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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
What Do We Know About the Preterm Behavioral Phenotype? A Narrative Review
Grace C Fitzallen1,2, H Gerry Taylor3, Samudragupta Bora2
1School of Psychology, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD, Australia.
Insights
Children born preterm face higher risks of psychopathology, with earlier birth linked to greater risk. A distinct preterm behavioral phenotype, characterized by co-occurring ADHD, autism, and anxiety symptoms, is increasingly recognized.
Area of Science:
- Developmental Psychology
- Pediatric Psychiatry
- Neuroscience
Background:
- Preterm birth elevates the risk for childhood and adolescent psychopathology compared to full-term birth.
- An inverse relationship exists between gestational age at birth and the later risk of psychopathology.
- Emotional and behavioral adjustment problems in preterm children present distinct symptomatology and comorbidity profiles.
Purpose of the Study:
- To comprehensively characterize the preterm behavioral phenotype.
- To identify knowledge gaps concerning symptom evolution and disorder co-occurrence.
- To explore associations between the preterm behavioral phenotype and chronological age/degree of prematurity.
Main Methods:
- State-of-the-art literature review.
- Synthesis of current research on preterm birth and psychopathology.
- Analysis of proposed preterm behavioral phenotype characteristics.
Main Results:
- A distinct preterm behavioral phenotype is increasingly recognized.
- This phenotype is characterized by the frequent co-occurrence of symptoms related to attention-deficit/hyperactivity disorder, autism spectrum disorder, and anxiety disorders.
- Key knowledge gaps remain regarding symptom evolution and comorbidity within this phenotype.
Conclusions:
- The preterm behavioral phenotype represents a unique cluster of emotional and behavioral challenges in this population.
- Further research is needed to understand the developmental trajectory and clinical implications of this phenotype.
- Understanding these distinct profiles is crucial for targeted interventions and support for preterm-born individuals.
Abstract:
Preterm birth is associated with a significantly increased risk for childhood and adolescent psychopathology relative to full-term birth, with an inverse relationship between gestational age at birth and later risk for psychopathology. The manifestation of symptomatology and comorbidity profiles of emotional and behavioral adjustment problems in this high-risk group have been shown to be distinct from the broader pediatric population. Acknowledging these differences, a preterm behavioral phenotype has been proposed and increasingly recognized, highlighting the unique, frequent co-occurrence of symptomatology associated with attention-deficit/hyperactivity disorder, autism spectrum disorder, and anxiety disorders. The current state-of-the-art review provides a comprehensive characterization of this phenotype to date and further highlights key knowledge gaps primarily regarding the evolution of symptoms, co-occurrence of disorders and/or symptomatology within the phenotype, and associations of the phenotype with chronological age and degree of prematurity.
