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Published on: August 25, 2014
Early predictors of late childhood behavioural outcomes following very preterm birth
Zeyuan Sun1,2, Andrew J Lawrence3,4, Laila Hadaya1,2
1Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Insights
Early cognitive and behavioral issues in very preterm children predict later problems. Early interventions focusing on cognitive development and behavior regulation are crucial for mitigating long-term psychiatric risks.
Area of Science:
- Neuroscience
- Developmental Psychology
- Child Psychiatry
Background:
- Children born very preterm (VPT; ≤32 weeks' gestation) exhibit increased risk for behavioral problems, including socio-emotional and attention deficits.
- These challenges persist into later childhood, impacting overall psychiatric outcomes.
Purpose of the Study:
- To identify multi-dimensional predictors of late childhood behavioral and psychiatric outcomes in very preterm children.
- To utilize longitudinal clinical, environmental, and cognitive measures for prediction.
Main Methods:
- Longitudinal neuropsychological assessments were conducted on 153 VPT children at multiple time points (18-24 months, 4-7 years, 8-11 years).
- Predictors included clinical, environmental, cognitive, and behavioral measures from toddlerhood and early childhood.
- Elastic-net regularization and nested cross-validation were employed to build and evaluate prediction models.
Main Results:
- Factor analysis identified two primary outcome factors: externalizing and internalizing-socio-emotional problems.
- Externalizing problems were best predicted by response inhibition, effortful control, and early internalizing symptoms (R²=.256).
- Internalizing problems were predicted by autism traits and poor cognitive flexibility (R²=.123), with more accurate prediction for externalizing symptoms.
Conclusions:
- Early childhood cognitive and behavioral patterns significantly predict later behavioral and psychiatric outcomes in very preterm children.
- Targeted early interventions are essential to enhance cognitive development and behavioral regulation, thereby reducing long-term psychiatric risks.
Background:
Children born very preterm (VPT; ≤32 weeks' gestation) are at higher risk of developing behavioural problems, encompassing socio-emotional processing and attention, compared to term-born children. This study aimed to examine multi-dimensional predictors of late childhood behavioural and psychiatric outcomes in very preterm children, using longitudinal clinical, environmental, and cognitive measures.
Methods:
Participants were 153 VPT children previously enrolled in the Evaluation of Preterm Imaging study who underwent neuropsychological assessments at 18-24 months, 4-7 years and 8-11 years as part of the Brain Immunity and Psychopathology following very Preterm birth (BIPP) study. Predictors of late childhood behavioural and psychiatric outcomes were investigated, including clinical, environmental, cognitive, and behavioural measures in toddlerhood and early childhood. Parallel analysis and exploratory factor analysis were conducted to define outcome variables. A prediction model using elastic-net regularisation and repeated nested cross-validation was applied to evaluate the predictive strength of these variables.
Results:
Factor analysis revealed two key outcome factors in late childhood: externalising and internalising-socio-emotional problems. The strongest predictors of externalising problems were response inhibition, effortful control and internalising symptoms in early childhood (cross-validated R2=.256). The strongest predictors of internalising problems were autism traits and poor cognitive flexibility in early childhood (cross-validated R2=.123). Cross-validation demonstrated robust prediction models, with higher accuracy for externalising symptoms.
Conclusions:
Early childhood cognitive and behavioural outcomes predicted late childhood behavioural and psychiatric outcomes in very preterm children. These findings underscore the importance of early interventions targeting cognitive development and behavioural regulation to mitigate long-term psychiatric risks in very preterm children.
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