Neurodevelopmental Disorders in Preterm Children born in Iceland between 2012 and 2017

Abstract

Introduction: Survival among extremely preterm infants has increased markedly due to advances in neonatal care. These children remain at elevated risk for neuropsychological difficulties, particularly ADHD, autism spectrum disorder (ASD), and executive function deficits, which impacts learning, behavior, and emotional regulation. This study aimed to assess the prevalence of such difficulties at 6-7 years of age and the proportion referred to The Councelling and Diagnostic Center (CDC). Methods: This was a retrospective cohort study. Data from neuropsychological assessments by the Children’s Hospital follow-up care for preterm infants and CDC evaluations were analyzed using RStudio 4.3.3. Results: The cohort included 60 children born before 28 weeks of gestation and/or with birthweight below 1000g. 18 (30.0%) were followed at the CDC and 45 underwent neuropsychological assessment at the Children’s Hospital. Attention difficulties were present in 53.3%, executive function deficits in 46.7%, hyperactivity in 28.6%, and signs of ASD in 13.3%. Full-scale IQ could not be determined in 64.4% of the children due to significant discrepancies between subtest scores, making it an unreliable measure of cognitive ability. Significant differences in the ability to obtain a full-scale IQ score (p<0,05) by sex. No significant associations were observed with ADHD or ASD or executive function deficits. Conclusion: Neurodevelopmental disorders are common among extremely preterm infants, and the findings suggest that a large proportion of them need to undergo further diagnostic evaluation. The results also indicate that many will require support within the educational and healthcare systems.