[Article Review] The Long-term Impact of Being Born Small for Gestational Age on Cognitive Performance

Reference

Eves, R., Mendonça, M., Bartmann, P., & Wolke, D. (2020). Small for gestational age—cognitive performance from infancy to adulthood: an observational study. BJOG: An International Journal of Obstetrics & Gynaecology, 127(13), 1600-1606. https://doi.org/10.1111/1471-0528.16341

Review

Eves et al. (2020) aimed to investigate the cognitive performance of individuals born small for gestational age (SGA) from infancy to adulthood and determine if the effect depends on the SGA reference used. The study involved 414 participants, including 197 term-born and 217 very preterm/very low birth weight (VP/VLBW) individuals, and used neonatal or fetal growth references to classify SGA. The results indicated that SGA is associated with an eight-point lower IQ compared to appropriate for gestational age, regardless of the reference used. The difference was evident throughout development but narrowed minimally in adulthood. Moreover, the authors found that low socioeconomic status and a poor parent-infant relationship were associated with lower IQ, which was comparable to the effects of SGA.

The study’s strengths lie in its comprehensive evaluation of cognitive performance across different developmental stages and its consideration of potential confounding factors such as VP/VLBW, socioeconomic status, and parent-infant relationship. The use of two SGA references also increases the study’s validity. However, the study's limitations include the lack of ethnic diversity in the sample and the use of only one measure for parent-infant relationship assessment. Nonetheless, the findings suggest that social factors should be considered for interventions aimed at improving cognitive development in SGA individuals.

The study’s findings have significant implications for healthcare providers and policymakers. Identifying SGA individuals and providing appropriate interventions could potentially mitigate the risk of lower IQ throughout development. Additionally, the study’s results suggest the importance of addressing social determinants of health to improve cognitive outcomes in individuals born to SGA. Healthcare providers could potentially screen for SGA individuals and offer developmental interventions while considering potential social factors affecting cognitive performance.

[Article Review] How Very Preterm Birth or Very Low Birth Weight Impacts Intelligence in Adulthood

Reference

Eves, R., Mendonça, M., Baumann, N., Ni, Y., Darlow, B. A., Horwood, J., Woodward, L. J., Doyle, L. W., Cheong, J., Anderson, P. J., Bartmann, P., Marlow, N., Johnson, S., Kajantie, E., Hovi, P., Nosarti, C., Indredavik, M. S., Evensen, K.-A. I., Räikkönen, K., Heinonen, K., Zeitlin, J., & Wolke, D. (2021). Association of very preterm birth or very low birth weight with intelligence in adulthood: An individual participant data meta-analysis. JAMA Pediatrics, 175(8), e211058. https://doi.org/10.1001/jamapediatrics.2021.1058

Review

In this article, Eves et al. (2021) assessed the differences in adult IQ between individuals born very preterm (VPT) or with very low birth weight (VLBW) and term-born individuals. The authors conducted a systematic review of published data and a meta-analysis of individual participant data (IPD) from cohorts in two consortia (RECAP and APIC). The study included 2135 adults (1068 VPT/VLBW and 1067 term-born participants) born between 1978 and 1995.

The researchers found that VPT/VLBW participants had mean adult IQ scores that were 0.78 SD lower than term-born participants, equivalent to a difference of 12 IQ points. Among VPT/VLBW participants, lower gestational age, lower birth weight z scores, the presence of neonatal bronchopulmonary dysplasia or any grade of intraventricular hemorrhage, and lower maternal educational levels were all significantly associated with lower IQ scores in adulthood.

The findings from this IPD meta-analysis provide valuable insights into the factors associated with lower adult IQ in individuals born with VPT or VLBW. The study emphasizes the importance of addressing neonatal morbidities and maternal educational levels as potential interventions to improve long-term cognitive outcomes for this population.

[Article Review] Early SSRI Treatment in 22q11.2 Deletion Syndrome: A Promising Path for Cognition and Brain Development?

Reference

Mancini, V., Maeder, J., Bortolin, K., Schneider, M., Schaer, M., & Eliez, S. (2021). Long-term effects of early treatment with SSRIs on cognition and brain development in individuals with 22q11.2 deletion syndrome. Translational Psychiatry, 11, 336. https://doi.org/10.1038/s41398-021-01480-3

Review

The present study by Mancini et al. (2021) investigates the long-term effects of early treatment with selective serotonin reuptake inhibitors (SSRIs) on cognition and brain development in individuals with 22q11.2 deletion syndrome (22q11DS). This genetic disorder has the highest risk for schizophrenia, making it an ideal population for studying the development of individuals at risk for psychosis. The authors conducted a retrospective cohort study with 98 participants, aged 10 to 32, diagnosed with 22q11DS, and followed up 2–4 times.

The participants were divided into three groups: those without psychiatric disorders and no psychotropic medications (n = 30), those with psychotic symptoms but not treated with SSRIs (n = 30), and those receiving SSRI treatment (n = 38). The authors observed increased IQ scores and developmental trajectories in participants treated with SSRIs, including those with psychotic symptoms. Additionally, the thickness of frontal regions and hippocampal volume were relatively increased in the treated group. The magnitude of the outcomes was inversely correlated to the age at the onset of the treatment.

This study provides preliminary evidence that early long-term treatment with SSRIs may attenuate the cognitive decline associated with psychosis in 22q11DS and developmental brain abnormalities. The findings hold promise for identifying novel strategies to improve cognitive and brain development in individuals with 22q11DS, as well as other populations at risk for psychosis. However, more research is needed to confirm and expand these findings and to explore the potential benefits and risks of early SSRI treatment in this population.