What Emotional Risks Do Low Weight Babies Have
Arch Dis Child Fetal Neonatal Ed. 2006 November; 91(6): F423–F428.
Behavioural and emotional problems in very preterm and very depression birthweight infants at age v years
Abstract
Background
Children born very preterm (VP; <32 weeks' gestation) or with very low birth weight (VLBW, <1500 g; hereafter chosen VP/VLBW) are at risk for behavioural and emotional problems during school historic period and adolescence. At school entrance these bug may hamper academic functioning, but testify on their occurrence at this age in VP/VLBW children is lacking.
Aim
To provide information on academic functioning of VP/VLBW children and to examine the clan of behavioural and emotional problems with other developmental problems assessed by paediatricians.
Blueprint, setting and participants
A cohort of 431 VP/VLBW children aged 5 years (response rate 76.i%) was compared with two large national samples of children of the same historic period (n = 6007, response rate 86.ix%).
Outcome measures
Behavioural and emotional problems measured by the Child Behavior Checklist (CBCL), and paediatrician assessment of other developmental domains amidst VP/VLBW children.
Results
The prevalence rate of a CBCL total bug score in the clinical range was higher among VP/VLBW children than among children of the same historic period from the general population (13.ii% v eight.seven%, odds ratio 1.60 (95% confidence interval one.eighteen to two.17)). Hateful differences were largest for social and attention bug. Moreover, they were larger in children with paediatrician‐diagnosed developmental problems at v years, and somewhat larger in children with astringent perinatal issues.
Conclusion
At schoolhouse archway, VP/VLBW children are more likely to accept behavioural and emotional bug that are detrimental for academic functioning. Targeted and timely help is needed to back up them and their parents in overcoming these problems and in enabling them to be socially successful.
Survival of very preterm (VP) or very low birthweight (VLBW; hereafter called VP/VLBW) infants has increased considerably during the past decades.1,2,3,4 Developmental upshot varies with the age of the child, the population studied and the definition of handicap. Follow‐up studies during the first 2 years of life indicate that very preterm and VLBW infants are at increased run a risk of chronic illnesses, particularly chronic lung disease, cerebral palsy and severe developmental delay in 10–20% of survivors.three,five,half-dozen
Follow‐upwardly studies across longer intervals show that VP/VLBW infants are at even greater risk of developmental impairments and disabilities that may bear upon their academic functioning during school age and adolescence.four These issues include poor motor performance, visual and auditory impairments, and poor cognitive and behavioural development.iii,4,5,7,eight,9,10,11,12,13 Bug at early school age seem to increase during the school career. In a nationwide follow‐up study of VLBW infants in Kingdom of the netherlands, attendance for special instruction increased from 19% at historic period ix years to 28% at 14 years.xiv Similar figures take been reported for children from Florida and Cleveland, Usa.3,15
One explanation for the worsening school career of VP/VLBW children is that they are more likely to have behavioural and emotional problems that hamper academic operation. School is commonly the first group setting that requires complex social skills from children, implying that potential mental health problems in these children will go more than pronounced at this age. Nonetheless, there is very fiddling evidence on the occurrence of these bug among VP/VLBW children at school archway. A study on children built-in before 30 weeks' gestation showed that 23% of the children had behavioural problems at age 5½ years according to their parents and 26% had problems according to their teachers.xvi Further evidence is needed to help target interventions to the groups most in need and to behavioural problems most oft found. The aim of this study is to compare the prevalence rate of behavioural and emotional issues at the historic period of v years among VP/VLBW children with those in children of the same age in the general population, and to assess the clan of these behavioural and emotional problems with more full general developmental problems among VP/VLBW children.
Methods
We compared behavioural and emotional bug measured by the Kid Behavior Checklist (CBCL) for VP/VLBW children and for two national samples of five‐year‐old Dutch children.
