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Premature birth is a significant risk factor for various developmental challenges, including attention-deficit/hyperactivity disorder (ADHD), social development issues, and lower academic performance. However, previous studies have not fully captured the diversity of outcomes seen in preterm-born children. A new study led by researchers at NYU Grossman School of Medicine identified three distinct profiles among preterm children, each with different results on cognitive and behavioral tests. These findings challenge the misconception that all preterm babies will face cognitive and behavioral deficits.

The first profile, representing 19.7% of children tested, performed above the average for full-term children on cognitive tests. The second profile, encompassing 41% of the children, exhibited both strengths and weaknesses in cognitive abilities. In contrast, the third profile, comprising 39.3% of children, scored below the norm on all tests, leading to attention deficits and lower academic grades. The study highlighted the significant variation in outcomes among preterm-born children, emphasizing the need for tailored care and interventions based on individual profiles.

Neuroimaging revealed differences in brain volume and connectivity between the three profiles. Children in profile 3, with the lowest cognitive and behavioral scores, had smaller brain volumes and weaker functional connectivity between key brain networks. These findings suggest potential neurobiological factors influencing the varying outcomes among preterm children. Further research is needed to explore the underlying causes of these differences and their implications for targeted interventions and treatments.

The study also found disparities based on race, with Black preterm children being nearly four times more likely to fall into the lower-performing profile. This highlights the importance of addressing social and structural factors that may contribute to inequities in care and outcomes for preterm-born children. Initiatives aimed at providing equitable access to therapies and interventions could help improve outcomes for all preterm infants, regardless of race or socioeconomic status.

Moving forward, the research team plans to investigate common factors contributing to poor outcomes among preterm children and identify protective factors that promote positive development. By understanding the complex interplay of genetic, environmental, and social factors influencing preterm birth outcomes, researchers aim to improve diagnostic accuracy and develop more effective interventions for children at risk for cognitive and behavioral challenges. This study underscores the need for personalized approaches to treating preterm-born children and advocates for a comprehensive, equitable system of care for all infants born prematurely.

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