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PEDIATRICS Vol. 102 No. 2 August 1998, pp. 329-336

Psychological Findings in Preterm Children Related to Neurologic Status and Magnetic Resonance Imaging

Received Aug 6, 1997; accepted Feb 19, 1998.

Paivi Olsén*, Dagger , Leena Vainionpää*, Eija Pääkkö§, Marit Korkmanparallel , Juhani Pyhtinen§, and Marjo-Riitta JärvelinDagger

From the Departments of * Pediatrics, Dagger  Public Health Science and General Practice, and § Radiology, University of Oulu, Oulu, Finland; and from parallel  the Department of Psychology, Free University of Brussels, Belgium.

Objective.  Preterm children experience learning disabilities more often than full-term children, but detailed information on their neuropsychological and neurologic determinants is lacking. We therefore examined these problems more closely and also studied if clinical neurologic examination and/or magnetic resonance imaging (MRI) can be used as tools to screen the preterm children at risk for these problems.

Methods.  In a population-based study, the psychological performance of 42 preterm children with a birth weight <1750 g and of their matched controls was assessed at 8 years of age and the findings were then related to clinical neurologic examination and MRI. Learning disabilities of these children, reported by the teachers, were also studied.

Results.  The cognitive ability of the preterm children, although in the normal range, was significantly lower than that of the control children. They performed particularly poorly in tasks requiring spatial and visuoperceptual abilities, which were associated with the finding of periventricular leukomalacia in MRI, especially with posterior ventricular enlargement. The preterm children with minor neurodevelopmental dysfunction (MND) had the most problems in neuropsychological tests, whereas the clinically healthy preterm children and those with cerebral palsy had fewer problems. The problems of MND children emerged in the domain of attention. They also experienced the most problems at school.

Conclusions.  Visuospatial problems were associated with periventricular leukomalacia in MRI, but learning disabilities were most frequent among the preterm children with minor neurologic abnormalities. We recommend closer follow-up of preterm children with MND.

Key words: cognition, preterm, magnetic resonance imaging, neurologic examination, follow-up studies.




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