Population
We obtained data on 431 children, delivered before 32 weeks' gestation or with a birth weight <1500 chiliad (called VP/VLBW children), born in iii regions of The Netherlands between 1992 and 1995. They represented 76.i% of all VP/VLBW children built-in in these regions. Complete information were available on 402 of these children. The hateful gestational age of the participating children was 30.ii (standard divergence (SD) 1.9) weeks and their mean nascence weight was 1268 (SD 329) one thousand. Of these 402 children, 258 (64.two%) were both very preterm and VLBW, 97 (24.1%) were only very preterm and 47 (11.7%) were merely VLBW. Details on this sample have been reported by de Kleine et al.17
We further obtained information on 12 217 children from two representative general population samples (response rate 86.9%). Both sets of data were obtained within the framework of the routine preventive health assessments that are provided regularly to all Dutch children. The first sample related to a cantankerous‐sectional national study on children aged iv–fifteen years (response rate 90.i%; due north = 4480), representative of the Dutch population.18,19 The second sample was related to the baseline measurements of 7737 children aged 4–vi years (response charge per unit 85.2%) participating in a national randomised controlled trial on comeback of the early detection of psychosocial problems past child health physicians and nurses (child health professionals).20,21 We restricted our analyses to children from these samples in the same age group equally the VP/VLBW children (n = 6007)—that is, five years, the age of obligatory school entrance in Holland (most children enter school at age 4 years). The local institutional review boards concerned had approved all iii studies. Written informed consent by parents was obtained for the first study and exact informed consent for the other ii studies.
Information and data drove
In all three samples, parents completed the CBCL before assessment by a paediatrician or a child health doc. The CBCL is a well‐validated questionnaire on behavioural and emotional issues over the preceding vi months.22,23 It contains 120 problem items on the basis of which a total problems score can be computed. We computed eight syndrome scales, two broad groups of syndromes designated internalising and externalising, and a total problems score. Internalising consists of withdrawn behaviour, somatic complaints and anxious/depressed syndrome scales, and externalising consists of delinquent and aggressive behaviour syndrome scales. Children were allocated to a normal or a clinical range of the scoring distribution based on the Dutch normative sample.23 Cut‐offs were set at the 97th centile for the eight syndrome scales and at the 90th centile for the total problems, and internalising and externalising scales.
Subsequently, paediatricians assessed all VP/VLBW children regarding neurological and cognitive functioning, language and general health in a structured manner. On the basis of the assessment, the children were categorised into three groups: optimal (all assessment domains normal), at take a chance (more than detailed examination or treatment necessary) and abnormal (abnormal in at least one domain). If for whatever domain further assessment or treatment was deemed necessary, the child was classified every bit having developmental problems. Data were also obtained on astringent issues in the perinatal period among the VP/VLBW children, which had been registered prospectively. Details accept been provided by de Kleine et al.17
Analysis
We first compared background characteristics across the samples (ie, age, sexual activity, family limerick and size, and maternal educational level) using the χ2 test. Next, nosotros compared the hateful scores for all CBCL scales using the t test. We repeated these analyses with adjustment for differences in background characteristics between the samples, using assay of variance and F tests. Moreover, because of the not‐normal distribution of the CBCL scores, we confirmed the statistical tests for the rough analyses past the non‐parametric (Mann–Whitney U) examination. Side by side, we carried out the same analysis on dichotomised scores (ie, clinical v normal), using logistic regression. We then computed standardised differences (hateful departure/standard deviation (SD)) between the two groups to adjust for differences in means and variability across the various CBCL scales. We likewise used the t test to examine differences in the frequency of behavioural and emotional bug between children with and without paediatrician‐assessed developmental bug; between children who were only very preterm, only VLBW, or both; and betwixt children with and without astringent problems in the perinatal period (Apgar score of <7 at 5 min, grade three or iv intraventricular haemorrhage, artificial respiration for ⩾ane week and use of steroids for bronchopulmonary dysplasia).17 Finally, nosotros examined differences by sex, also using the t test.
Results
The VP/VLBW cohort and the reference samples had similar background characteristics except for maternal educational level, which was lower for VP/VLBW children (p < 0.05; table 1 ).
Table 1 Groundwork characteristics of the very preterm or very depression birthweight children and children from the Dutch general population*
| VP/VLBW cohort | Full general population | p Value | |
|---|---|---|---|
| Male sex | 219/402 (54.5) | 3021/6007 (50.iii) | 0.104 |
| 5 years of historic period† | 394/402 (98.0) | 5889/6007 (98.0) | 0.97 |
| Family composition | 0.21 | ||
| 2‐parent family | 368/399 (92.2) | 5577/5985 (93.2) | |
| One‐parent family | 28/399 (7.0) | 392/5985 (half-dozen.five) | |
| Other | three/399 (0.eight) | 16/5985 (0.3) | |
| Number of siblings | 0.095 | ||
| 0 | 71/399 (17.8) | 823/6004 (13.vii) | |
| one | 193/399 (48.4) | 3203/6004 (53.3) | |
| two | 103/399 (25.8) | 1527/6004 (25.4) | |
| ⩾3 | 32/399 (8.0) | 451/6004 (7.5) | |
| Maternal educational level‡ | 0.035 | ||
| Low | 19/300 (6.iii) | 205/5883 (iii.five) | |
| Medium | 205/300 (68.3) | 4109/5883 (69.8) | |
| High | 76/300 (25.3) | 1569/5883 (26.7) |
VP/VLBW children had higher mean scores on CBCL full issues, on internalising and externalising problems, and on all syndrome scales (p<0.05), except for sex problems and anxious/depressed behaviour (table 2 ). Repetition of the analyses with adjustment for background characteristics did not affect differences in whatever important mode (data non shown). The Mann–Whitney U test mostly confirmed the results of the t examination (table 2 ).
