This study assessed the impact of extremely preterm birth on academic attainment at 11 years of
age, investigated neuropsychological antecedents of attainment in reading and mathematics, and
examined early predictors of educational outcomes. Children born extremely preterm had significantly
poorer academic attainment and a higher prevalence of learning difficulties than their term
peers. General cognitive ability and specific deficits in visuospatial skills or phoneme deletion at 6
years were predictive of mathematics and reading attainment at 11 years in both extremely preterm
and term children. Phonological processing, attention, and executive functions at 6 years were also
associated with academic attainment in children born extremely preterm. Furthermore, social factors,
neonatal factors (necrotizing enterocolitis, breech delivery, abnormal cerebral ultrasound, early
breast milk provision), and developmental factors at 30 months (head circumference, cognitive development),
were independent predictors of educational outcomes at 11 years. Neonatal complications
combined with assessments of early cognitive function provide moderate prediction for educational
outcomes in children born extremely preterm
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