the nearest primary school. The WISC-R test was administered to all children. Classification was made according to gestational age. The comparison of cognitive functions was performed by comparing the WISC-R scores of the preterm group and the control group. Results: 238 children were included in our prospective study. (case group: 175 children, control group: 63 children). Because of the comparison of the WISC-R scores of the preterm and control groups, the WISC-R verbal score and WISC-R total score were found to be statistically significant between the preterm and control groups. In the analysis made according to the gestation age, no statistical significance was found between the WISC-R Verbal, WISC-R performance, and WISC-R total scores according to the week of gestation. No statistically significant difference was found in terms of previous and current psychiatric diagnoses. Conclusions: While the WISC-R score was, found to be statistically significantly higher in the case group compared to controls. Our results differed from those in the literature that preterm children had a lower WISC-R score and it indicates the need to investigate this situation by further studies, even by different tests.

          Translated abstract

          Resumen Introducción: A pesar del aumento de las tasas de supervivencia, los estudios de seguimiento de niños prematuros han documentado una mayor prevalencia de discapacidades del neurodesarrollo y déficits cognitivos. Mediante el uso de la evaluación psiquiátrica, nuestro objetivo fue evaluar las funciones cognitivas comparando los bebés prematuros según la semana de gestación comparando los puntajes de la Escala de inteligencia de Wechsler para niños-Forma revisada (WISC-R) en la infancia. Material y métodos: Se incluyeron en el estudio niños con antecedentes de parto prematuro entre 1998-2004. Los niños nacidos entre 27 y 36 semanas, actualmente de 6 a 13 años, fueron admitidos en el estudio. Los controles consistieron en niños sanos elegidos de la escuela primaria más cercana. La prueba WISC-R se administró a todos los niños. La clasificación se hizo de acuerdo a la edad gestacional. La comparación de las funciones cognitivas se realizó comparando las puntuaciones WISC-R del grupo de prematuros y el grupo control. Resultados: 238 niños fueron incluidos en nuestro estudio prospectivo. (grupo de casos: 175 niños, grupo de control: 63 niños). Debido a la comparación de las puntuaciones de WISC-R de los grupos de control y de prematuros, se encontró que la puntuación verbal de WISC-R y la puntuación total de WISC-R eran estadísticamente significativas entre los grupos de control y de prematuros. En el análisis realizado según la edad de gestación, no se encontró significancia estadística entre las puntuaciones del WISC-R Verbal, WISC-R de rendimiento y WISC-R total según la semana de gestación. No se encontraron diferencias estadísticamente significativas en términos de diagnósticos psiquiátricos previos y actuales. Conclusiones: Si bien la puntuación WISC-R fue estadísticamente significativamente mayor en el grupo de casos en comparación con los controles. Nuestros resultados difieren de los de la literatura en que los niños prematuros tienen un puntaje WISC-R más bajo e indica la necesidad de investigar esta situación mediante más estudios, incluso mediante diferentes pruebas.

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          Brain injury in premature infants: a complex amalgam of destructive and developmental disturbances.

          Brain injury in premature infants is of enormous public health importance because of the large number of such infants who survive with serious neurodevelopmental disability, including major cognitive deficits and motor disability. This type of brain injury is generally thought to consist primarily of periventricular leukomalacia (PVL), a distinctive form of cerebral white matter injury. Important new work shows that PVL is frequently accompanied by neuronal/axonal disease, affecting the cerebral white matter, thalamus, basal ganglia, cerebral cortex, brain stem, and cerebellum. This constellation of PVL and neuronal/axonal disease is sufficiently distinctive to be termed "encephalopathy of prematurity". The thesis of this Review is that the encephalopathy of prematurity is a complex amalgam of primary destructive disease and secondary maturational and trophic disturbances. This Review integrates the fascinating confluence of new insights into both brain injury and brain development during the human premature period.
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            Neurologic and developmental disability at six years of age after extremely preterm birth.