Table 2 Mean Kid Behavior Checklist scores of very preterm or very depression nativity weight children and children from the Dutch general population (aged 5 years)
| CBCL problems scale | VP/VLBW (due north = 402)* | Population (n = 6007) | Difference (95% CI) | p Value† | ||
|---|---|---|---|---|---|---|
| Mean | SD | Mean | SD | |||
| Withdrawn | ii.00 | two.xiii | 1.42 | i.71 | 0.57 (0.36 to 0.79) | <0.001 |
| Somatic complaints | i.17 | one.55 | 0.89 | 1.40 | 0.29 (0.13 to 0.45) | <0.001 |
| Anxious/depressed | one.69 | ii.29 | 1.47 | 2.26 | 0.22 (0.01 to 0.45) | 0.062 |
| Social problems | ane.58 | one.73 | 0.91 | i.37 | 0.68 (0.50 to 0.85) | <0.001 |
| Thought problems | 0.65 | one.sixteen | 0.33 | 0.83 | 0.32 (0.21 to 0.44) | <0.001 |
| Attending issues | 3.67 | 3.eighteen | 2.16 | 2.43 | 1.51 (i.nineteen to 1.83) | <0.001 |
| Delinquent behaviour | one.03 | 1.56 | 0.82 | one.31 | 0.21 (0.05 to 0.36) | <0.01 |
| Ambitious behaviour | 6.66 | 6.ten | 5.48 | v.30 | one.eighteen (0.57 to ane.lxxx) | <0.001 |
| Sex issues | 0.24 | 0.66 | 0.18 | 0.59 | 0.05 (−0.01 to 0.12) | <0.111 |
| Total problems | 22.37 | 16.77 | 17.57 | 15.00 | 4.79 (3.10 to six.48) | <0.001 |
| Internalising problems | iv.78 | 4.50 | iii.72 | iv.eighteen | one.05 (0.threescore to 1.51) | <0.001 |
| Externalising problems | 7.69 | seven.19 | 6.30 | 6.22 | i.39 (0.67 to two.eleven) | <0.001 |
Table 3 shows that the proportion of children scoring in the clinical range of CBCL total problems was 13.2% among VP/VLBW children versus 8.seven% amidst those from the full general population (odds ratio (OR) one.60, 95% confidence interval (CI) 1.eighteen to 2.17); for the somewhat lower borderline cut‐off criterion, these figures were 22.i% v 15.0% (OR 1.61, 95% CI ane.26 to 2.05), respectively. The proportion of VP/VLBW children scoring in the clinical range was higher also for externalising issues but not for internalising issues. Differences in proportions regarding carve up syndrome scales reflected those for mean scores, although some differences did non reach statistical significance, considering the relatively small proportions of children with a clinical score.
