504 - Executive Functioning in Adults Born Preterm With Very Low Birth Weight- A Two-Country Birth Cohort Study

Poster Number: 504
Publication Number: 504.1541

Background: Challenges with executive functioning in daily life are common among children born preterm ( < 37 weeks of gestation) with very low birth weight (VLBW; ≤1500g). However, whether these challenges persist into mid-adulthood is not known.

Objective: To assess self-reported executive functions in mid-adulthood in a group of adults born preterm with VLBW and a control group of adults born at term and to compare changes in executive functions from young to mid-adulthood between the groups.

Design/Methods: In a joint study, participants were recruited from two birth cohorts: the Helsinki Study of Very Low Birth Weight Adults in Finland and the NTNU Low Birth Weight Life study in Norway. We assessed 137 adults born preterm with VLBW and 158 adults born at term with a mean age of 35.9 (SD 3.2). We harmonized data from a previous follow-up (of 99 VLBW and 81 control participants) in both birth cohorts at a mean age of 24.4 (SD 2.2). Self-reported executive functions were assessed with the Behavior Rating Inventory of Executive Function-Adult version (BRIEF-A). Linear regression was performed to assess mean differences between the VLBW and control group, and a mixed model analysis was performed to assess the effect of age (young versus mid-adulthood) on BRIEF-A composite scores in the two groups (group x age). All analyses were adjusted for birth cohort, sex, age, and parental education.

Results: Mean Global Executive Composite (GEC) score was 100.7 (SD 23.5) in the VLBW group and 94.6 (SD 19.5) in the control group. Adjusted mean difference was 6.2 (95% CI: 1.2 to 11.1, p=.016). Mean differences for the Behavioral Regulation Index and Meta Cognition Index (MCI) were 2.9 (95% CI: 0.70 to 5.1, p=.010) and 3.9 (95% CI: 1.0 to 6.8, p=.012), respectively. Scores of the clinical scales inhibition, shift, initiate, and working memory were also higher in the VLBW group compared with the control group (Table 1). There was an interaction effect of group x age on GEC and MCI scores (Figure 1). The control group showed an improvement in executive functions from 24 to 36 years, but this was not seen in the VLBW group.

Conclusion(s): Individuals born preterm with VLBW reported more challenges with executive functioning than controls in mid-adulthood. The general improvement in executive functions from young to mid-adulthood in the control group was not found in the VLBW group. This finding indicates that the gap in executive functions between individuals born VLBW and at term may persist across adulthood.