Everts Regula, Schöne Corina G, Mürner-Lavanchy Ines, Steinlin Maja
Division of Neuropediatrics, Development and Rehabilitation, Children's University Hospital, Inselspital, Bern University Hospital, University of Bern, Switzerland.
Institute of Psychology, University of Bern, Switzerland; Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, Switzerland.
Early Hum Dev. 2019 Feb;129:45-51. doi: 10.1016/j.earlhumdev.2018.12.012. Epub 2019 Jan 11.
Preterm-born individuals are at risk for poorer executive functions. Longitudinal studies investigating whether preterm-born individuals present persistent cognitive deficits, or a transient delay of development are scarce. We assessed developmental trajectories of executive functions (inhibition, working memory, cognitive flexibility) in 29 very preterm-born individuals (<32 weeks' gestation) and 25 term-born controls longitudinally over two time points, namely in childhood (7-12 years of age, TP1) and adolescence (13-16 years of age, TP2). Individual changes in executive functions were examined using relative difference scores (TP2 - TP1) / TP1). There was a significantly stronger improvement of inhibition (U = 477, p = .024) and cognitive flexibility (U = 312, p = .029) between childhood and adolescence in very preterm-born individuals than in term-born controls. Preterm-born individuals improved their performance in the domain of cognitive flexibility significantly more often (76%) between childhood and adolescence than controls (31%, χ = 8.6, p = .003). Controls worsened significantly more often (36%) in the domain of inhibition than the preterm group (14%, χ = 4.8, p = .028). Results indicate that healthy preterm-born individuals show prolonged development of executive functions throughout childhood up into adolescence.
早产个体存在执行功能较差的风险。关于早产个体是否存在持续性认知缺陷或发育短暂延迟的纵向研究很少。我们纵向评估了29名极早产个体（妊娠<32周）和25名足月儿对照在两个时间点的执行功能（抑制、工作记忆、认知灵活性）发展轨迹，这两个时间点分别是儿童期（7 - 12岁，TP1）和青春期（13 - 16岁，TP2）。使用相对差异分数（TP2 - TP1）/TP1）来检查执行功能的个体变化。与足月儿对照相比，极早产个体在儿童期和青春期之间抑制功能（U = 477，p = 0.024）和认知灵活性（U = 312，p = 0.029）的改善明显更强。与对照组（31%，χ = 8.6, p = 0.003）相比，早产个体在儿童期和青春期之间认知灵活性领域的表现改善更为频繁（76%）。对照组在抑制领域恶化的频率（36%）明显高于早产组（14%，χ = 4.8, p = 0.028）。结果表明，健康的早产个体在整个儿童期直至青春期都表现出执行功能的持续发展。