Table three Prevalence rates of scores in the clinical range on Kid Behavior Checklist problems scales for very preterm or very low birthweight children and children from the Dutch full general population (anile 5 years)
| CBCL problems calibration | VP/VLBW (n = 402) (%) | Population (n = 6007) (%) | OR (95% CI) |
|---|---|---|---|
| Withdrawn | 8 (2.0) | 70 (1.2) | i.72 (0.82 to 3.threescore) |
| Somatic complaints | 15 (three.7) | 120 (2.0) | 1.xc (1.10 to 3.28)* |
| Broken-hearted/depressed | 4 (i.0) | 52 (0.ix) | ane.15 (0.41 to 3.xx) |
| Social problems | x (2.5) | 58 (1.0) | 2.62 (1.38 to 5.16)* |
| Thought problems | xiii (three.2) | 73 (one.ii) | 2.72 (i.49 to iv.94)* |
| Attention problems | 17 (4.ii) | 76 (1.three) | 3.45 (2.02 to 5.89)* |
| Delinquent behaviour | 11 (ii.7) | 63 (i.0) | two.65 (1.39 to 5.08)* |
| Ambitious behaviour | 14 (three.5) | 134 (2.2) | 1.58 (0.90 to two.77) |
| Sex issues | seven (one.7) | 71 (1.2) | ane.48 (0.68 to three.24) |
| Total problems | 53 (13.ii) | 520 (8.7) | 1.60 (ane.xviii to 2.17)* |
| Internalising | 28 (7.0) | 398 (six.half-dozen) | 1.06 (0.71 to 1.57) |
| Externalising | 48 (11.9) | 504 (eight.four) | 1.48 (i.08 to ii.03)* |
Standardised differences (effect sizes) ranged from 0.08 to 0.44 (fig 1 ). Values for four CBCL syndromes and for externalising and full problems were >0.2, which Cohen24 designates as small effects, which were largest for attention and social bug. Differences were much larger for VP/VLBW children in whom the paediatrician assessed developmental bug than for the other children. Again, excesses in problems were largest for attention and social problems, 0.70 and 0.67, respectively, which Cohen24 designates as medium (ie >0.50) effects. Regarding the grouping with paediatrician‐assessed issues, the backlog of problems was larger if the paediatricians were certain of the existence of developmental problems than if they were uncertain and showtime needed additional investigation, for all CBCL syndromes (information not shown).
Figure i Standardised differences in mean Child Behavior Checklist scores of very preterm or very low birthweight (VP/VLBW) children and those of children in the general population (that form the cipher x centrality level of the figure), overall and separately for children with and without paediatrician‐assessed developmental problems (age 5 years).
Whether the children were just very preterm, only VLBW or both had no statistically significant effect on differences in behavioural and emotional problems, and neither had the v‐min Apgar score. Notwithstanding, children who had needed artificial ventilation for at least i week in the neonatal period (north = 66) had significantly college scores on social (p<0.001) and attention bug (p = 0.020). Children with grade three or 4 intraventricular haemorrhage (northward = 19) had higher scores on somatic complaints (p = 0.027), and children who received corticosteroids (n = 14) had college mean scores for total problems (p = 0.028), and social (p<0.001), thought (p = 0.011) and attending problems (p = 0.014). In all cases, differences between the VP/VLBW children without additional perinatal problems and children from the general population sample remained statistically significant. Moreover, differences regarding receipt of artificial ventilation, presence of intraventricular haemorrhage and receipt of corticosteroids were much smaller than those regarding paediatrician‐assessed issues at 5 years (fig i ).
Finally, the excess of problems among VP/VLBW children differed somewhat by sex activity (table iv ). Among VP/VLBW boys, this excess was slightly larger for behavioural (externalising) type problems, only sex‐related differences were statistically significant regarding only social and attention issues. Among girls, the excess of problems was somewhat larger for emotional (internalising) blazon issues, but this sexual activity‐related difference was statistically meaning regarding just the withdrawn behaviour on the CBCL syndrome scale.
