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Pettinger KJ, Copper C, Boyle E, Blower S, Hewitt C, Fraser L. Risk of Developmental Disorders in Children Born at 32 to 38 Weeks' Gestation: A Meta-Analysis. Pediatrics 2023; 152:e2023061878. [PMID: 37946609 PMCID: PMC10657778 DOI: 10.1542/peds.2023-061878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/23/2023] [Indexed: 11/12/2023] Open
Abstract
CONTEXT Very preterm birth (<32 weeks) is associated with increased risk of developmental disorders. Emerging evidence suggests children born 32 to 38 weeks might also be at risk. OBJECTIVES To determine the relative risk and prevalence of being diagnosed with, or screening positive for, developmental disorders in children born moderately preterm, late preterm, and early term compared with term (≥37 weeks) or full term (39-40/41 weeks). DATA SOURCES Medline, Embase, Psychinfo, Cumulative Index of Nursing, and Allied Health Literature. STUDY SELECTION Reported ≥1 developmental disorder, provided estimates for children born 32 to 38 weeks. DATA EXTRACTION A single reviewer extracted data; a 20% sample was second checked. Data were pooled using random-effects meta-analyses. RESULTS Seventy six studies were included. Compared with term born children, there was increased risk of most developmental disorders, particularly in the moderately preterm group, but also in late preterm and early term groups: the relative risk of cerebral palsy was, for 32 to 33 weeks: 14.1 (95% confidence intervals [CI]: 12.3-16.0), 34 to 36 weeks: 3.52 (95% CI: 3.16-3.92) and 37 to 38 weeks: 1.44 (95% CI: 1.32-1.58). LIMITATIONS Studies assessed children at different ages using varied criteria. The majority were from economically developed countries. All were published in English. Data were variably sparse; subgroup comparisons were sometimes based on single studies. CONCLUSIONS Children born moderately preterm are at increased risk of being diagnosed with or screening positive for developmental disorders compared with term born children. This association is also demonstrated in late preterm and early term groups but effect sizes are smaller.
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Affiliation(s)
| | | | - Elaine Boyle
- University of Leicester, Leicester, United Kingdom
| | | | | | - Lorna Fraser
- University of York, York, United Kingdom
- King’s College London, London, United Kingdom
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Christians JK, Ahmadzadeh-Seddeighi S, Bilal A, Bogdanovic A, Ho R, Leung EV, MacGregor MA, Nadasdy NM, Principe GM. Sex differences in the effects of prematurity and/or low birthweight on neurodevelopmental outcomes: systematic review and meta-analyses. Biol Sex Differ 2023; 14:47. [PMID: 37434174 DOI: 10.1186/s13293-023-00532-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 07/04/2023] [Indexed: 07/13/2023] Open
Abstract
BACKGROUND Premature birth and/or low birthweight have long-lasting effects on cognition. The purpose of the present systematic review is to examine whether the effects of prematurity and/or low birth weight on neurodevelopmental outcomes differ between males and females. METHODS Web of Science, Scopus, and Ovid MEDLINE were searched for studies of humans born premature and/or of low birthweight, where neurodevelopmental phenotypes were measured at 1 year of age or older. Studies must have reported outcomes in such a way that it was possible to assess whether effects were greater in one sex than the other. Risk of bias was assessed using both the Newcastle-Ottawa scale and the National Institutes of Health Quality assessment tool for observational cohort and cross-sectional studies. RESULTS Seventy-five studies were included for descriptive synthesis, although only 24 presented data in a way that could be extracted for meta-analyses. Meta-analyses found that severe and moderate prematurity/low birthweight impaired cognitive function, and severe prematurity/low birthweight also increased internalizing problem scores. Moderate, but not severe, prematurity/low birthweight significantly increased externalizing problem scores. In no case did effects of prematurity/low birthweight differ between males and females. Heterogeneity among studies was generally high and significant, although age at assessment was not a significant moderator of effect. Descriptive synthesis did not identify an obvious excess or deficiency of male-biased or female-biased effects for any trait category. Individual study quality was generally good, and we found no evidence of publication bias. CONCLUSIONS We found no evidence that the sexes differ in their susceptibility to the effects of severe or moderate prematurity/low birthweight on cognitive function, internalizing traits or externalizing traits. Result heterogeneity tended to be high, but this reflects that one sex is not consistently more affected than the other. Frequently stated generalizations that one sex is more susceptible to prenatal adversity should be re-evaluated.
