Cognitive development at 5.5 years of children with chronic lung disease of prematurity

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Abstract
Background: Preterm infants with chronic lung disease (CLD) had impaired cognitive development and poorer eye-hand coordination at 10 months of age. Aims: To study whether this effect of CLD persisted until school age and whether the severity of CLD affected outcome. Method: Cognition and visual-motor skills were examined (Wechsler preschool and primary scale of intelligence, and tests from the Nepsy scale) in 60 very preterm children, without intraventricular haemorrhage or periventricular leucomalacia, at 5.5 years of age. Thirty two children suffered from CLD and 28 were controls. Results: The groups did not differ significantly in cognitive outcome. Children with CLD and controls attained a full scale intelligence quotient (IQ) of 94.4 and 99.1, a verbal IQ of 99.6 and 101.5, and a performance IQ of 90.9 and 96.7 respectively. Similarly, no difference was found in tests of eye-hand control. However, the children with the most severe form of CLD had significantly lower performance (84.8) and full scale(87.6) IQs and worse visual-motor performance than the controls. CLD grade III, together with the need for glasses or lenses, had a significant impact on the explained variance. Conclusions: At school age, children born very preterm and who experienced severe CLD had deficits in cognition, visual-motor perception, and performance. The findings suggest a need to consider intervention programmes for such infants.