Table 4 Mean Child Beliefs Checklist scores of very preterm or very low birthweight children and of children from the general Dutch population, by sex (age v years)
| Girls | Boys | p Value | |||||
|---|---|---|---|---|---|---|---|
| VP/VLBW (n = 183) | Population (north = 2986) | Difference (95% CI) | VP/VLBW (n = 219) | Population (north = 3021) | Divergence (95% CI) | ||
| Withdrawn | ii.xv | 1.35 | 0.80 (0.55 to 1.05) | ane.86 | 1.48 | 0.38 (0.thirteen to 0.62) | <0.05* |
| Somatic complaints | i.22 | 0.89 | 0.33 (0.12 to 0.53) | ane.15 | 0.89 | 0.26 (0.06 to 0.46) | |
| Anxious/depressed | 1.68 | 1.42 | 0.26 (0.06 to 0.58) | i.69 | 1.52 | 0.eighteen (−0.15 to 0.50) | |
| Social problems | 1.30 | 0.82 | 0.48 (0.29 to 0.67) | 1.82 | 0.99 | 0.83 (0.62 to ane.04) | <0.05† |
| Idea problems | 0.52 | 0.27 | 0.26 (0.14 to 0.37) | 0.76 | 0.38 | 0.37 (0.24 to 0.50) | <0.05† |
| Attention bug | 2.86 | 1.77 | one.10 (0.78 to 1.41) | iv.34 | 2.55 | 1.79 (1.42 to 2.16) | |
| Delinquent behaviour | 0.81 | 0.67 | 0.14 (−0.03 to 0.31) | 1.21 | 0.97 | 0.24 (0.04 to 0.45) | |
| Aggressive behaviour | 5.xx | 4.49 | 0.71 (0.01 to 1.xl) | vii.88 | 6.44 | 1.43 (0.64 to 2.23) | |
| Sexual activity problems | 0.13 | 0.xiii | 0.00 (−0.08 to 0.07) | 0.33 | 0.23 | 0.x (0.00 to 0.19) | |
| Full problems | 19.68 | 15.53 | four.15 (2.15 to 6.fifteen) | 24.61 | 19.60 | 5.01 (2.77 to 7.26) | |
| Internalising problems | 4.96 | 3.61 | 1.35 (0.75 to one.95) | 4.63 | 3.84 | 0.79 (0.19 to 1.39) | |
| Externalising problems | six.02 | 5.17 | 0.85 (0.04 to 1.66) | nine.09 | 7.41 | ane.67 (0.73 to 2.61) | |
Word and conclusion
The results of our study using large national samples showed that behavioural and emotional problems occur more frequently among 5‐year‐old VP/VLBW children. Differences are plant in most types of problems, but are largest for social and attention problems. Increases in the prevalence of clinical scores are larger for behavioural than for emotional problems. Moreover, they are much larger in children with paediatrician‐assessed developmental problems and somewhat larger in children with severe neonatal problems, especially those needing corticosteroids. For 5‐year‐former children, our results confirm the findings from previous studies on other age groups that indicated that behavioural and emotional problems were more than probable amongst very preterm, VLBW or VP/VLBW children.iii,4,ix,11,12,13,25,26,27
The difference in hateful scores of VP/VLBW children and those of children from the full general population was similar for internalising and externalising issues, whereas nigh previous studies institute an excess of externalising and attention problems.12 Notwithstanding, when examining clinical scores, we besides constitute an excess of externalising and attention problems, but not of internalising problems. This indicates that mean levels of internalising problems are somewhat increased among VP/VLBW children, but that these increases are by and large moderate (whereas they are more than pronounced for the other types of issues). At the level of specific CBCL syndrome scales, standardised hateful differences between the two groups (fig 1 ) were largest for the scales designated as attention issues, social issues, thought bug and withdrawn (by decreasing size of standardised differences). An explanation for the larger mean backlog of internalising issues among VP/VLBW children in our study, especially withdrawn behaviour, may exist that this behaviour becomes especially visible when children enter schoolhouse. At that item moment, owing to the higher prevalence of intellectual and physical bug, a VP/VLBW child may be shyer than average. This state of affairs‐oriented character of emotional issues could also explain the moderate nature of this excess that seldom reached a clinical level.
Regarding withdrawn behaviour, nosotros plant larger hateful differences between VP/VLBW children and children from the general population for girls than for boys. Sykes et al28 and Botting et al26 found similar sex‐related differences among older school‐aged (vii–8‐yr‐old and 12‐year‐one-time) VLBW children. Nonetheless, most studies aiming at VLBW children in these age groups found no sexual activity‐related differences.xi On the other hand, Hack et al12 found an backlog of this type of withdrawn behaviour besides among 20‐yr‐onetime VLBW women according to both parent reports and self‐report, merely not among men in this age group. This can be interpreted as an increased vulnerability for this type of trouble amongst VLBW women.
Regarding externalising and attention problems, nigh studies accept shown VLBW boys to be more susceptible to bug than boys from the general population,12,25,26,27 and our study is no exception. We establish especially large differences between VP/VLBW boys and boys from the general population regarding social and attention problems. The process of school entrance may reinforce this well‐known upshot of VP/VLBW on children, and the rather general response of children to this procedure, that they get either too active or likewise shy, may but be more than pronounced amid this group. Schoolhouse is the first setting in which children actually have to concentrate on specific tasks for long periods, and have continuous social interaction in a large group. Nadeau et al29 showed that a relatively isolated problem in working retentivity may explain attention bug amid 7‐year‐quondam VP/VLBW children. Targeted educational assist for VP/VLBW children and their parents during at schoolhouse entrance might help them in overcoming such attention problems.