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Affiliation(s)
- Julian K Christians
- Department of Biological Sciences, Simon Fraser University, Burnaby, BC, Canada.
- Centre for Cell Biology, Development and Disease, Simon Fraser University, Burnaby, BC, Canada.
- British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada.
- Women's Health Research Institute, BC Women's Hospital and Health Centre, Vancouver, BC, Canada.
| | | | - Alishba Bilal
- Department of Biological Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Anastasia Bogdanovic
- Department of Molecular Biology and Biochemistry, Simon Fraser University, Burnaby, BC, Canada
| | - Rebecca Ho
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Molecular Oncology, British Columbia Cancer Research Institute, Vancouver, BC, Canada
| | - Estee V Leung
- Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada
| | - Megan A MacGregor
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Nolan M Nadasdy
- Department of Biological Sciences, Simon Fraser University, Burnaby, BC, Canada
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3
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Robert de Saint Vincent M, Rouger V, Rozé JC, Flamant C, Muller JB. Assessing Behavioral Disorders with SDQ in Very Preterm Children at 5 Years of Age in LIFT Cohort. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1191. [PMID: 37508688 PMCID: PMC10378436 DOI: 10.3390/children10071191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 06/20/2023] [Accepted: 06/30/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND Preterm-born children are at risk of behavioral disorders and the systematic assessment of these disorders remains a challenge. Questions remain about the accuracy of self-reported parent questionnaires and the real everyday life behavior of the child. AIM To evaluate the association between SDQ reported by parents in the preterm and behavioral difficulties in the everyday school life environment reported by teacher. METHODS All children born before 33 weeks and who followed-up in the LIFT (Loire Infant Follow-up team) network were included. The Strengths and Difficulties Parental Questionnaire (SDQ), completed at 5 years, was used to check for behavioral difficulties and identified three groups: "normal", "borderline" and "abnormal". Then, the SDQ results were compared to the Global School Adaptation Score (GSA) at 5 years. RESULTS Out of the 1825 children followed in the cohort at the age of 5, 1397 questionnaires were analyzed. A total of 11.1% of children had an abnormal score, and 9.7% had a borderline score. Male gender and a lower birth weight z-score were significantly associated with the "abnormal SDQ" group. There is a significant relationship between the probability of being in the "abnormal SDQ" group at 5 years and with difficulty in global school adaptation at 5 years, as well as an SDQ borderline score in the preterm (p < 0.001). CONCLUSIONS SDQ abnormal and borderline scores are associated with behavioral difficulties in the classroom and everyday life behavior. In preterm children, one should be alerted even by a borderline SDQ score.
