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The Role of Executive and General Cognitive Functioning in the Attention Problems of Very and Extremely Preterm Adults

Eves, R; von Mühlenen, A; Mendonça, M; Johnson, S; OʼReilly, H; Bartmann, P; Marlow, N; (2020) The Role of Executive and General Cognitive Functioning in the Attention Problems of Very and Extremely Preterm Adults. Journal of Developmental & Behavioral Pediatrics , 41 (6) pp. 461-469. 10.1097/DBP.0000000000000806. Green open access

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Abstract

OBJECTIVE: To determine whether the attention problems in adults born very preterm/very low birth weight (VP/VLBW; <32 weeks' gestation/<1500 g) or extremely preterm (EP; <26 weeks' gestation) are associated with specific executive or general cognitive deficits. METHOD: Cohorts of VP/VLBW (the Bavarian Longitudinal Study [BLS]) and EP (the EPICure Study) participants were followed from birth to early adulthood, each also following a respective control group. Adult attention deficit hyperactivity disorder (ADHD) symptoms were assessed via self-report in both cohorts and additionally by parent report in the BLS. Participants in both cohorts also had their attention span rated by trained observers. Performed separately in each cohort, hierarchical regression analyses were used to assess whether the association between preterm birth status and attention problems remained after accounting for executive functioning (inhibitory control and working memory) in adulthood, childhood intelligence score (IQ), or sex. RESULTS: In the discovery cohort of the BLS, significant differences were found between VP/VLBW adults and controls for parent-rated inattention (p < 0.001). However, for self-reported measures of ADHD, no significant differences were found in the BLS or in the EPICure replication cohort. In both cohorts, observer-rated attention spans were lower for VP/VLBW and EP participants in comparison to their respective control groups (p < 0.001). In final models for the BLS, inhibitory control and childhood IQ were significantly associated with parent-rated inattention symptoms (p < 0.006), whereas working memory and childhood IQ were significantly associated with observer-rated attention span (p < 0.001). The effect of childhood IQ on observer-rated attention span was replicated in EPICure. CONCLUSION: VP/VLBW and EP adults are at increased risk of observer-rated attention problems. These problems were predominantly associated with poorer general cognitive ability in early childhood and somewhat with adult executive functioning.

Type: Article
Title: The Role of Executive and General Cognitive Functioning in the Attention Problems of Very and Extremely Preterm Adults
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1097/DBP.0000000000000806
Publisher version: https://doi.org/10.1097/DBP.0000000000000806
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher's terms and conditions.
Keywords: Attention-deficit; Hyperactivity Disorder; Preterm; attention; executive functioning; intelligence
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health > Neonatology
URI: https://discovery.ucl.ac.uk/id/eprint/10097581
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