Regarding other types of externalising bug, such as assailment and delinquent behaviour, nosotros found a somewhat college prevalence, but non a large excess, among VP/VLBW children for each sex activity. This may imply that a (very) depression nativity weight is associated with problems in normal social interaction with others, without leading to more general antisocial behaviour. A second domain showing relatively numerous problems amidst VP/VLBW children relates to attention and thinking, which seem to exist specifically vulnerable to the consequences of being built-in with very low weight.
Overall, our results show rather full general difficulties in the domain of socioemotional evolution. This may betoken that an underlying developmental trouble affects several domains, as our study also shows more behavioural and emotional issues among VP/VLBW children with paediatrician‐confirmed problems than among others. Some other study on extremely preterm children likewise institute that many children show disabilities in more than than one developmental domain.16 These problems at 5 years of historic period were related to developmental outcome measures at 2 years. A written report that longitudinally followed up a group of preterm children until 10 years of age and distinguished between subgroups co-ordinate to academic issues present at 10 years showed differences in the developmental form of these subgroups that gradually diverged during the first 2 years.30 Interventions regarding behavioural issues may therefore be already advisable in toddlers.
We found smaller differences between VP/VLBW children and those from the full general population than those institute by Hille et al31 regarding extremely low birthweight (<one thousand yard) Dutch children anile 8–10 years. Extremely low birthweight children can be expected to take more developmental harm in general. Thus, there is a dose–response relationship between this general developmental damage and the occurrence of behavioural and emotional problems, similar to that in other developmental domains.32
Potential limitations
Our study used large samples with high response rates, in which data were obtained using a standardised method. Moreover, nosotros used the CBCL questionnaire, which has been shown to exist a valid measure out for behavioural and emotional issues.22,23 Although response rates were somewhat higher in the population samples than in the VP/VLBW sample, even if all non‐responding VP/VLBW children had CBCL scores in the normal range, most differences would remain statistically pregnant. The reverse, a higher prevalence of problems among non‐responding VP/VLBW children, seems, however, to be more likely.33,34 If so, differences between VP/VLBW and normal children will be even larger than we found. Moreover, our study may still have somewhat underestimated differences, because some VP/VLBW children may also take been included in the population sample. Finally, our study lacked an in‐depth psychiatric interview and additional behavioural observations that would have enabled a more than specific description of mental wellness bug.
Implications
The relative proportion of surviving VP/VLBW children among all births has increased during the past decades,1,three,iv,five,11 and our results testify that these children are l% more likely than children from the general population (thirteen% v 9%) to have CBCL problems scores in the clinical range. The increased prevalence of problems among this group can therefore be expected to increase the burden of mental health morbidity among children in the community. Paediatricians and other kid health professionals working with VP/VLBW children should thus exist prepared to meet relatively many behavioural and attending problems, and should also fix parents concerning this.35 Routine screenings for these problems36,37 should be intensified among the VP/VLBW children. Moreover, routine follow‐upwardly examinations regarding different developmental domains of VP/VLBW children should be carried out to identify potential problems as soon as possible.
Our results farther show that this college rate of problems continues at school age, which may imply an increased demand for additional support at school or even specialised school services. VP/VLBW children could as well be offered supportive treatments from birth onwards to amend developmental outcomes.35 Yet, results of studies conducted on the effectiveness of the treatments so far vary,38 with decreasing effects in the longer teem, indicating a connected need for specific and age‐appropriate aid.39,40 The results of our report show that better health proceeds may be achieved in VP/VLBW children. This urgently requires effective programmes that continue at least into school age, to maintain positive long‐term effects,4,29,35 paying special attending to VP/VLBW children who have had astringent difficulties in the perinatal period.
Acknowledgements
Nosotros thank Roy E Stewart, statistician, for his advice.
Abbreviations
CBCL - Kid Behavior Checklist
VLBW - very low nativity weight
VP/VLBW - very preterm or very low birth weight
Footnotes
Funding: The fieldwork for this study was supported past grants from the Dutch Health Organisations Praeventiefonds, projection number 28–2756, and from The Netherlands System for Health Research and Evolution (ZonMw), projection number 1010004–20.
Competing interests: None.
