Very Low Birth Weight Linked to Reduced Executive Function as an Adult
Being born pre-term (before 37 weeks of development) at a very low birth weight (less than 1500 grams, or 3.3 pounds) is linked to hindered executive functioning as an adult, according to a new study published in Scientific Reports.
Being born pre-term (before 37 weeks of development) at a very low birth weight (less than 1500 grams, or 3.3 pounds) is linked to hindered executive functioning as an adult, according to a new study published in Scientific Reports.
Nobody likes to be impeded by circumstances that are out of their control, so this new finding, courtesy of researchers at the Norwegian University of Science and Technology (NTNU), is a bit of a bummer. It's also not necessarily surprising. Pre-term infants are born during a during a critical window of brain development in which the cortex and other regions are susceptible to environmental shocks. Abruptly departing the womb certainly counts.
Executive functioning describes higher-order cognitive processes that support goal-directed behavior and emotional response. These processes include:
- Working memory: holding and utilizing information over short periods
- Inhibitory control: resisting impulses and thinking before acting
- Cognitive flexibility: adapting to sudden changes
- Emotion regulation: managing feelings to maintain a stable mood
Research has long revealed that children born preterm often have deficits in executive functioning that begin in early childhood and last into adolescence, making them more likely to face challenges in school. The NTNU researchers wondered whether the deficits persist decades later.
They compared cognitive assessment scores of 184 adult subjects born preterm with very low birth rate to those of 211 control participants born at term with a birth weight greater than the 10th percentile for their gestational age. The subjects were given a battery of executive function tests in their mid-20s and mid-30s. One assessment, for example, was the trail making test, in which individuals connect numbers in ascending order on a piece of paper as fast as possible.
Excluding individuals with cerebral palsy, blindness, deafness, or intellectual disability, the researchers found that adults born preterm had lower levels of emotion control and working memory than control adults, however the differences just missed statistical significance. They did, however, have statistically significant deficits in visual attention and processing speed, as gauged by various forms of the trail making test.
Preterm adults' executive function scores were not that far off population norms, so the deficits may not affect their lives much, if at all. Interestingly, the researchers found that the gap in executive functioning between the preterm and control groups grew between young adulthood and middle adulthood.
"The transition from young to mid-adulthood is often accompanied by the transition from compulsory education, where executive functions are regularly used and practised, to independence, in which higher education and employment are voluntary," they noted. "Preterm birth/low birth weight has been associated with decreased rates of higher education and jobs, and increased use of social welfare benefits in adulthood. Lower education, more frequent need for remedial education, and higher unemployment rates could, therefore, have a ripple effect on daily executive functioning and cognitive abilities."
Source: Ingvaldsen, S.H., Weider, S., Heinonen, K. et al. Executive functioning in adults born with very low birth weight. Sci Rep (2026). https://doi.org/10.1038/s41598-026-67104-w