The association of birth weight with children's anxiety, depression and developmental disabilities

Low birth weight (LBW) has been linked to the risk of developmental disabilities. However, few studies have been large enough to assess the associations between children's mental health (anxiety, depression) and a comprehensive range of developmental disabilities in a large general children's population, and limited studies have examined dose-response associations.

This population-based, nationally representative cross-sectional study included 35,379 children aged 6-17 years who participated in the 2022-2023 National Survey of Children's Health (NSCH) in the U.S from July 2022 to January 2024. Data of NSCH survey were based on retrospective parental or primary caregiver self-reports. Multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated by multivariable logistic regression models to explore the association between low or high birth weight, anxiety, depression, behavior problems, developmental delay, intellectual disability, speech disorder, learning disability, autism spectrum disorder (ASD), and attention deficit disorder/attention-deficit hyperactivity disorder (ADD/ADHD).

The weighted prevalence for each of the adverse outcomes was as follows: anxiety, 10.6; depression, 5.0; behavior problems, 7.6; developmental delay, 5.3; intellectual disability, 0.8; speech disorder, 6.5; learning disability, 6.6; ASD, 3.2; and ADD/ADHD, 10.5. The prevalence of LBW was 9.5 (95%CI, 8.9-10.2, [weighted]). LBW was associated with a higher risk of anxiety (OR, 1.14 [95% CI, 1.02-1.27]), behavior problems (OR, 1.29 [95% CI, 1.14-1.47]), developmental delay (OR, 2.18 [95% CI, 1.91-2.48]), intellectual disability (OR, 2.00 [95% CI, 1.45-2.75]), speech disorder (OR, 1.61 [95% CI, 1.42-1.84]), learning disability (OR, 1.69 [95% CI, 1.49-1.92]), ASD (OR, 1.32 [95% CI, 1.09-1.59]) and ADD/ADHD (OR, 1.36 [95% CI, 1.22-1.52]), respectively. There was no statistically significant association between high birth weight and anxiety, depression, or any developmental disabilities. The dose-response analysis showed a decreasing association between increasing birth weight and anxiety, behavior problems, developmental delay, intellectual disability, speech disorder, learning disability, ASD, and ADD/ADHD, respectively. Similar results were obtained in the sensitivity analyses. Compared to youth without LBW and PTB, youth with LBW and PTB have the highest risk of outcomes.

In conclusion, this large population-based, nationally representative, comprehensive study demonstrates that LBW was associated with a higher risk of anxiety and developmental disabilities in US youths aged 6-17 years. Our findings suggested that for monitoring, maintaining, and supporting the health of children born with LBW.