Late preterm birth and neurocognitive performance in late adulthood: a birth cohort study

Pediatrics. 2015 Apr;135(4):e818-25. doi: 10.1542/peds.2014-3556. Epub 2015 Mar 2.


Objectives: We studied if late preterm birth (34 weeks 0 days-36 weeks 6 days of gestation) is associated with performance on the Consortium to Establish a Registry for Alzheimer's Disease Neuropsychological Battery (CERAD-NB) in late adulthood and if maximum attained lifetime education moderated these associations.

Methods: Participants were 919 Finnish men and women born between 1934 and 1944, who participated in the Helsinki Birth Cohort Study. They underwent the CERAD-NB at a mean age of 68.1 years. Data regarding gestational age (late preterm versus term) were extracted from hospital birth records, and educational attainment data were gathered from Statistics Finland.

Results: After adjustment for major confounders, those born late preterm scored lower on word list recognition (mean difference: -0.33 SD; P = .03) than those born at term. Among those who had attained a basic or upper secondary education, late preterm birth was associated with lower scores on word list recognition, constructional praxis, constructional praxis recall, clock drawing, Mini-Mental State Examination, and memory total and CERAD total 2 compound scores (mean differences: >0.40 SD; P values <.05), and had a 2.70 times higher risk of mild cognitive impairment (Mini-Mental State Examination score: <26 points) (P = .02). Among those with tertiary levels of education, late preterm birth was not associated with CERAD-NB scores.

Conclusions: Our findings offer new insight into the lifelong consequences of late preterm birth, and they add late preterm birth as a novel risk factor to the list of neurocognitive impairment in late adulthood. Our findings also suggest that attained lifetime education may mitigate aging-related neurocognitive impairment, especially among those born late preterm.

Keywords: education; epidemiology; follow-up studies; mild cognitive impairment; neurocognitive aging; neuropsychology; premature; premature birth; preterm.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Alzheimer Disease / diagnosis*
  • Alzheimer Disease / epidemiology
  • Alzheimer Disease / psychology
  • Cohort Studies
  • Educational Status
  • Female
  • Finland
  • Follow-Up Studies
  • Gestational Age*
  • Humans
  • Infant, Premature, Diseases / diagnosis*
  • Infant, Premature, Diseases / epidemiology
  • Infant, Premature, Diseases / psychology
  • Male
  • Mental Status Schedule / statistics & numerical data*
  • Neuropsychological Tests / statistics & numerical data*
  • Psychometrics / statistics & numerical data
  • Recognition, Psychology
  • Reference Values
  • Risk Factors
  • Verbal Learning