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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
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Burden of mental, behavioral, and neurodevelopmental disorders in the Finnish most preterm children: a national

Marika Leppänen1, Bernd Pape2, Liisi Ripatti3

  • 1Neuropsychiatric Outpatient Clinic, Turku University Hospital, and Preventive Medicine, University of Turku, 20014, Turun Yliopisto, Turku, Finland. marika.leppanen@utu.fi.

European Child & Adolescent Psychiatry
|February 27, 2023
PubMed

Insights

Children born preterm, especially extremely preterm, face a significantly higher risk of mental and behavioral disorders up to age 12. Lower gestational age correlates with increased risk and earlier onset of these childhood disorders.

Area of Science:

  • Child and Adolescent Psychiatry
  • Developmental Pediatrics
  • Public Health

Background:

  • Gestational age (GA) and its impact on childhood mental, behavioral, and neurodevelopmental disorders remain incompletely understood.
  • Existing research lacks a comprehensive overview of the full spectrum of disorders associated with varying GAs.

Purpose of the Study:

  • To investigate the association between gestational age and the prevalence of mental and behavioral disorders in children aged 0-12 years.
  • To identify specific risk factors that may exacerbate these disorders in relation to GA.

Main Methods:

  • Utilized national registry data of all Finnish children born between 2001-2006 (N=341,632) and their mothers (N=241,284).
  • Excluded children with unclear GA, severe congenital malformations, cognitive impairment, or perinatal death.
  • Analyzed the prevalence of mental and behavioral disorders (ICD) by GA, adjusting for gender and prenatal factors.

Main Results:

  • 16.6% of included children (N=326,902) were diagnosed with a mental health disorder by age 12.
  • Preterm birth (<37 weeks GA) was associated with a 1.37 OR for any disorder, while extreme preterm birth (≤28 weeks GA) showed a 4.03 OR compared to term-born children.
  • Lower GA increased the risk for multiple disorders and earlier onset. Male gender, maternal mental health disorders, and smoking during pregnancy were significant risk factors, particularly pronounced in preterm infants.

Conclusions:

  • Extreme preterm birth is a substantial independent risk factor for mental health disorders in childhood.
  • The risk and severity of mental health disorders increase with lower gestational age.
  • Preterm children exhibit an accumulation of risk factors, highlighting the need for targeted interventions and support.

Keywords:
DevelopmentMaternal factorsMental healthPrematurity

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