Kongstad Ida, Petersson Suzanne
Örebro University Hospital, Örebro, Sweden.
Faculty of Health and Life Sciences, MEO, Linnaeus University, Kalmar, Region Kalmar County, Sweden.
BMC Pediatr. 2025 Mar 15;25(1):196. doi: 10.1186/s12887-025-05564-1.
Children born small for gestational age (SGA) have shown an increased risk of developing cognitive impairment and more difficulties regarding academic performance later in life. However, it is not known whether cognitive impairment can be detected in very young children. This study aimed to investigate whether children born SGA, with a birthweight of ≤ 3 SD, aged 2:6-3:0 years, showed impairments of executive functions in everyday life based on parental ratings, compared to children born appropriate for gestational age (AGA).
Thirty children with birth week 33-41, 15 in each group, were included. The children in the groups were matched based on gender, age at testing (± 3 months), and parental educational level. Cognitive development was measured with the Bayley-III assessment. The BRIEF-P was used for parental ratings of the children's executive functioning.
In terms of development a statistically significant difference between groups was shown regarding language ability, where the SGA group performed slightly worse compared to the AGA group (MD = -10.5 index points; 95% CI = -18.7-2.2; t(14) = -2.7; p = 0.02). No statistically significant differences were found between groups regarding parental ratings on the BRIEF-P.
The study found no significant differences in EF between children born SGA and AGA based on parental ratings. Given the small sample the lower language ability in the SGA group suggests potential EF impairments, which could be detected at a younger age than is presently customary. These findings underscore the need for further research using varied assessment methods and larger samples to better understand EF development in this population. Early discovery of EF impairment is important for enabling adequate interventions for family, school, and health care.
小于胎龄儿(SGA)出生的儿童在日后出现认知障碍的风险增加,在学业表现方面也会面临更多困难。然而,尚不清楚能否在幼儿期检测出认知障碍。本研究旨在调查出生体重≤3标准差、年龄在2岁6个月至3岁的小于胎龄儿,与适于胎龄儿(AGA)相比,基于父母评分,在日常生活中是否存在执行功能障碍。
纳入30名出生孕周为33 - 41周的儿童,每组15名。两组儿童根据性别、测试时年龄(±3个月)和父母教育水平进行匹配。使用贝利婴幼儿发展量表第三版(Bayley-III)评估认知发展。使用执行功能行为评定量表家长版(BRIEF-P)对儿童的执行功能进行家长评分。
在发育方面,两组在语言能力上显示出统计学上的显著差异,小于胎龄儿组的表现略逊于适于胎龄儿组(平均差=-10.5指数点;95%置信区间=-18.7 - 2.2;t(14)=-2.7;p=0.02)。在执行功能行为评定量表家长版的家长评分方面,两组未发现统计学上的显著差异。
该研究发现,基于父母评分,小于胎龄儿和适于胎龄儿在执行功能方面无显著差异。鉴于样本量较小,小于胎龄儿组较低的语言能力表明可能存在执行功能障碍,且这种障碍可能在比目前习惯的年龄更小的时候就能被检测到。这些发现强调需要使用多种评估方法和更大的样本进行进一步研究,以更好地了解这一人群的执行功能发展。早期发现执行功能障碍对于为家庭、学校和医疗保健提供适当干预非常重要。