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Antenatal and early postnatal antecedents of parent-reported attention problems at 2 years of age

L Corbin Downey1, T Michael O'Shea1, Elizabeth N Allred2

  • 1Division of Neonatology, Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC.

The Journal of Pediatrics
|September 22, 2014
PubMed

Insights

Maternal education and secondhand smoke exposure are linked to attention problems in extremely preterm infants. Certain infections and placental issues also increase risk, while multifetal gestation may be protective.

Area of Science:

  • Neonatal care
  • Developmental pediatrics
  • Behavioral science

Background:

  • Extremely preterm infants face heightened risks for developmental challenges.
  • Attention problems are a significant concern in this vulnerable population.
  • Identifying early risk factors is crucial for timely intervention.

Purpose of the Study:

  • To investigate antenatal and early postnatal risk factors for attention problems.
  • To analyze antecedents of attention deficit/hyperactivity problems (ADHP(DSM)) in extremely preterm children.
  • To inform strategies for mitigating behavioral issues in this cohort.

Main Methods:

  • A cohort of 826 extremely preterm infants (23-27 weeks' gestation) was studied.
  • Parental Child Behavior Checklist ratings were used at 2 years adjusted age.
  • Time-oriented logistic regression identified risk factors for attention problems and ADHP(DSM).

Main Results:

  • Maternal education level below high school and secondhand smoke exposure increased attention problem risk.
  • Placental infections (Mycoplasma) and fetal stem vessel thrombosis were linked to ADHP(DSM).
  • Tracheal aspirate bacterial recovery was a postnatal risk factor; multifetal gestation showed a protective effect.

Conclusions:

  • Several antenatal and perinatal factors are associated with attention problems in extremely preterm infants.
  • Some identified risk factors, such as maternal education and smoke exposure, are potentially modifiable.
  • Early identification of these antecedents can guide targeted support for affected children.
Abstract

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