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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
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High-risk neighbourhoods and behaviour outcomes in children born extremely preterm

Ogochukwu Y Nwanne1,2,3, Michelle L Rogers4, Elisabeth C McGowan1,2

  • 1Division of Neonatal Medicine, Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.

Acta Paediatrica (Oslo, Norway : 1992)
|April 10, 2024
PubMed

Insights

Extreme preterm children in high-risk neighborhoods show increased behavioral problems. Cognitive delay is also a risk factor, but breast milk may offer protection.

Area of Science:

  • Pediatrics
  • Developmental Psychology
  • Public Health

Background:

  • Extreme preterm (EPT) children face developmental challenges.
  • Neighbourhood socioeconomic factors can influence child development and behaviour.
  • Understanding these influences is crucial for targeted interventions.

Purpose of the Study:

  • To investigate the association between neighbourhood risk and behavioural outcomes in EPT children.
  • To determine if living in high-risk neighbourhoods increases the likelihood of behavioural problems at 30-36 months corrected age.

Main Methods:

  • Retrospective analysis of Child Behavior Checklist (CBCL) scores for 739 EPTs born between 2005-2016.
  • Geocoding of addresses to classify neighbourhoods as high or low risk based on census block groups.
  • Regression analyses to assess the impact of neighbourhood risk on behavioural outcomes, controlling for other factors.

Main Results:

  • Children in high-risk neighbourhoods (39%) had significantly higher odds of clinical range behavioural problems, including Emotionally Reactive, Somatic Complaints, Withdrawn, Aggressive Behaviour, Internalising, and Total scores.
  • Cognitive delay was more prevalent in high-risk neighbourhoods and independently associated with Attention Problems.
  • Breast milk feeding at discharge showed a protective effect against Emotionally Reactive and Sleep Problems.

Conclusions:

  • Neighbourhood risk is an independent contributor to adverse behavioural outcomes in EPT children.
  • Cognitive delay represents an additional, independent risk factor for behavioural issues.
  • Breast milk intake at discharge demonstrates a protective effect, highlighting its importance for EPT child development.
Abstract

Keywords:
behaviourextreme pretermhigh‐risk neighbourhoodoutcomes

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