Abstract
Background
This paper examines the visuospatial working memory (WM) performance of children and adults born very preterm (VPT) and/or very low birth weight (VLBW) relative to their full-term (FT)-born peers. Of interest was the nature and severity of observed impairments, as well associations with educational/occupational functioning at each age point.
Methods
Participants were drawn from two prospective cohort studies: (1) a regional cohort of 110 VPT (<32 weeks’ gestation and <1500 g) and 113 FT born children assessed at age 12 years; (2) a national cohort of 229 VLBW (<1500 g) and 100 FT born adults assessed at age 28 years. Visuospatial WM was assessed using a four-span/difficulty-level computerized task.
Results
Both children and adults born VPT/VLBW had poorer visuospatial WM than FT controls, with their performance less accurate, slower (correct trials), and less efficient with increasing task difficulty (Cohen’s d = 0.27–0.51; p < 0.05). Adults had better visuospatial WM than children, but between-group differences were highly similar across ages, before and after adjustment for confounding social background and individual factors. Poorer WM was associated with lower levels of educational and occupational/socioeconomic achievement.
Conclusions
Visuospatial WM difficulties persist into adulthood raising concerns for the longer-term cognitive and adaptive functioning of VPT survivors.
Impact
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Both children and adults born very preterm have poorer visuospatial working memory than their term-born peers. They are less accurate, take longer to respond correctly and are less efficient, with test performance declining with increasing cognitive demand.
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Similar differences in visuospatial working memory are observed between VPT/VLBW and full-term individuals during both childhood and adulthood, with these differences remaining even after covariate adjustment.
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Individuals with poorer visuospatial working memory have lower levels of educational achievement and occupational/socioeconomic success.
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Visuospatial working memory difficulties persist into adulthood and appear to continue to impact everyday functioning and life-course opportunities.
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Funding
This work was supported by grants from the Health Research Council of New Zealand (11-283; 12-129) and Cure Kids (CHRF 5040; CHRF 5041) to B.A.D., L.J.H., and L.J.W., and a Mater Foundation Principal Research Fellowship to S.B. The funding sources had no role in the writing of the manuscript or in the decision to submit it for publication. The authors have no financial relationships relevant to this work to disclose.
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Substantial contributions to conception and design: B.A.D., L.J.H., and L.J.W.; acquisition of data: L.J.H. and B.A.D.; analysis: L.J.H. and S.B.; interpretation of data: all authors). Drafting the article or revising it critically for important intellectual content: L.J.W. with L.J.H., B.A.D., and S.B. Final approval of the version to be published: all authors.
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Woodward, L.J., Horwood, L.J., Darlow, B.A. et al. Visuospatial working memory of children and adults born very preterm and/or very low birth weight. Pediatr Res 91, 1436–1444 (2022). https://doi.org/10.1038/s41390-021-01869-w
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DOI: https://doi.org/10.1038/s41390-021-01869-w
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