Cl. Fawer et al., INFLUENCE OF PERINATAL, DEVELOPMENTAL AND ENVIRONMENTAL-FACTORS ON COGNITIVE-ABILITIES OF PRETERM CHILDREN WITHOUT MAJOR IMPAIRMENTS AT 5 YEARS, Early human development, 43(2), 1995, pp. 151-164
The relative role of perinatal factors (birthweight, gestational age,
gender, asphyxia, mechanical ventilation and cerebral lesions), develo
pmental factors (neuromotor development during the first 18 months of
life) and environmental factors (socio-economic status and bilingualis
m) on cognitive abilities was evaluated in a cohort of preterm childre
n who had been prospectively examined for haemorrhage (PVH) and perive
ntricular leucomalacia (PVL) and followed-up to 5 years of age. Standa
rdised neurological examinations and development assessment including
tests of cognitive function were carried out. Major impairments could
be ascribed to the presence of large PVL changes. Among the 226 childr
en without major impairment, the overall incidence of neuropsychologic
al anomalies (neuromotor, language, visual, auditory and behaviour ano
malies) was 46.5% and did not differ within ultrasound groups (normal
scans, PVH and small PVL). However, children with small changes of PVL
presented more abnormal neuromotor development within the first 18 mo
nths of life and had more complex neuropsychological anomalies at 5 ye
ars. The multiple regression analysis (General Intellectual Index (GII
) predicted = 113.7 - coefficient x social class - 8.5 x bilingualism
- 5.5 x dystonia + 1.4 x gestational age + 8 x mechanical ventilation)
showed that socioeconomic status was the most important factor affect
ing the General Intellectual Index (GII). The contribution of sex and
cerebral lesions was not significant. As children grew-up, environment
al factors seemed to overcome perinatal factors.