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Cognitive development in low risk preterm infants at 3–4 years of life
  1. B Caravale1,
  2. C Tozzi2,
  3. G Albino2,
  4. S Vicari1
  1. 1IRCCS, Ospedale Pediatrico Bambino Gesù, Santa Marinella, Roma, Italy
  2. 2Dipartimento di Ginecologia, Perinatologia e Puericultura, Università “La Sapienza”, Roma, Italy
  1. Correspondence to:
    B Caravale
    UOS di Neurologia e Riabilitazione, IRCCS, Ospedale Pediatrico Bambino Gesù, Lungomare Guglielmo Marconi 36, I-00058, Santa Marinella, Rome, Italy;


Background: Major neurological handicaps and neuropsychological disturbances are more common in ex-preterm children than their counterparts born at term.

Objective: To establish in a prospective study whether a characteristic neuropsychological profile exists in ex-preterm children who do not exhibit neurodevelopmental deficits on routine clinical examination.

Methods: Thirty intellectually normal children born preterm (30–34 weeks gestation) without major neurological disabilities and a control group of term children matched for age, sex, and parental educational and occupational status were assessed at 3–4 years of age to obtain a complete neuropsychological profile. Intellectual ability, language comprehension and expression, perceptual and visual motor function, working memory, and attention and behavioural problems were investigated.

Results: Even in the absence of major neurological signs, children born preterm achieved lower mean scores than controls on the Stanford-Binet intelligence scale (110.8 v 121, p<0.001), visual perception test (33.8 v 42.7, p<0.001), visual motor integration test (42.6 v 47.4, p  =  0.049), memory for location test (8.4 v 9.5, p  =  0.007), sustained attention test (41.6 v 51.5, p  =  0.009), and the picture vocabulary test (33.3 v 44.7, p  =  0.021).

Conclusions: Neuropsychological abnormalities can be detected early in childhood in apparently normal ex-preterm children and are consistent with a growing body of evidence that prematurity may be associated with long term neuropsychological morbidity in childhood and adolescence.

  • ELBW, extremely low birthweight
  • IQ, intelligence quotient
  • LBW, low birthweight
  • VLBW, very low birthweight
  • preterm
  • low birth weight
  • outcome
  • cognitive
  • neuropsychological assessment

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  • Published online first 14 June 2005

  • Competing interests: none declared