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• Posted August 14, 2024

Not Born Equal: Preemie Babies Fall Into 3 Risk Categories

Not all babies born prematurely will suffer long-term developmental problems, a new study finds.

Preemies tend to fall into three risk categories, with about one in five (20%) scoring above average on standard cognitive tests, researchers reported Aug. 13 in the journal Child Development.

A second profile representing 41% of preemies scored above normal on tests of memory, vocabulary and reading, but below average on tests of pattern recognition and working memory, researchers said.

And a third profile representing nearly 40% of preemies scored below normal on all tests, suffering both cognitive and attention deficits.

“Our study dispels the notion that every preterm child is born with cognitive and behavioral deficits,” said lead researcher Iris Menu, a post-doctoral scholar of child and adolescent psychiatry with the NYU Grossman School of Medicine in New York City.

About 13 million babies are born prematurely each year, and preterm birth has been linked to a higher risk of ADHD, problems with social development and lower grades, researchers said in background notes.

But the tendency to lump preemies into a single group hinders efforts to tailor care for any one child, they added.

For the study, researchers analyzed cognitive and behavioral data for nearly 1,900 boys and girls born prematurely who had reached 9 to 11 years of age.

The team found that children who fell within the first profile did an average 21% better on standard cognitive tests than kids in the third profile.

Children in the first profile also fared better when it came to attention deficits, with only 2.5% suffering from them compared with about 10% of those in the third profile.

First-profile children also did better in school, with more than 66% achieving a grade average of A- or better compared with about 61% of the second profile and 32% of the third, results show.

“Precision psychiatry is not based on a general diagnosis, because two patients with the same diagnosis, like preterm birth, may have totally different experiences,” said senior researcher Moriah Thomason, vice chair for research of child and adolescent psychiatry at the NYU Grossman School of Medicine. “Our work highlights the complexity of preterm birth, and promises to improve treatment for each individual child.”

Brain scans of the children revealed that the kids in the third profile had brains an average 3% smaller by ages 9 to 11 than kids in the first profile.

Researchers also found weaker connections between two key brain circuits in third-profile kids -- the dorsal attention network that plays a role in sustaining attention, and the default mode network that handles brain processing when a person isn’t focused on a specific task.

The connection between these two networks was 11% weaker in third-profile kids compared to first-profile children.

This profiling approach could help researchers better direct education, therapy and drug treatment to the preemies most likely to need it, researchers said.

“Based on these results, we call for the launch of social and structural interventions that ensure all preterm-born children receive equitable care,” Menu said in a university news release.

“Children that get speech, physical and behavioral therapy almost every day, which is more likely to happen in affluent households, tend do better on the study tests, but there are other factors involved,” Menu added. “For instance, children in communities where more are covered by health insurance were less likely to belong to Profile 3.”

The team also noted that Black preterm children were nearly four times as likely to fall into the lower-performing third profile.

More information

The American Academy of Pediatrics has more on developmental milestones for preemies.

SOURCE: New York University, news release, Aug. 13, 2024