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Published on: August 25, 2014
Co-occurrence of developmental and behavioural problems in moderate to late preterm-born children
Marieke R Potijk1, Andrea F de Winter1, Arend F Bos2
1Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Insights
Moderate to late preterm children with developmental delay show higher rates of emotional and behavioural problems (EBP). Increased awareness of these co-occurring issues is crucial for this vulnerable population.
Area of Science:
- Child development
- Developmental pediatrics
- Behavioral science
Background:
- Developmental delay affects a significant number of children.
- Preterm birth is a known risk factor for developmental challenges.
- Emotional and behavioural problems (EBP) can co-occur with developmental delay.
Purpose of the Study:
- To investigate the prevalence of EBP in moderate to late preterm (MLP) children with developmental delay.
- To compare EBP occurrence in MLP children versus full-term children with developmental delay.
- To identify risk factors associated with co-occurring EBP and developmental delay.
Main Methods:
- A cohort of 903 MLP children and 538 full-term controls aged 4 years were assessed.
- Parents completed the Ages and Stages Questionnaire (ASQ) and Child Behaviour Checklist (CBCL).
- Co-occurrence was defined by abnormal scores on ASQ and CBCL indicating EBP.
Main Results:
- MLP children exhibited higher EBP prevalence than full-term controls, especially externalizing problems (33.8% vs 23.8%).
- In MLP children, EBP were most common in problem-solving and personal-social domains.
- The risk of co-occurrence was significantly higher in MLP children (OR 1.86), with male gender, low SES, and young maternal age as risk factors.
Conclusions:
- Up to 39% of 4-year-old MLP children with developmental delay also experience EBP.
- Heightened awareness and screening for EBP are essential in MLP children with developmental delay.
- Further research is needed to evaluate the long-term impact of early detection of co-occurring problems.
Objective:
To determine the occurrence of emotional and behavioural problems (EBP) in moderate to late preterm (MLP) and full-term children with developmental delay.
Design:
Participants were recruited from 13 randomly selected preventive child healthcare (PCH) centres in the Netherlands. We included 903 MLP children of 32-36 weeks' gestation and 538 full-term controls, born between January 2002 and June 2003. Parents completed the Ages and Stages Questionnaire (ASQ) and Child Behaviour Checklist (CBCL) shortly before the scheduled PCH visit at 4 years of age. Co-occurrence was defined as: ASQ total or domain score >2 SDs below the mean and a CBCL score >84th percentile on total problems, internalising (emotional) or externalising (behavioural) problems.
Results:
EBP were more prevalent among MLP children with abnormal ASQ total problems scores than among full-term children, particularly regarding externalising problems (33.8% vs 23.8%). In MLP children, rates of EBP differed per developmental domain and were highest for the domains problem-solving (36.0% had externalising problems, 95% CI 24.1% to 49.9%) and personal-social skills (38.7% had internalising problems, 95% CI 26.4% to 52.8%). The risk of any type of co-occurrence was higher for MLP than for full-term children (OR 1.86; 95% CI 1.14 to 3.03). Independent risk factors for co-occurrence were male gender, low socioeconomic status and young maternal age.
Conclusions:
Up to 39% of 4-year-old MLP children with developmental delay also have EBP, indicating that increased awareness of EBP is warranted in MLP children with developmental delay. Further research is needed to determine whether early detection of co-occurring problems results in better long-term health.
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