Abstract
Objectives:
Poor executive functioning is associated with life-long difficulty. Identification of children at risk for executive dysfunction is important for early intervention to improve neurodevelopmental outcomes.
Study design:
This study is designed to examine relationships between birthweight and executive functioning in US children during kindergarten. Our hypothesis was that children with higher birthweights would have better executive function scores. We evaluated data from 17506 US children from the Early Childhood Longitudinal Study—Kindergarten 2011 cohort. Birthweight and gestational age were obtained by parental survey. Executive functions were directly assessed using the number reverse test and card sort test to measure working memory and cognitive flexibility, respectively. Teacher evaluations were used for additional executive functions. Data were analyzed using SAS to run all linear and logistical regressions.
Results:
For every kilogram of birthweight, scores of working memory increased by 1.47 (P<0.001) and cognitive flexibility increased by 0.28 (P<0.001) independent of gender, gestational age, parental education, and family income. Low birthweight infants were 1.5 times more likely to score in the bottom 20% of children on direct assessment OR=1.49 (CI 1.21−1.85) and OR=1.55 (CI 1.26−1.91).
Conclusions:
Infants born low birthweight are at increased risk of poor executive functioning. As birthweight increases executive function scores improve, even among infants born normal weight. Further evaluation of this population including interventions and progression through school is needed.
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Acknowledgements
This work was supported by Doris Duke Charitable Foundation, Clinical Scientist Development Award (RJS).
Author contributions
SEM participated in the design and analysis of the research and was responsible for the first draft of the manuscript. MDDB participated in the design and analysis of the research and the write-up. RJS participated in the design and analysis of the research and the write-up. All authors approved of the final manuscript as submitted and agree to be accountable for all aspects of the work.
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Miller, S., DeBoer, M. & Scharf, R. Executive functioning in low birth weight children entering kindergarten. J Perinatol 38, 98–103 (2018). https://doi.org/10.1038/jp.2017.147
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DOI: https://doi.org/10.1038/jp.2017.147
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