References
i. Richardson D K, Gray J Due east, Gortmaker S 50.et al Failing severity adjusted mortality: show of improving neonatal intensive care. Pediatrics 1998102893–899. [PubMed] [Google Scholar]
2. International Neonatal Network, Scottish Neonatal Consultants, Nurses Collaborative Study Group Risk adapted and population based studies of the upshot for loftier take chances infants in Scotland and Australia. Arch Dis Child Fetal Neonatal Ed 200082F118–F123. [PMC free article] [PubMed] [Google Scholar]
3. Hack Thousand, Flannery D J, Schluchter M.et al Outcomes in young adulthood for very‐depression‐birth‐weight infants. N Engl J Med 2002346149–157. [PubMed] [Google Scholar]
4. Reichman N E. Depression nascency weight and school readiness. Futurity Child 2005fifteen91–116. [PubMed] [Google Scholar]
5. The Victorian Infant Collaborative Report Grouping Neurosensory effect at v years and extremely low birthweight. Arch Dis Kid Fetal Neonatal Ed 199573F143–F146. [PMC free article] [PubMed] [Google Scholar]
half-dozen. Wood N S, Marlow N, Costeloe Thousand.et al Neurologic and developmental disability subsequently extremely preterm birth. EPICure Report Group. N Engl J Med 2000343378–384. [PubMed] [Google Scholar]
vii. Veen S, Ens‐Dokkum M H, Schreuder A M.et al Impairments, disabilities, and handicaps in low‐birthweight babies. Lancet 19913381011–1012. [PubMed] [Google Scholar]
8. Hille Due east T, den Ouden A L, Bauer Fifty.et al School performance at nine years of age in very premature and very low birth weight infants: perinatal run a risk factors and predictors at five years of historic period. Collaborative Project on Preterm and Small for Gestational Historic period (POPS) Infants in The Netherlands. J Pediatr 1994125426–434. [PubMed] [Google Scholar]
9. Taylor H Thou, Klein N, Schatschneider C.et al Predictors of early schoolhouse age outcomes in very depression birth weight children. J Dev Behav Pediatr 199819235–243. [PubMed] [Google Scholar]
ten. Schaap A H, Wolf H, Bruinse H Due west.et al School performance and behaviour in extremely preterm growth‐retarded infants. Eur J Obstet Gynecol Reprod Biol 19998643–49. [PubMed] [Google Scholar]
eleven. Bhutta A T, Cleves M A, Casey P H.et al Cognitive and behavioral outcomes of school‐anile children who were born preterm: a meta‐analysis. JAMA 2002288728–737. [PubMed] [Google Scholar]
12. Hack M, Youngstrom Due east A, Cartar L.et al Behavioral outcomes and evidence of psychopathology among very depression nascence weight infants at age 20 years. Pediatrics 2004114932–940. [PubMed] [Google Scholar]
xiii. Klassen A F, Lee S Yard, Raina P.et al Health condition and health‐related quality of life in a population‐based sample of neonatal intensive care unit graduates. Pediatrics 2004113594–600. [PubMed] [Google Scholar]
14. Walther F J, den Ouden A L, Verloove‐Vanhorick S P. Looking back in time: outcome of a national cohort of very preterm infants built-in in The Netherlands in 1983. Early on Hum Dev 200059175–191. [PubMed] [Google Scholar]
15. Resnick M B, Gomatam S V, Carter R Fifty.et al Educational disabilities of neonatal intensive care graduates. Pediatrics 1998102308–314. [PubMed] [Google Scholar]
xvi. van Baar A L, van Wassenaer A M, Briet J M.et al Very preterm nascency is associated with disabilities in multiple developmental domains. J Pediatr Psychol 2005thirty247–255. [PubMed] [Google Scholar]
17. de Kleine Grand J, den Ouden A L, Kollee L A.et al Development and evaluation of a follow up cess of preterm infants at v years of age. Arch Dis Child 200388870–875. [PMC free article] [PubMed] [Google Scholar]
18. Reijneveld S A, Harland P, Brugman East.et al Psychosocial issues amid immigrant and non‐immigrant children—ethnicity plays a role in their occurrence and identification. Eur Child Adolesc Psychiatry 200514145–152. [PubMed] [Google Scholar]
nineteen. Reijneveld S A, Brugman East, Verhulst F C.et al Expanse impecuniousness and child psychosocial problems—a national cantankerous‐exclusive study among school‐anile children. Soc Psychiatry Psychiatr Epidemiol 2005forty18–23. [PubMed] [Google Scholar]