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Affiliation(s)
- Marine Robert de Saint Vincent
- Department of Neonatal Medicine, University Hospital of Nantes, 44000 Nantes, France
- Loire Infant Follow-Up Team (LIFT) Network, 44000 Nantes, France
| | - Valérie Rouger
- Loire Infant Follow-Up Team (LIFT) Network, 44000 Nantes, France
- National Institute of Health and Medical Research, CIC 1413, University Hospital of Nantes, 44000 Nantes, France
| | - Jean Christophe Rozé
- Department of Neonatal Medicine, University Hospital of Nantes, 44000 Nantes, France
- Loire Infant Follow-Up Team (LIFT) Network, 44000 Nantes, France
- National Institute of Health and Medical Research, CIC 1413, University Hospital of Nantes, 44000 Nantes, France
| | - Cyril Flamant
- Department of Neonatal Medicine, University Hospital of Nantes, 44000 Nantes, France
- Loire Infant Follow-Up Team (LIFT) Network, 44000 Nantes, France
- National Institute of Health and Medical Research, CIC 1413, University Hospital of Nantes, 44000 Nantes, France
| | - Jean-Baptiste Muller
- Department of Neonatal Medicine, University Hospital of Nantes, 44000 Nantes, France
- Loire Infant Follow-Up Team (LIFT) Network, 44000 Nantes, France
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4
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Vanes L, Fenn-Moltu S, Hadaya L, Fitzgibbon S, Cordero-Grande L, Price A, Chew A, Falconer S, Arichi T, Counsell SJ, Hajnal JV, Batalle D, Edwards AD, Nosarti C. Longitudinal neonatal brain development and socio-demographic correlates of infant outcomes following preterm birth. Dev Cogn Neurosci 2023; 61:101250. [PMID: 37150083 PMCID: PMC10195853 DOI: 10.1016/j.dcn.2023.101250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 01/31/2023] [Accepted: 04/24/2023] [Indexed: 05/09/2023] Open
Abstract
Preterm birth results in premature exposure of the brain to the extrauterine environment during a critical period of neurodevelopment. Consequently, infants born preterm are at a heightened risk of adverse behavioural outcomes in later life. We characterise longitudinal development of neonatal regional brain volume and functional connectivity in the first weeks following preterm birth, sociodemographic factors, and their respective relationships to psychomotor outcomes and psychopathology in toddlerhood. We study 121 infants born preterm who underwent magnetic resonance imaging shortly after birth, at term-equivalent age, or both. Longitudinal regional brain volume and functional connectivity were modelled as a function of psychopathology and psychomotor outcomes at 18 months. Better psychomotor functioning in toddlerhood was associated with greater relative right cerebellar volume and a more rapid decrease over time of sensorimotor degree centrality in the neonatal period. In contrast, increased 18-month psychopathology was associated with a more rapid decrease in relative regional subcortical volume. Furthermore, while socio-economic deprivation was related to both psychopathology and psychomotor outcomes, cognitively stimulating parenting predicted psychopathology only. Our study highlights the importance of longitudinal imaging to better predict toddler outcomes following preterm birth, as well as disparate environmental influences on separable facets of behavioural development in this population.
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Affiliation(s)
- Lucy Vanes
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom; Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, United Kingdom.
| | - Sunniva Fenn-Moltu
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, United Kingdom; Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom
| | - Laila Hadaya
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, United Kingdom; Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Sean Fitzgibbon
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Lucilio Cordero-Grande
- Biomedical Image Technologies, TelecomunicacionETSI Telecomunicación, Universidad Politécnica de Madrid & CIBER-BBN, ISCIII, Spain
| | - Anthony Price
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, United Kingdom
| | - Andrew Chew
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, United Kingdom
| | - Shona Falconer
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, United Kingdom
| | - Tomoki Arichi
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, United Kingdom; MRC Centre for Neurodevelopmental Disorders, King's College London, United Kingdom; Paediatric Neurosciences, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Serena J Counsell
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, United Kingdom
| | - Joseph V Hajnal
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, United Kingdom
| | - Dafnis Batalle
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, United Kingdom; Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom
| | - A David Edwards
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, United Kingdom; MRC Centre for Neurodevelopmental Disorders, King's College London, United Kingdom
| | - Chiara Nosarti
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, United Kingdom; Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
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5
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Barra L, Coo S. Preterm‐born children's development: A bioecological perspective. INFANT AND CHILD DEVELOPMENT 2022. [DOI: 10.1002/icd.2384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Lisseth Barra
