Executive functioning in adults born with very low birth weight

Few have explored executive functioning in individuals born preterm into adulthood. We assessed whether challenges with executive functions in individuals born with very low birth weight (VLBW ≤ 1500g) persist into mid-adulthood. From two birth cohorts from Finland and Norway, 137 VLBW adults and 158 term-born controls were assessed with the Behavior Rating Inventory of Executive Function - Adult version (BRIEF-A) and the Trail Making Test (TMT) at mean age 35.9 (SD3.2) years. We also pooled data from both birth cohorts at young adulthood (23–26 years). Linear regression analyses were performed to assess mean differences between the VLBW and control group, and the interaction effect with age, adjusted for birth cohort and sex. In mid-adulthood, the Global Executive Composite score was 6.2 (95% CI: 1.3, 11.6) points higher in the VLBW group than in the control group, indicating poorer functioning. Group differences were also observed in metacognition and behavioral regulation. The VLBW group used 6.3 (95%CI: 3.9, 8.9) seconds more on TMT-2 and 22.8 (95%CI: 16.2, 29.6) seconds more on TMT-4 than the control group. Executive functioning generally improved from young to mid-adulthood in the control group, but not in the VLBW group. Our findings suggest that the gap between the groups in executive functioning becomes larger across adulthood.