Rossetti Lauren, Pascoe Leona, Mainzer Rheanna M, Ellis Rachel, Olsen Joy E, Spittle Alicia J, Doyle Lex W, Cheong Jeanie L Y, Anderson Peter J
School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia; Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia.
School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia; The Centre for Community Child Health, Murdoch Children's Research Institute, Melbourne, Australia.
J Pediatr. 2025 Sep;284:114634. doi: 10.1016/j.jpeds.2025.114634. Epub 2025 May 8.
To compare executive function (EF) outcomes at school age between children born moderate-to-late preterm (MLP; 32-36 weeks' gestation) and term (≥37 weeks' gestation) across subdomains of attentional control, cognitive flexibility, goal setting, and everyday executive behaviors.
Two hundred one children born MLP and 201 born at term were recruited from the Royal Women's Hospital, Melbourne, Australia. Children completed EF measures at 9 years of corrected age. Group differences in mean or median outcome z-scores were estimated using linear or quantile regression. EF impairment risk ratios [RRs] between groups were estimated using generalized linear models. Analyses were adjusted for multiple birth and social risk.
One hundred fifty-nine children born MLP (79%) and 134 born at term (67%) were assessed. Compared with the term group, the MLP group performed poorer in goal setting (mean difference = -0.26, 95% CI = -0.50, -0.03, P = .03) and cognitive flexibility (mean difference = -0.32, 95% CI = -0.59, -0.05, P = .02). Children born MLP were at increased risk of behavioral executive dysfunction (RR = 1.86, 95% CI = 1.05, 3.27, P = .03), impairments in cognitive flexibility (RR = 1.80, 95% CI = 1.05, 3.09, P = .03), and goal setting (RR = 1.69, 95% CI = 1.08, 2.65, P = .02).
Children born MLP demonstrate a pattern of increased EF difficulties at school-age compared with term children, mostly within the goal setting subdomain. These difficulties are likely to affect other outcomes such as academic performance and social skills.
比较中度至晚期早产儿（MLP；妊娠32 - 36周）和足月儿（≥37周妊娠）在学龄期注意力控制、认知灵活性、目标设定和日常执行行为等子领域的执行功能（EF）结果。
从澳大利亚墨尔本皇家妇女医院招募了201名中度至晚期早产儿和201名足月儿。儿童在矫正年龄9岁时完成了EF测量。使用线性或分位数回归估计平均或中位数结果z分数的组间差异。使用广义线性模型估计组间的EF损害风险比[RRs]。分析对多胎和社会风险进行了调整。
评估了159名中度至晚期早产儿（79%）和134名足月儿（67%）。与足月儿组相比，中度至晚期早产儿组在目标设定（平均差异 = -0.26，95%置信区间 = -0.50，-0.03，P = 0.03）和认知灵活性（平均差异 = -0.32，95%置信区间 = -0.59，-0.05，P = 0.02）方面表现较差。中度至晚期早产儿出现行为执行功能障碍（RR = 1.86，95%置信区间 = 1.05，3.27，P = 0.03）、认知灵活性损害（RR = 1.80，95%置信区间 = 1.05，3.09，P = 0.03）和目标设定损害（RR = 1.69，95%置信区间 = 1.08，2.65，P = 0.02）的风险增加。
与足月儿相比，中度至晚期早产儿在学龄期表现出执行功能困难增加的模式，主要在目标设定子领域。这些困难可能会影响其他结果，如学业成绩和社交技能。