- School of Psycholy Universidad del Desarrollo Santiago Chile
- Deparment of Physical Therapy, Faculty of Medicine University of Chile Santiago Chile
| | - Soledad Coo
- School of Psycholy Universidad del Desarrollo Santiago Chile
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6
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McGill MG, Purkey E, Davison CM, Watson A, Bayoumi I. Financial stress during COVID-19: implications for parenting behaviour and child well-being. BMJ Paediatr Open 2022; 6:10.1136/bmjpo-2022-001569. [PMID: 36645755 PMCID: PMC9462077 DOI: 10.1136/bmjpo-2022-001569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 08/09/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Family financial stress and parenting behaviours are each associated with child behaviours. We sought to explore the association between parent financial stress and child socioemotional and behavioural difficulties during the COVID-19 pandemic and examine parenting behaviour, including overreactive and lax parenting approaches, as a potential mediator to this relationship. METHODS Cross-sectional sample of parent and child data pairings in Ontario, Canada between April and November of 2020. Linear models were used to describe the relationships between financial worry, child Strengths and Difficulties Questionnaire (SDQ) total difficulties and parenting behaviours measured by the Parenting Scale 8-item (PS-8), which includes measures of both overreactive and lax parenting tendencies. Formal mediation testing was performed to assess the potential mediating role of parenting behaviour. RESULTS 528 parent and child pairs were enrolled from largely European ancestry (78%), female (93%) and varied household income levels. Analysis revealed increased financial worry during the COVID-19 pandemic was significantly associated with increased child SDQ total difficulties scores (β=0.23, SE=0.10, p=0.03). This relationship was mediated by reported parenting behaviour, independent of parent education, household income, parent age, parent sex, parent anxiety and child sex (total effect: β=0.69, p=0.02, average causal mediation effects: β=0.50, p=0.02, average direct effects: β=0.19, p=0.08). CONCLUSION Financial stress during the COVID-19 pandemic was associated with poorer child social and emotional well-being. Parenting behaviours measured by the PS-8 significantly mediated these effects. This work supports the importance of policies aimed to alleviate family financial stresses and highlights the potential impact such policies have on child well-being.
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Affiliation(s)
- Megan G McGill
- School of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Eva Purkey
- Department of Family Medicine, Queen's University, Kingston, Ontario, Canada.,Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Colleen M Davison
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Autumn Watson
- Department of Family Medicine, Queen's University, Kingston, Ontario, Canada.,Indigenous Health Council, Kingston, Ontario, Canada
| | - Imaan Bayoumi
- Department of Family Medicine, Queen's University, Kingston, Ontario, Canada .,Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
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7
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Zhang L, Cao H, Lin C, Ye P. Family socio-economic status and Chinese Preschoolers' anxious symptoms during the COVID-19 pandemic: the roles of parental investment, parenting style, home quarantine length, and regional pandemic risk. EARLY CHILDHOOD RESEARCH QUARTERLY 2022; 60:137-149. [PMID: 35125643 PMCID: PMC8802162 DOI: 10.1016/j.ecresq.2022.01.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 01/18/2022] [Accepted: 01/27/2022] [Indexed: 05/15/2023]
Abstract
Using data from 16,161 families with target child of 3-6 years old in Hubei, China during COVID-19 pandemic, this study examined the association between family socio-economic status (SES) and preschoolers' anxious symptoms (PAS). Parental investment and parenting style were tested as mediators for this association. Home quarantine length was tested as a moderator for this direct association and for the associations between family SES and parenting processes, whereas regional pandemic risk was tested as a moderator for the entire model. Results support the utility of Family Stress and Family Investment Models in a Chinese context by identifying unique roles of parental investment and parenting style in mediating the link between family SES and PAS. Quarantine length moderated the link between family SES and authoritarian parenting: Strength of this negative association was stronger for families with longer quarantine than for those with shorter quarantine. Further, family SES was negatively associated with PAS through its negative association with authoritarian parenting, regardless of the quarantine length. Model comparison analyses between high-risk region versus low/medium-risk region groups indicated that the pandemic risk for living regions did not alter any pathway in the model. Such findings inform the designs of targeted interventions to help families cope with pandemic-related challenges. Promoting parental investment and adaptive patenting style represents an avenue to diminish consequences of family economic hardship for young children's mental health, regardless of macrolevel pandemic risk. Interventions should attend to home quarantine duration, as it contextualizes the links among family SES, parenting, and child well-being.
