The effect of birthweight and gestational age on cognitive function in midlife: the Bogalusa heart study

Abstract Background Although the relationships between birthweight, gestational age (GA), and cognitive function (CF) before midlife have been demonstrated, the relationships after midlife and potential racial disparities remain inconclusive. This study examined the association between birthweight,...

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Main Authors: Eunsun Gill, David J. Libon, Soo Jung Kang, Ileana De Anda-Duran, Lydia A. Bazzano, Wei Chen, Camilo Fernandez-Alonso, Emily W. Harville
Format: Article
Language:English
Published: BMC 2025-06-01
Series:BMC Neurology
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Online Access:https://doi.org/10.1186/s12883-025-04242-0
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author Eunsun Gill
David J. Libon
Soo Jung Kang
Ileana De Anda-Duran
Lydia A. Bazzano
Wei Chen
Camilo Fernandez-Alonso
Emily W. Harville
author_facet Eunsun Gill
David J. Libon
Soo Jung Kang
Ileana De Anda-Duran
Lydia A. Bazzano
Wei Chen
Camilo Fernandez-Alonso
Emily W. Harville
author_sort Eunsun Gill
collection DOAJ
description Abstract Background Although the relationships between birthweight, gestational age (GA), and cognitive function (CF) before midlife have been demonstrated, the relationships after midlife and potential racial disparities remain inconclusive. This study examined the association between birthweight, GA, and midlife CF stratified by race. Method 1,032 subjects from the Bogalusa Heart Study (67% Whites, 33% Blacks, mean age 48.1 ± 5.3 years) were studied. Cognition was assessed with tests measuring verbal episodic memory, working memory, attention, graphomotor information processing speed, and global CF. Each test was standardized by sex and age, then averaged. The global CF was computed by averaging all cognitive test scores. Standardized scores from the Wide Range Achievement Test-IV (WRAT- IV)–Reading subtest and the Wechsler Adult Intelligence Scale- IV (WAIS-IV)–Vocabulary subtest measured achieved education. Multivariate linear regression was used to estimate the association. Results A 100-gram increase in birthweight was associated with an increase of 0.007 standardized units in global CF (SE: 0.003; p = 0.016), 0.007 in working memory (SE: 0.003; p = 0.041), and 0.012 in graphomotor processing speed (SE: 0.004; p = 0.010). Stratified by race, the associations between birthweight and global CF and CF subdomains were not statistically significant in either race, likely due to reduced power, as the estimates in both races showed similar effect sizes to those in the total sample. No differences were observed in CF subdomains among small for GA, appropriate for GA, and large for GA groups. GA, analyzed as a continuous variable, was not associated with CF. However, in preterm births, it was associated with better global CF, working memory, and graphomotor information processing speed, while there was no association in term-born births. Conclusions The impact of birthweight on the global CF remained in middle age, while the impact of birthweight adjusted for GA did not. GA as a continuous variable was not associated with CF, except in preterm individuals, where it was associated with better CF. These results suggest that birthweight may influence CF in midlife, and GA may play a role, particularly in those born preterm.
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spelling doaj-art-9d61cab8385741ec8bc9f5ef831bc88d2025-08-20T03:25:19ZengBMCBMC Neurology1471-23772025-06-0125111310.1186/s12883-025-04242-0The effect of birthweight and gestational age on cognitive function in midlife: the Bogalusa heart studyEunsun Gill0David J. Libon1Soo Jung Kang2Ileana De Anda-Duran3Lydia A. Bazzano4Wei Chen5Camilo Fernandez-Alonso6Emily W. Harville7Department of Epidemiology, Celia Scott Weatherhead School of Public Health and Tropical Medicine, Tulane UniversityDepartment of Geriatrics and Gerontology, New Institute for Successful Aging, Rowan University-School of Osteopathic MedicineDepartment of Epidemiology, Celia Scott Weatherhead School of Public Health and Tropical Medicine, Tulane UniversityDepartment of Epidemiology, Celia Scott Weatherhead School of Public Health and Tropical Medicine, Tulane UniversityDepartment of Epidemiology, Celia Scott Weatherhead School of Public Health and Tropical Medicine, Tulane UniversityDepartment of Epidemiology, Celia Scott Weatherhead School of Public Health and Tropical Medicine, Tulane UniversityDepartment of Orthopedics, Tulane University School of MedicineDepartment of Epidemiology, Celia Scott Weatherhead School of Public Health and Tropical Medicine, Tulane UniversityAbstract Background Although the relationships between birthweight, gestational age (GA), and cognitive function (CF) before midlife have been demonstrated, the relationships after midlife and potential racial disparities remain inconclusive. This study examined the association between birthweight, GA, and midlife CF stratified by race. Method 1,032 subjects from the Bogalusa Heart Study (67% Whites, 33% Blacks, mean age 48.1 ± 5.3 years) were studied. Cognition was assessed with tests measuring verbal episodic memory, working memory, attention, graphomotor information processing speed, and global CF. Each test was standardized by sex and age, then averaged. The global CF was computed by averaging all cognitive test scores. Standardized scores from the Wide Range Achievement Test-IV (WRAT- IV)–Reading subtest and the Wechsler Adult Intelligence Scale- IV (WAIS-IV)–Vocabulary subtest measured achieved education. Multivariate linear regression was used to estimate the association. Results A 100-gram increase in birthweight was associated with an increase of 0.007 standardized units in global CF (SE: 0.003; p = 0.016), 0.007 in working memory (SE: 0.003; p = 0.041), and 0.012 in graphomotor processing speed (SE: 0.004; p = 0.010). Stratified by race, the associations between birthweight and global CF and CF subdomains were not statistically significant in either race, likely due to reduced power, as the estimates in both races showed similar effect sizes to those in the total sample. No differences were observed in CF subdomains among small for GA, appropriate for GA, and large for GA groups. GA, analyzed as a continuous variable, was not associated with CF. However, in preterm births, it was associated with better global CF, working memory, and graphomotor information processing speed, while there was no association in term-born births. Conclusions The impact of birthweight on the global CF remained in middle age, while the impact of birthweight adjusted for GA did not. GA as a continuous variable was not associated with CF, except in preterm individuals, where it was associated with better CF. These results suggest that birthweight may influence CF in midlife, and GA may play a role, particularly in those born preterm.https://doi.org/10.1186/s12883-025-04242-0Birth weightGestational ageCognitionMiddle agedRace
spellingShingle Eunsun Gill
David J. Libon
Soo Jung Kang
Ileana De Anda-Duran
Lydia A. Bazzano
Wei Chen
Camilo Fernandez-Alonso
Emily W. Harville
The effect of birthweight and gestational age on cognitive function in midlife: the Bogalusa heart study
BMC Neurology
Birth weight
Gestational age
Cognition
Middle aged
Race
title The effect of birthweight and gestational age on cognitive function in midlife: the Bogalusa heart study
title_full The effect of birthweight and gestational age on cognitive function in midlife: the Bogalusa heart study
title_fullStr The effect of birthweight and gestational age on cognitive function in midlife: the Bogalusa heart study
title_full_unstemmed The effect of birthweight and gestational age on cognitive function in midlife: the Bogalusa heart study
title_short The effect of birthweight and gestational age on cognitive function in midlife: the Bogalusa heart study
title_sort effect of birthweight and gestational age on cognitive function in midlife the bogalusa heart study
topic Birth weight
Gestational age
Cognition
Middle aged
Race
url https://doi.org/10.1186/s12883-025-04242-0
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