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Neurobehavioral symptoms in children born extremely preterm: A Swedish National Study

Fredrik Serenius1,2, Ylva Fredriksson Kaul1, Karin Källén3

  • 1Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.

Acta Paediatrica (Oslo, Norway : 1992)
|August 8, 2023
PubMed

Insights

Extremely preterm (EPT) children show significantly higher rates of neurobehavioral problems, including attention and social difficulties, compared to term-born peers. These issues persist even in EPT children without intellectual disabilities, highlighting the need for early monitoring.

Area of Science:

  • Developmental Pediatrics
  • Neuroscience
  • Public Health

Background:

  • Extremely preterm (EPT) birth (<27 weeks' gestation) poses risks for neurodevelopmental outcomes.
  • Previous studies indicate neurobehavioral challenges in EPT survivors, but comprehensive domain-specific data at school age is limited.

Purpose of the Study:

  • To determine the prevalence of neurobehavioral symptoms at 6.5 years in children born extremely preterm.
  • To compare neurobehavioral outcomes between EPT children and term-born controls, including EPT children without neurodevelopmental disabilities (NDD).

Main Methods:

  • A population-based cohort study in Sweden (2004-2007) included 375 EPT survivors and 369 matched term-born controls.
  • Parental questionnaires assessed hyperactivity, attention, emotional, peer-relation, conduct, and social problems, alongside perceptual, language, and memory deficits.
  • EPT children were analyzed as a whole group and separately for those free from NDD.

Main Results:

  • EPT children exhibited significantly higher odds (over threefold) of neurobehavioral problems across all assessed domains compared to controls.
  • Increased neurobehavioral problems were observed in EPT children even when neurodevelopmental disabilities were excluded, except for conduct problems.
  • The likelihood of experiencing ≥3 co-occurring neurobehavioral problems was five times higher in the overall EPT group and three times higher in the NDD-free EPT group.

Conclusions:

  • Extremely preterm children, with or without NDD, demonstrate a higher prevalence of neurobehavioral problems in multiple domains compared to their term-born peers.
  • Early identification and ongoing monitoring of behavioral symptoms, including attention, social, perceptual, emotional, and language difficulties, are crucial for EPT children through school age and beyond.
Abstract

Keywords:
cohort studydevelopmentlanguagemental healthperception

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