Trajectories of behavior, attention, social and emotional problems from childhood to early adulthood following extremely preterm birth: a prospective cohort study

doi:10.1007/s00787-018-1219-8

. 2019 Apr;28(4):531-542.

doi: 10.1007/s00787-018-1219-8. Epub 2018 Sep 7.

Trajectories of behavior, attention, social and emotional problems from childhood to early adulthood following extremely preterm birth: a prospective cohort study

Louise Linsell¹, Samantha Johnson², Dieter Wolke³, Joan Morris⁴, Jennifer J Kurinczuk⁵, Neil Marlow⁶

Affiliations

¹ National Perinatal Epidemiology Unit (NPEU), Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, Oxford, OX3 7LF, UK. louise.linsell@npeu.ox.ac.uk.
² Department of Health Sciences, Centre for Medicine, University of Leicester, University Road, Leicester, LE1 7RH, UK.
³ Division of Health Sciences, Department of Psychology, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK.
⁴ Centre for Environmental and Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, UK.
⁵ National Perinatal Epidemiology Unit (NPEU), Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, Oxford, OX3 7LF, UK.
⁶ Medical School Building, Institute of Women's Health, University College London, 74 Huntley Street, London, WC1E 6AU, UK.

PMID: 30191335
PMCID: PMC6445809
DOI: 10.1007/s00787-018-1219-8

Trajectories of behavior, attention, social and emotional problems from childhood to early adulthood following extremely preterm birth: a prospective cohort study

Louise Linsell et al. Eur Child Adolesc Psychiatry. 2019 Apr.

. 2019 Apr;28(4):531-542.

doi: 10.1007/s00787-018-1219-8. Epub 2018 Sep 7.

Authors

Louise Linsell¹, Samantha Johnson², Dieter Wolke³, Joan Morris⁴, Jennifer J Kurinczuk⁵, Neil Marlow⁶

Affiliations

¹ National Perinatal Epidemiology Unit (NPEU), Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, Oxford, OX3 7LF, UK. louise.linsell@npeu.ox.ac.uk.
² Department of Health Sciences, Centre for Medicine, University of Leicester, University Road, Leicester, LE1 7RH, UK.
³ Division of Health Sciences, Department of Psychology, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK.
⁴ Centre for Environmental and Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, UK.
⁵ National Perinatal Epidemiology Unit (NPEU), Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, Oxford, OX3 7LF, UK.
⁶ Medical School Building, Institute of Women's Health, University College London, 74 Huntley Street, London, WC1E 6AU, UK.

PMID: 30191335
PMCID: PMC6445809
DOI: 10.1007/s00787-018-1219-8

Abstract

To investigate trajectories of behavior, attention, social and emotional problems to early adulthood in extremely preterm survivors compared to a term-born comparison group. Longitudinal analysis of a prospective, population-based cohort of 315 surviving infants born < 26 completed weeks of gestation recruited at birth in 1995, from the UK/Republic of Ireland, and a term-born comparison group recruited at age 6. The parent-report Strengths and Difficulties Questionnaire was completed at age 6, 11, 16 and 19 years. The Total Behavioral Difficulties Score was 4.81 points higher in extremely preterm individuals compared to their term-born peers over the period (95% CI 3.76-5.87, p < 0.001) and trajectories were stable in both groups. The impact of difficulties on home life, friendships, school or work and/or leisure activities was greater in the EPT group (RR 4.28, 95% CI 2.89-6.35, p < 0.001), and hyperactivity/inattention and peer problems accounted for the largest differences. A clinically significant behavioral screen at age 2.5 was associated with a higher Total Behavioral Difficulties Score from 6 years onwards in extremely preterm participants (Mean difference 6.90, 95% CI 5.01-8.70, p < 0.0.01), as was moderate/severe cognitive impairment at last assessment (Mean difference: 4.27, 95% CI 2.76-5.77, p < 0.001). Attention, social and emotional problems in extremely preterm individuals persist into early adulthood with significant impact on daily life. A positive behavioral screen in infancy and moderate/severe cognitive impairment are associated with early adult outcomes.

Keywords: Adolescent behavior; Child behavior; Cohort analysis; Extremely premature; Follow-up studies.