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Affiliation(s)
- Limin Zhang
- Department of Early Childhood Education, School of Education, Guangzhou University, 602 Xing Zheng Xi Building, No. 230 Wai Huan Xi Road, Guangzhou 510006 China
| | - Hongjian Cao
- Institute of Early Childhood Education, Faculty of Education, Beijing Normal University, China
| | - Chaopai Lin
- Department of Early Childhood Education, School of Education, Central China Normal University, China
| | - Pingzhi Ye
- Department of Early Childhood Education, School of Education, Guangzhou University, 602 Xing Zheng Xi Building, No. 230 Wai Huan Xi Road, Guangzhou 510006 China
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8
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Vohr BR, McGowan EC, Brumbaugh JE, Hintz SR. Overview of Perinatal Practices with Potential Neurodevelopmental Impact for Children Affected by Preterm Birth. J Pediatr 2022; 241:12-21. [PMID: 34673090 DOI: 10.1016/j.jpeds.2021.10.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 09/27/2021] [Accepted: 10/15/2021] [Indexed: 12/16/2022]
Affiliation(s)
- Betty R Vohr
- Department of Pediatrics, Alpert Medical School of Brown University and Women & Infants Hospital, Providence, RI.
| | - Elisabeth C McGowan
- Department of Pediatrics, Alpert Medical School of Brown University and Women & Infants Hospital, Providence, RI
| | - Jane E Brumbaugh
- Children's Center of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN
| | - Susan R Hintz
- Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Palo Alto, CA
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9
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Ross GS, Perlman JM. Relationship of withdrawn, anxious/depressed and attention problems to cognitive performance in preterm children at 18 months and 36 months of age. Infant Behav Dev 2021; 66:101660. [PMID: 34773854 DOI: 10.1016/j.infbeh.2021.101660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 09/17/2021] [Accepted: 10/26/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE A positive significant association has been found between behavior problems and lower cognition in very low birthweight (VLBW) preterm children at school age, but there is relatively little information about whether such an association exists in toddlers and on the continuity of this association. The aim of this study was to assess if there is a relationship between behavior problems and cognitive performance in VLBW preterm children at 18 months post conception and 3 years old, independent of socioeconomic status and sex. METHOD Parents of 124 preterm children completed a behavior rating questionnaire (Child Behavior Checklist 1.5-5) to measure behavior problems characteristic of preterm children (Withdrawn, Anxious/Depressed, and Attention Problems). Children completed the Cognitive Scale of the Bayley Scales of Infant Development-III at 18 months and the Wechsler Preschool and Primary Scale (III or IV) at 36 months old. Socioeconomic status (SES), sex, and diagnoses of autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) at 3 years were recorded for each child. RESULTS Withdrawn problems at 18 months were associated with lower cognitive scores at 18 months and both Withdrawn problems at 18 months and 36 months were associated with lower cognitive scores at 36 months. Increases in Attention Problems scores from 18 to 36 months were associated with decreases in cognitive scores over that period. Lower SES was associated with lower cognitive scores at 36 months and decreases in cognitive scores between 18 and 36 months. Sex was not related to behavior problems or cognition. Diagnoses of ASD and ADHD were significantly associated with increased Withdrawn behavior and Attention Problems, respectively. CONCLUSIONS The early association of Withdrawn behaviors with less favorable cognitive performance at 18 months and 36 months and the relationship between increases in Attention Problems with decreases in cognitive scores between the toddler and preschool period indicate the need for early assessment of and intervention for behavior problems, as well as concurrent cognitive delays, in VLBW preterm children.
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Affiliation(s)
- Gail S Ross
- Department of Pediatrics, Weill Cornell Medical College, New York, NY, USA.
