Executive function deficits in children born preterm or at low birthweight: a meta-analysis.
Carolien A van Houdt, Jaap Oosterlaan, Aleid G van Wassenaer-Leemhuis and 2 others
PMID 30945271WHAT IT FOUND
Children born preterm or low birthweight had lower group scores than term-born controls on working memory, inhibition, and cognitive flexibility.
The three score differences were similar, and a gestational-age association was unstable.
Key findings
01Across pooled studies, children born preterm or low birthweight performed lower than term-born controls on working memory, inhibition, and cognitive flexibility.
02The pooled deficit sizes did not differ significantly between the three executive-function domains.
03For working memory, an apparent association with gestational age disappeared when two extreme gestational-age studies were removed.
STILL TO COME
How it was doneWhat they found
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What it does not show
Only 35 of the 45 eligible studies provided usable executive-function data, so some relevant studies were missing. Cognitive flexibility was based on only five studies, so its pooled result is less stable than working memory or inhibition. For working memory, only one study included children born after 32 weeks' gestation, so that group is poorly represented. Substantial heterogeneity was reported for working memory and inhibition, so the pooled deficit varied widely across studies. The apparent working-memory relationship with gestational age was driven by two extreme studies and disappeared when they were removed. The analysis included children assessed at least 4 years old, so it does not describe executive function before that age. Different executive-function tasks were combined within each domain, which assumes they measure the same construct.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not conclude that preterm or low birthweight birth causes a specific executive-function disorder in an individual child, or that any therapy will improve these deficits. This is a pooled group comparison of task scores, not a diagnostic test or an intervention study.