Lee Samantha J, Woodward Lianne J, Moor Stephanie, Austin Nicola C
School of Health Sciences and Canterbury Child Development Research Group, University of Canterbury, Christchurch, New Zealand.
Older Person's Mental Health, Burwood Hospital, Christchurch, New Zealand.
Front Psychol. 2024 Dec 11;15:1487908. doi: 10.3389/fpsyg.2024.1487908. eCollection 2024.
Children born very preterm (VPT; <32 weeks) are at increased risk of executive functioning (EF) difficulties. But less is known about the nature and extent of these executive difficulties during late adolescence, particularly across multiple EF domains and in response to varying degrees of executive demand.
Using data from a prospective longitudinal study, this paper describes the EF profiles of 92 VPT and 68 full-term (FT) adolescents at age 17 years. Relations between gestational age (GA) and later EF performance, in addition to neonatal predictors, were examined.
VPT-born adolescents performed less well than FT adolescents across the domains of working memory, planning, and cognitive flexibility, with the largest differences observed for those born <28 weeks GA (effect sizes -0.6 to -1.0 SD), and when task demands were high. The effects of GA on EF outcome were fully mediated by neonatal medical complexity ( = 0.169, = -1.73) and term equivalent white matter abnormalities ( = 0.107, = -3.33).
Findings support the need for long-term cognitive support for individuals born very preterm, particularly those exposed to high levels of medical and neurological risk, with these factors largely explaining associations between GA and EF outcome.
极早产儿（VPT；孕周<32周）出现执行功能（EF）困难的风险增加。但对于青春期后期这些执行功能困难的性质和程度，尤其是在多个EF领域以及对不同程度执行需求的反应方面，我们了解较少。
利用一项前瞻性纵向研究的数据，本文描述了92名极早产儿和68名足月儿（FT）在17岁时的EF概况。研究了胎龄（GA）与后期EF表现之间的关系，以及新生儿预测因素。
在工作记忆、计划和认知灵活性等领域，极早产儿出生的青少年表现不如足月儿出生的青少年，对于那些孕周<28周出生的青少年（效应大小为-0.6至-1.0标准差）以及任务需求较高时，差异最为明显。GA对EF结果的影响完全由新生儿医疗复杂性（β = 0.169，t = -1.73）和足月等效白质异常（β = 0.107，t = -3.33）介导。
研究结果支持对极早产儿个体提供长期认知支持的必要性，特别是那些面临高水平医疗和神经风险的个体，这些因素在很大程度上解释了GA与EF结果之间的关联。
