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Neurodevelopmental Outcomes in Preterm Children with Sickle Cell Disease

Published online by Cambridge University Press:  29 November 2021

Sarah E. Bills Open the ORCID record for Sarah E. Bills [Opens in a new window] ,
Jeffrey Schatz Open the ORCID record for Jeffrey Schatz [Opens in a new window] ,
Erin Hunt ,
Sreya Varanasi ,
Julia Johnston  and
Jessica Bradshaw
Sarah E. Bills*
Affiliation:
Department of Psychology, University of South Carolina, Columbia, SC, USA
Jeffrey Schatz
Affiliation:
Department of Psychology, University of South Carolina, Columbia, SC, USA
Erin Hunt
Affiliation:
Department of Psychology, University of South Carolina, Columbia, SC, USA
Sreya Varanasi
Affiliation:
Department of Psychology, University of South Carolina, Columbia, SC, USA
Julia Johnston
Affiliation:
Department of Psychology, University of South Carolina, Columbia, SC, USA
Jessica Bradshaw
Affiliation:
Department of Psychology, University of South Carolina, Columbia, SC, USA
*
*Correspondence and reprint requests to: Sarah E. Bills, M.A., Department of Psychology, University of South Carolina, Columbia, SC, 29208, USA. E-mail: sbills@email.sc.edu
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Abstract

Objectives:

To explore the combined effect of pediatric sickle cell disease (SCD) and preterm birth on cognitive functioning.

Methods:

Cognitive functioning was examined in children ages 6–8 with high risk SCD genotypes born preterm (n = 20) and full-term (n = 59) and lower risk SCD genotypes/no SCD born preterm (n = 11) and full-term (n = 99) using tests previously shown to be sensitive to SCD-related neurocognitive deficits. Factorial ANOVAs and log linear analyses were conducted to examine the relationship between SCD risk, preterm birth status, and cognitive outcomes. Continuous scores were examined for specific tests. Children were categorized as having an abnormal screening outcome if at least one cognitive score was ≥1.5 standard deviations below the population mean.

Results:

Children with elevated risk due to high risk SCD and preterm birth performed worse than other groups on a test of expressive language but not on tests that emphasize processing speed and working memory. There was a three-way interaction between preterm status, SCD risk, and abnormal screening outcome, which was largely driven by the increased likelihood of abnormal cognitive scores for children with high risk SCD born preterm.

Conclusions:

The combination of SCD and preterm birth may confer increased risk for language deficits and elevated rates of abnormal cognitive screenings. This suggests that neurodevelopmental risk imparted by comorbid SCD and preterm birth may manifest as heterogenous, rather than specific, patterns of cognitive deficits. Future studies are needed to clarify the domains of cognitive functioning most susceptible to disease-related effects of comorbid SCD and preterm birth.

Keywords

Premature birthcognitive functioningdouble hitchronic illnessbrain developmentneurocognitive risk
Type
Research Article
Information
Journal of the International Neuropsychological Society , Volume 28 , Issue 10 , November 2022 , pp. 1039 - 1049
Copyright
Copyright © INS. Published by Cambridge University Press, 2021

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