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Conflict of interest statement

Conflict of interest

The sponsor, funder and authors have no conflicts of interest to disclose.

Ethical approval

No ethical approval was required for this study as it was based on data already collected for the EPICure Study.

Informed consent

Full informed parental consent was obtained for all participants recruited to the EPICure Study.

Figures

**Fig. 1**
Mean plus 95% confidence intervals for SDQ Total Difficulties and subscale scores in extremely preterm participants and term-born controls at age 6, 11, 16 and 19

**Fig. 2**
Percentage in abnormal range and 95% confidence intervals for SDQ Total Difficulties and subscale scores in the extremely preterm participants and term-born controls at age 6, 11, 16 and 19

See this image and copyright information in PMC

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References

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[1] Goldenberg RL, Culhane JF, Iams JD, Romero R. Epidemiology and causes of preterm birth. Lancet. 2008;371:75–84. doi: 10.1016/S0140-6736(08)60074-4. - DOI - PMC - PubMed

[2] Goldenberg RL, Culhane JF, Iams JD, Romero R. Epidemiology and causes of preterm birth. Lancet. 2008;371:75–84. doi: 10.1016/S0140-6736(08)60074-4. - DOI - PMC - PubMed

[3] Taylor HG, Margevicius S, Schluchter M, Andreias L, Hack M. Persisting behavior problems in extremely low birth weight adolscents. J Dev Behav Pediatr. 2015;36(3):178–187. doi: 10.1097/DBP.0000000000000139. - DOI - PMC - PubMed

[4] Taylor HG, Margevicius S, Schluchter M, Andreias L, Hack M. Persisting behavior problems in extremely low birth weight adolscents. J Dev Behav Pediatr. 2015;36(3):178–187. doi: 10.1097/DBP.0000000000000139. - DOI - PMC - PubMed

[5] Hutchinson EA, de Luca CR, Doyle LW, Roberts G, Anderson PJ. School-age outcomes of extremely preterm or extremely low birth weight children. Pediatrics. 2013;131:e1053–e1061. doi: 10.1542/peds.2012-2311. - DOI - PubMed

[6] Hutchinson EA, de Luca CR, Doyle LW, Roberts G, Anderson PJ. School-age outcomes of extremely preterm or extremely low birth weight children. Pediatrics. 2013;131:e1053–e1061. doi: 10.1542/peds.2012-2311. - DOI - PubMed

[7] Farooqi A, Hagglof B, Sedin G, Gothefors L, Serenius F. Mental health and social competencies of 10- to 12-year-old children born at 23 to 25 weeks of gestation in the 1990s: a Swedish national prospective follow-up study. Pediatrics. 2007;120(1):118–133. doi: 10.1542/peds.2006-2988. - DOI - PubMed

[8] Farooqi A, Hagglof B, Sedin G, Gothefors L, Serenius F. Mental health and social competencies of 10- to 12-year-old children born at 23 to 25 weeks of gestation in the 1990s: a Swedish national prospective follow-up study. Pediatrics. 2007;120(1):118–133. doi: 10.1542/peds.2006-2988. - DOI - PubMed

[9] Bhutta AT, Cleves MA, Casey PH, Cradock MM, Anand KJS. Cognitive and behavioral outcomes of school-aged children who were born preterm: a meta-analysis. JAMA. 2002;288(6):728–737. doi: 10.1001/jama.288.6.728. - DOI - PubMed

[10] Bhutta AT, Cleves MA, Casey PH, Cradock MM, Anand KJS. Cognitive and behavioral outcomes of school-aged children who were born preterm: a meta-analysis. JAMA. 2002;288(6):728–737. doi: 10.1001/jama.288.6.728. - DOI - PubMed

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Trajectories of behavior, attention, social and emotional problems from childhood to early adulthood following extremely preterm birth: a prospective cohort study

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Trajectories of behavior, attention, social and emotional problems from childhood to early adulthood following extremely preterm birth: a prospective cohort study

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Affiliations

Abstract

Conflict of interest statement

Conflict of interest

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Informed consent

Figures

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References

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Abstract

Conflict of interest statement

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