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Long-term behavioral sequelae of prematurity
P F Schothorst1, H van Engeland
1Rudolf Magnus Institute of Neuroscience, Department of Child and Adolescent Psychiatry, Academic Hospital/Utrecht University, The Netherlands.
Insights
Preterm children, especially those born very early or small for gestational age (SGA), face lasting challenges in social skills and school performance. These developmental issues persist into adolescence.
Area of Science:
- Developmental Pediatrics
- Neonatal Intensive Care Outcomes
- Child Psychology
Background:
- Preterm birth is associated with potential long-term neurodevelopmental challenges.
- Neonatal complications can impact a child's developmental trajectory.
- Understanding the long-term competence and behavioral outcomes in preterm children is crucial.
Purpose of the Study:
- To longitudinally evaluate the competence and behavioral problems in preterm children with serious neonatal complications.
- To identify specific risk factors within the preterm population, such as very preterm birth or small for gestational age (SGA).
Main Methods:
- Prospective follow-up study of 177 nonhandicapped preterm children hospitalized in a neonatal intensive care unit.
- Assessment from early school age to early adolescence using the Child Behavior Checklist (CBCL) parent form.
- Comparison with a control group of 276 children from the general population.
Main Results:
- Preterm children exhibited lower social and school competence scores compared to controls.
- Preterm children were more likely to attend special schools.
- Increased social problems were noted in preterm children, particularly those who were very preterm or SGA.
- Internalizing problems, attention problems, and social problems showed high stability over time in at-risk preterm subgroups.
Conclusions:
- Very preterm and preterm SGA children are at a significantly increased risk for persistent social and academic functioning difficulties.
- These challenges in social functioning and school performance are evident from early school age through early adolescence.
Objective:
Longitudinal evaluation of the competence and the prevalence of behavior problems in preterm children with serious neonatal complications.
Method:
Prospective follow-up of nonhandicapped preterm children who had been hospitalized in a neonatal intensive care unit (n = 177). The follow-up extended from early school age to early adolescence and was conducted with the help of the Child Behavior Checklist (CBCL) (parent form).
Results:
The preterm children had lower scores on the Social and School Competence scales than did controls (n = 276). They also were more likely to attend special schools than were children in the general population. With regard to behavior problems, the preterm children had more social problems. The very preterm children and the children who were small for gestational age (SGA) were the ones who contributed to the significant findings. The children who were appropriate for gestational age did not differ from controls. No differential changes in CBCL ratings were found between the preterm and control children. The stability with regard to internalizing problems, attention problems, and social problems was high among the very preterm children and SGA children.
Conclusion:
Very preterm and preterm SGA children are at increased risk of problems in social functioning and functioning at school. These problems persist with age.