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Longitudinal growth and emotional and behavioral problems at age 7 in moderate and late preterms
Baukje M Dotinga1, Andrea F de Winter2, Inger F A Bocca-Tjeertes1
1Division of Neonatology, Department of Pediatrics, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Insights
Postnatal growth in moderately and late preterm children (MLPs) from birth to age 7 was not linked to emotional and behavioral problems at age 7. This suggests different causes for growth and behavioral issues in these children.
Area of Science:
- Pediatrics
- Developmental Psychology
- Child Health
Background:
- Moderately and late preterm children (MLPs) exhibit increased risks for impaired growth and neuropsychological deficits.
- Limited evidence exists regarding the association between growth and emotional and behavioral (EB) problems in MLPs.
- Understanding these associations is crucial for targeted interventions and support for preterm populations.
Purpose of the Study:
- To investigate the longitudinal association between growth patterns from birth to age 7 and the presence of EB problems at age 7 in MLPs.
- To determine if growth trajectories in preterm children predict later emotional and behavioral outcomes.
Main Methods:
- Prospective cohort study involving 248 MLPs within the Longitudinal Preterm Outcome Project.
- Growth parameters (height, weight, head circumference, catch-up growth) assessed from birth to age 7.
- Emotional and behavioral problems evaluated at age 7 using the Child Behavior Checklist; logistic regression analysis adjusted for covariates.
Main Results:
- Postnatal growth measures in the MLP cohort were below Dutch reference norms.
- EB problems were more prevalent in MLPs compared to the general Dutch population.
- No significant associations were found between longitudinal growth and EB problems at age 7 (ORs 0.20–2.72).
Conclusions:
- Longitudinal growth from birth to age 7 in MLPs is not associated with EB problems at age 7.
- The findings suggest that while poorer growth may relate to neuropsychological issues, it does not predict EB problems.
- The distinct associations imply partially different etiological pathways for growth deficits versus EB problems in MLPs.
Objectives:
Moderately and late preterm children (MLPs, 32.0-36.9 weeks gestational age) have a greater risk of poorer growth. This seems to be associated with poorer neuropsychological functioning. Evidence is limited on whether this also holds for emotional and behavioral (EB) problems. Therefore, we assessed whether longitudinal growth from birth until age 7 was associated with EB problems at age 7 in MLPs.
Study Design:
This study was part of the Longitudinal Preterm Outcome Project, a prospective cohort study. Data on growth (height, weight, head circumference, and extent of catch-up growth) were obtained from assessments from birth until age 7. EB problems were assessed at age 7 with the Child Behavior Checklist. We assessed whether growth and EB problems were associated using logistic regression analyses, adjusting for multiple birth, parity, and socioeconomic status.
Results:
We included 248 MLPs. Median gestational age was 34 weeks (interquartile range: 33-35 weeks). Mean birth weight was 2.2 kg (standard deviation: 0.5 kg). Postnatal growth measures were below the Dutch reference norm. EB problems were more prevalent in MLPs than in the general Dutch population. Generally, we found no associations between growth and EB problems; odds ratios ranged from 0.20 to 2.72.
Conclusions:
In MLPs, postnatal growth from birth until age 7 was not associated with EB problems at age 7. Poorer growth thus seems to relate to neuropsychological problems, but not to EB problems. This suggests that the etiologies of these problems differ at least partially.
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