            Birth before 26 weeks of gestation is associated with a high prevalence of neurologic and developmental disabilities in the infant during the first two years of life. We studied at the time of early school age children who had been born at 25 or fewer completed weeks of gestation in the United Kingdom and Ireland in 1995. Each child had been evaluated at 30 months of age. The children underwent standardized cognitive and neurologic assessments at six years of age. Disability was defined as severe (indicating dependence on caregivers), moderate, or mild according to predetermined criteria. Of 308 surviving children, 241 (78 percent) were assessed at a median age of six years and four months; 160 classmates delivered at full term served as a comparison group. Although the use of test reference norms showed that cognitive impairment (defined as results more than 2 SD below the mean) was present in 21 percent of the children born extremely preterm (as compared with 1 percent in the standardized data), this value rose to 41 percent when the results were compared with those for their classmates. The rates of severe, moderate, and mild disability were 22 percent, 24 percent, and 34 percent, respectively; disabling cerebral palsy was present in 30 children (12 percent). Among children with severe disability at 30 months of age, 86 percent still had moderate-to-severe disability at 6 years of age. In contrast, other disabilities at the age of 30 months were poorly predictive of developmental problems at 6 years of age. Among extremely preterm children, cognitive and neurologic impairment is common at school age. A comparison with their classroom peers indicates a level of impairment that is greater than is recognized with the use of standardized norms. Copyright 2005 Massachusetts Medical Society.
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              Quality of life of formerly preterm and very low birth weight infants from preschool age to adulthood: a systematic review.

              The goal of this systematic review was to synthesize studies that examined the health-related quality of life of preschool- and school-aged children, adolescents, and young adults who were born preterm and/or at very low birth weight. We searched 7 databases up to September 2006 (Medline, PubMed, Embase, EBM Reviews, Cumulative Index of Nursing and Allied Health Literature, PsycINFO, and the Educational Resource Information Center) as well as gray literature sources. We independently screened studies and included them only if a quality-of-life outcome measure was used and findings compared preterm, very low birth weight, or extremely low birth weight infants with term or normal birth weight peers. We independently assessed the methodologic quality of each study by using criteria adapted from the Centre for Reviews and Dissemination. Fifteen cohort or cross-sectional studies met the review criteria. In 6 studies of preschool-aged children, differences were found between study and control groups, suggesting that many preschool children born preterm or at very low birth weight perform more poorly than their peers in physical, emotional, and/or social functioning. Extremely low birth weight school-aged children had lower health utility scores compared with their peers, and similar results were found for adolescents. Parents of preterm and very low birth weight teens noted significantly poorer performance in their child's global health, behavior, and physical functioning, whereas the teenagers themselves did not. In young adulthood, differences in physical functioning remained, but subjective quality of life was similar to normal birth weight peers. The effects of preterm birth/very low birth weight on health-related quality of life seem to diminish over time, which possibly reflects issues related to a child's report versus a parent-proxy report, differing definitions of health-related quality of life, and adaptation of individuals over time, versus true change in health-related quality of life.
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                Author and article information

                Journal
                ijm
                Iberoamerican Journal of Medicine
                Iberoam J Med
                Hospital San Pedro (Logroño, La Rioja, Spain )
                2695-5075
                2695-5075
                2022
                : 4
                : 3
                : 136-142
                Affiliations
                [1] Istanbul orgnameİstanbul University-Cerrahpasa orgdiv1Cerrahpasa School of Medicine orgdiv2Child and Adolescent Psychiatry Clinic Turquía
                [7] Istanbul orgnameFree-Lance psychologist Turquía
                [3] Istanbul orgnameÜsküdar University School of Medicine orgdiv1Child and Adolescent Psychiatry Clinic Turquía
                [2] Istanbul orgnameSanko University Hospital orgdiv1Child and Adolescent Psychiatry Clinic Turquía
                [10] Istanbul orgnameİstanbul University-Cerrahpasa orgdiv1Cerrahpasa School of Medicine orgdiv2Child and Adolescent Psychiatry Clinic Turquía
                [5] Batman orgnameBatman University orgdiv1Child development Turkey
                [9] Istanbul orgnameMaltepe University orgdiv1School of Medicine orgdiv2Neonatology Department Turkey
                [8] Istanbul orgnameFree-Lance psychologist Turquía
                [6] İzmir orgnameIzmir Ekonomi Üniversitesi Turquía
                [4] Istanbul orgnameOxford Health NHS Foundation Trust Turquía
                Article
                S2695-50752022000300003 S2695-5075(22)00400300003
                10.53986/ibjm.2022.0022
                923f8c57-ca73-4fc7-9916-e020e7111492

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 30 April 2022
                : 29 January 2022
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 34, Pages: 7
                Product

                SciELO Spain

                Categories
                Original Article

                Prematuro,WISC-R Scores,Cognitive functions,Preterm,Escala WISC-R,Funciones cognitivas

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