twenty. Wiefferink C H, Reijneveld South A, de Wijs J.et al Screening for psychosocial bug in 5–vi‐twelvemonth olds: a randomised controlled trial of routine wellness assessments. Patient Educ Couns 2006lx57–65. [PubMed] [Google Scholar]
21. Reijneveld South A, Wiefferink C H, Brugman E.et al Continuous access to chief schoolhouse and mental health problems. BMC Public Wellness 20066145 [PMC free article] [PubMed] [Google Scholar]
22. Achenbach T M.Transmission for the Child Behavior Checklist/4–18 and 1991 contour. Burlington, VT: Section of Psychiatry, University of Vermont, 1991
23. Verhulst F C, van der Ende J, Koot H M.Manual for the CBCL/iv–eighteen(In Dutch.). Rotterdam: Department of Child and Boyish Psychiatry, Erasmus University, 1996
24. Cohen J.Statistical power analysis for the behavioral sciences. Hillsdale, NJ: Lawrence Erlbaum, 1988
25. McCormick M C, Brooks‐Gunn J, Workman‐Daniels K.et al The health and developmental status of very depression‐birth‐weight children at school age. JAMA 19922672204–2208. [PubMed] [Google Scholar]
26. Botting North, Powls A, Cooke R West.et al Attention deficit hyperactivity disorders and other psychiatric outcomes in very low birthweight children at 12 years. J Child Psychol Psychiatry 199738931–941. [PubMed] [Google Scholar]
27. Saigal S, Pinelli J, Hoult L.et al Psychopathology and social competencies of adolescents who were extremely low birth weight. Pediatrics 2003111969–975. [PubMed] [Google Scholar]
28. Sykes D H, Hoy E A, Pecker J M.et al Behavioural adjustment in schoolhouse of very low birthweight children. J Child Psychol Psychiatry 199738315–325. [PubMed] [Google Scholar]
29. Nadeau 50, Boivin Grand, Tessier R.et al Mediators of behavioral problems in 7‐yr‐old children built-in after 24 to 28 weeks of gestation. J Dev Behav Pediatr 2001221–10. [PubMed] [Google Scholar]
30. van Baar A 50, Ultee One thousand, Gunning W B.et al Develomental course of very preterm children in relation to schoolhouse outcome. J Dev Phys Disabil 2005. doi: 10.1007/s10882‐006‐9016‐vi
31. Hille East T, den Ouden A L, Saigal S.et al Behavioural problems in children who weigh 1000 g or less at birth in four countries. Lancet 20013571641–1643. [PubMed] [Google Scholar]
32. Marlow N, Wolke D, Bracewell M A.et al Neurologic and developmental disability at six years of historic period after extremely preterm birth. Due north Engl J Med 20053529–19. [PubMed] [Google Scholar]
33. Wariyar U G, Richmond South. Morbidity and preterm delivery: importance of 100% follow‐upwards. Lancet 1989ane387–388. [PubMed] [Google Scholar]
34. Hille Eastward T, Elbertse L, Gravenhorst J B.et al Nonresponse bias in a follow‐upwards report of 19‐year‐quondam adolescents born as preterm infants. Pediatrics 2005116e662–e666. [PubMed] [Google Scholar]
35. Greene Thousand F. Outcomes of very low birth weight in young adults. N Engl J Med 2002346146–148. [PubMed] [Google Scholar]
36. Brugman E, Reijneveld S A, Verhulst F C.et al Identification and management of psychosocial issues by preventive kid health care. Arch Pediatr Adolesc Med 2001155462–469. [PubMed] [Google Scholar]
37. Reijneveld S A, Brugman E, Verhulst F C.et al Identification and direction of psychosocial problems among toddlers in Dutch preventive child wellness care. Arch Pediatr Adolesc Med 2004158811–817. [PubMed] [Google Scholar]
38. Blair C. Early intervention for low nativity weight, preterm infants: the role of negative emotionality in the specification of effects. Dev Psychopathol 2002xiv311–332. [PubMed] [Google Scholar]
39. McCarton C M, Brooks‐Gunn J, Wallace I F.et al Results at age viii years of early on intervention for low‐birth‐weight premature infants. The Infant Health and Development Programme. JAMA 1997277126–132. [PubMed] [Google Scholar]
40. Johnson Southward, Ring W, Anderson P.et al Randomised trial of parental support for families with very preterm children: consequence at 5 years. Arch Dis Child 200590909–915. [PMC free article] [PubMed] [Google Scholar]
stthomasolcou1970.blogspot.com
Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2672756/
0 Response to "What Emotional Risks Do Low Weight Babies Have"
Post a Comment