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Exploring the "Preterm Behavioral Phenotype" in Children Born Extremely Preterm
Alice C Burnett1,2,3,4, George Youssef5,6, Peter J Anderson1,7
1Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Australia.
Insights
Children born extremely preterm or with extremely low birth weight show distinct behavioral patterns. Higher symptom levels in these children correlate with poorer cognitive and academic results.
Area of Science:
- Developmental Psychology
- Neonatal Research
- Behavioral Science
Background:
- Extremely preterm (EP) and extremely low birth weight (ELBW) infants face risks for neurodevelopmental challenges.
- A 'preterm behavioral phenotype' encompassing emotional, attention, and social difficulties is proposed.
- Understanding behavioral profiles in EP/ELBW survivors is crucial for targeted interventions.
Purpose of the Study:
- To investigate the co-occurrence of emotional, attention, and social functioning difficulties in children born EP/ELBW.
- To identify distinct behavioral profiles among these children.
- To examine the relationship between these behavioral profiles and cognitive/academic outcomes.
Main Methods:
- A population-based cohort study of EP/ELBW survivors and matched controls in Victoria, Australia.
- Parental ratings of child behavior using the Strengths and Difficulties Questionnaire at 7-8 years.
- Latent profile analysis to identify behavioral patterns.
Main Results:
- Four distinct behavioral profiles were identified, including minimal difficulties, a preterm behavioral phenotype, and globally elevated symptoms.
- EP/ELBW children were overrepresented in the preterm behavioral phenotype (20% vs. 12% controls) and globally elevated symptom groups (8% vs. 3%).
- Higher levels of behavioral symptoms were associated with poorer cognitive and academic performance, independent of birth group and demographics.
Conclusions:
- While a preterm behavioral phenotype exists, it is present in only 20% of EP/ELBW children.
- Behavioral symptom severity is a significant predictor of cognitive and academic outcomes in this population.
- Further research is needed to understand the underlying mechanisms and develop effective support strategies.
Objective:
To examine whether difficulties in emotional, attention, and peer or social functioning (a proposed "preterm behavioral phenotype") co-occur within individual children born extremely preterm (EP; <28 weeks of gestation) and/or extremely low birth weight (ELBW; <1,000 g) and whether different behavioral profiles are related to cognitive and academic outcomes.
Methods:
Population-based cohort of all EP/ELBW survivors born in the state of Victoria, Australia, in 2005, and contemporaneous matched controls were recruited at birth. At age 7 to 8 years, parents of 181 EP/ELBW and 185 control children rated their children's behavior on the Strengths and Difficulties Questionnaire problem scales (emotional symptoms, conduct problems, hyperactivity/inattention, and peer problems). Latent profile analysis was used to explore patterns of behavior within individual children.
Results:
Four behavioral profiles were identified: (1) minimal difficulties in all domains; (2) a profile consistent with the preterm behavioral phenotype; (3) elevations in all domains except peer problems; and (4) marked global elevations in all domains. Most preterm children (55%) had a profile of minimal difficulties. Relative to their risk of being in the minimal difficulties group, EP/ELBW children were overrepresented in the preterm behavioral phenotype (20% vs. 12% controls) and the globally elevated symptom groups (8% vs. 3%). Accounting for birth group and demographic variables, profiles with higher levels of behavior symptoms were associated with poorer cognitive and academic performance.
Conclusion:
Although more EP/ELBW children exhibited the proposed preterm behavioral phenotype than controls, it occurred in only 20% of EP/ELBW children. Greater behavior symptoms were associated with poorer cognitive and academic outcomes.