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Behavioral problems and cognitive performance at 5 years of age after very preterm birth: the EPIPAGE Study

Malika Delobel-Ayoub1, Catherine Arnaud, Mélanie White-Koning

  • 1Institut National de la Santé et de la Recherche Médicale, U558, 37 Allées Jules Guesde, 31073 Toulouse Cedex, France. carnaud@cict.fr.

Pediatrics
|June 2, 2009
PubMed

Insights

Very preterm children exhibit significantly more behavioral problems than term-born children. These issues persist even after accounting for cognitive development and environmental factors, highlighting the need for early screening.

Area of Science:

  • Developmental Pediatrics
  • Child Psychology
  • Epidemiology

Background:

  • Behavioral problems are a concern in childhood development.
  • Preterm birth is a known risk factor for adverse neurodevelopmental outcomes.

Purpose of the Study:

  • To compare behavioral problem frequency in very preterm and term children at age 5.
  • To investigate associations with cognitive impairment and environmental factors.
  • To determine if group differences persist after adjustment.

Main Methods:

  • Prospective population-based cohort study (EPIPAGE) of preterm (22-32 weeks gestation) and term infants.
  • Behavioral problems assessed at 5 years using the Strengths and Difficulties Questionnaire in 1102 very preterm and 375 term singletons.
  • Data included cognitive development, maternal well-being, and sociodemographic factors.

Main Results:

  • Very preterm children had a twofold higher prevalence of hyperactivity/inattention, emotional symptoms, and peer problems.
  • Behavioral problems correlated with low cognitive performance, developmental delay, hospitalizations, young maternal age, and poor maternal mental well-being.
  • Preterm children remained at higher risk for behavioral problems post-adjustment.

Conclusions:

  • Cognitive impairment strongly relates to behavioral problems, but very preterm children face elevated risk independently.
  • Early screening for behavioral issues is crucial for very preterm infants.
  • Maternal well-being requires focused attention in this population.
Abstract

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