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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Childhood and adolescent mental health of NICU graduates: an observational study
Andreea Chiorean1, Calan Savoy2, Karen Beattie3
1Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada andreea.chiorean@mail.utoronto.ca.
Insights
Children and adolescents who were in neonatal intensive care units (NICUs) face a higher risk of developing psychiatric disorders. This includes conditions like ADHD, anxiety, and oppositional defiant disorder, persisting into adolescence.
Area of Science:
- Pediatric Mental Health
- Neonatal Care Outcomes
- Child Psychiatry
Background:
- Neonatal intensive/special care units (NICUs) provide critical care for vulnerable infants.
- Long-term mental health outcomes for NICU graduates require ongoing investigation.
- Understanding developmental trajectories is crucial for early intervention.
Purpose of the Study:
- To investigate the prevalence and risk of psychiatric disorders in children and adolescents with a history of NICU admission.
- To compare mental health outcomes between NICU graduates and a control group.
Main Methods:
- A cross-sectional study utilizing the 2014 Ontario Child Health Study cohort.
- Parental and self-reported psychiatric diagnoses were assessed using the MINI International Neuropsychiatric Interview for Children and Adolescents.
- Analysis included children aged 4-11 years and adolescents aged 12-17 years, comparing NICU graduates with controls.
Main Results:
- NICU graduates aged 4-11 showed increased odds for any psychiatric disorder (OR 1.78), ADHD (OR 1.61), and separation anxiety disorder (OR 4.11).
- Adolescents (12-17 years) with NICU history also had higher odds for psychiatric comorbidity (OR 1.64 parent-reported, OR 1.74 self-reported).
- Increased risks for oppositional defiant disorder were reported by both parents (OR 1.89) and adolescents (OR 3.17).
Conclusions:
- Neonatal intensive care unit graduates are at a significantly increased risk for developing psychiatric disorders throughout childhood and adolescence.
- These findings highlight the need for long-term mental health monitoring and support for NICU survivors.
- Early identification and intervention strategies are essential for mitigating long-term psychiatric morbidities.
Objective:
To investigate the mental health of children and adolescents admitted to neonatal intensive/special care units (NICUs) in infancy.
Methods:
This cross-sectional study used a provincially representative cohort from the 2014 Ontario Child Health Study. Parents provided data on psychiatric disorders using the MINI International Neuropsychiatric Interview for Children and Adolescents in 3141 children aged 4-11 years (NICU n=389; control n=2752) and in 2379 children aged 12-17 years (NICU n=298; control n=2081). Additionally, 2235 adolescents aged 12-17 years completed the interview themselves (NICU n=285; control n=1950). Odds of psychiatric disorder were compared in those admitted and controls.
Results:
Based on parent reports, NICU graduates aged 4-11 years had increased adjusted ORs (95% CI) of 1.78 (1.39 to 2.28) for any psychiatric disorder, with a marginal prevalence of 32.4% in NICU participants and 27.6% in controls. At this age, NICU graduates also had increased ORs of 1.74 (1.25 to 2.40) for psychiatric comorbidity, 1.48 (1.04 to 2.11) for oppositional defiant disorder, 1.61 (1.19 to 2.19) for attention-deficit hyperactivity disorder, 4.11 (2.33 to 7.25) for separation anxiety disorder and 2.13 (1.37 to 3.31) for specific phobia. At 12-17 years, 40.5% and 30.5% of NICU graduates and 30.6% and 17.9% of controls had any psychiatric disorder as reported by parents and self-report, respectively. Parents and adolescents, respectively, reported increased adjusted ORs (95% CI) of 1.63 (1.18 to 2.26) and 1.55 (1.13 to 2.11) for any disorder, 1.64 (1.06 to 2.54) and 1.74 (1.11 to 2.73) for psychiatric comorbidity, and 1.89 (1.22 to 2.93) and 3.17 (2.03 to 4.95) for oppositional defiant disorder.
Conclusions:
NICU graduates are at increased risk for psychiatric disorders during childhood and adolescence.
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