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Psychiatric disorders at five years among children with birthweights less than 1000g: a regional perspective
P Szatmari1, S Saigal, P Rosenbaum
1Department of Psychiatry, McMaster University, Hamilton, Ontario, Canada.
Insights
Extremely low birthweight (ELBW) children face higher risks for developmental delays and attention deficit disorder with hyperactivity (ADDH). However, these risks diminish when neurodevelopmental problems are accounted for.
Area of Science:
- Pediatrics
- Child Psychiatry
- Developmental Psychology
Background:
- Extremely low birthweight (ELBW) is associated with various developmental challenges.
- Understanding the specific psychiatric risks for ELBW children is crucial for early intervention.
- Previous research indicates potential links between birthweight and neurodevelopmental outcomes.
Purpose of the Study:
- To investigate the relationship between extremely low birthweight (ELBW) and psychiatric disorders in a cohort of children.
- To identify specific psychiatric conditions associated with ELBW.
- To explore the role of neurodevelopmental problems in mediating the link between ELBW and psychiatric disorders.
Main Methods:
- A cohort study of children born between 1980-1982 with birthweights between 500-1000g.
- Assessment at five years of age included psychiatric symptoms, developmental delay, and psychosocial factors.
- Comparison with a control group to determine risk differences.
Main Results:
- ELBW children showed increased rates of developmental delay and motor coordination problems.
- Attention deficit disorder with hyperactivity (ADDH) was diagnosed in 16% of ELBW children versus 6.9% of controls.
- The association between ELBW and ADDH became non-significant after controlling for neurodevelopmental problems.
Conclusions:
- ELBW is a specific risk factor for ADDH, but this association is mediated by neurodevelopmental issues.
- Early identification and support for neurodevelopmental problems in ELBW infants are critical.
- Further research is needed to understand the complex interplay between birthweight, neurodevelopment, and psychiatric outcomes.
Abstract:
The relationship between extremely low birthweight (ELBW) and psychiatric disorder was investigated in a cohort of children of 500 to 1000g birthweight, born between 1980 and 1982. At five years of age data were collected for 82 of 90 survivors on psychiatric symptoms, parent-reported developmental delay and various aspects of psychosocial disadvantage. Compared with controls, ELBW children did not come from more disadvantaged environments, but were much more likely to experience developmental delay and problems with motor co-ordination. 16 per cent had an attention deficit disorder with hyperactivity (ADDH), compared with 6.9 per cent of controls. Rates of conduct disorder and emotional disorder were not raised, indicating that ELBW is a specific risk factor for ADDH. Controlling for the effect of neurodevelopmental problems rendered the association between ELBW and ADDH non-significant.