| | - Jeffrey M Perlman
- Department of Pediatrics, Weill Cornell Medical College, New York, NY, USA
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10
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Heuser-Spura KM, Jaekel J, Wolke D. The Impact of Formal School Entry on Children's Social Relationships with Parents, Siblings, and Friends. CHILDREN (BASEL, SWITZERLAND) 2021; 8:891. [PMID: 34682156 PMCID: PMC8535132 DOI: 10.3390/children8100891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/24/2021] [Accepted: 10/02/2021] [Indexed: 11/17/2022]
Abstract
The normative transition to formal schooling confronts children with social challenges but also opportunities. Longitudinal research on how school entry impacts children's family and friend-ship relationships is scarce. This study investigated social relationship qualities with parents, siblings, and friends among 1110 children (49.9% female) from the prospective, population-based Bavarian Longitudinal Study at 6 years (before school entry) and 8 years using a forced-choice card-sorting task. Multivariate analyses of variance revealed significant effects of age (i.e., school entry) on social relationship qualities with mothers (Pillai's Trace (PT) = 0.28, F(9, 1101) = 47.73, p < 0.001), fathers (PT = 0.14, F(9, 1101) = 19.47, p < 0.001), siblings (PT = 0.27, F(9, 1101) = 46.14, p < 0.001), and friends (PT = 0.21, F(9, 1101) = 32.57, p < 0.001). On average, children reported higher levels of parental comfort after school entry. Companionable qualities increased in relationships with friends, whereas sibling relationships became more conflictual from preschool to early school age. Findings provide unique insights into how social relationships develop from preschool to early school age, supporting evidence of the growing importance of friends. Conflict was predominant and increasing in sibling relationships and should be considered more in future research.
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Affiliation(s)
- Katharina M. Heuser-Spura
- Department of Pediatrics I, Neonatology, Pediatric Intensive Care and Pediatric Neurology, University Hospital Essen, University of Duisburg-Essen, 45122 Essen, Germany
- Faculty of Psychology, Ruhr-University Bochum, 44801 Bochum, Germany
| | - Julia Jaekel
- Unit of Psychology, Faculty of Education, University of Oulu, 90570 Oulu, Finland;
- Department of Psychology, University of Warwick, Coventry CV4 7AL, UK;
| | - Dieter Wolke
- Department of Psychology, University of Warwick, Coventry CV4 7AL, UK;
- Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
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11
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Van Minde MRC, Lagendijk J, Raat H, Steegers EAP, de Kroon MLA. An innovative postnatal risk assessment and corresponding care pathways in Preventive Child Healthcare. J Adv Nurs 2021; 78:739-749. [PMID: 34590735 PMCID: PMC9293120 DOI: 10.1111/jan.15003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 06/12/2021] [Accepted: 07/24/2021] [Indexed: 11/29/2022]
Abstract
Aims This study aims to evaluate the effectiveness of an innovative postnatal risk assessment (the postnatal Rotterdam Reproductive Risk Reduction checklist: R4U) and corresponding care pathways in Preventive Child Healthcare (PCHC), along with PCHC professional satisfaction. Design Four PCHC organizations located in three municipalities with a higher adverse perinatal outcome than the national average were selected for participation. The study concerns a historically controlled study design. Methods The study enrolled participants from September 2016 until December 2017. The historical cohort existed of children born in previous years from 2008 until 2016. The outcome measure was defined as catch‐up growth: more than 0.67 standard deviation score weight for height increase in the first 6 months of life. PCHC professional opinion was assessed with a digital survey. Results After the inclusion period, 1,953 children were included in the intervention cohort and 7,436 children in the historical cohort. Catch‐up growth was significantly less common in the intervention cohort; 14.9% versus 19.5% in the historical cohort (p < 0.001). A regression sensitivity analysis, using matching, showed an odds ratio of 0.957 (95% CI 0.938–0.976) for the intervention cohort. In the survey, 74 PCHC physicians and nurses participated; most of them were neutral concerning the benefits of the postnatal R4U. Conclusion This study shows that the implementation of a novel postnatal risk assessment including in PCHC is feasible and effective. Final efforts to ensure a widespread implementation should be taken. Impact PCHC offers a unique opportunity to recognize and address risk factors for growth and development in children and to implement care pathways. Effective and widely implemented risk assessments in antenatal and PCHC are scarce. To our knowledge, this kind of evidence‐based postnatal risk assessment has not been implemented in PCHC before and seizes the opportunity to prevent catch‐up growth and its long‐term effects.
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Affiliation(s)
- Minke R C Van Minde
- Department of Obstetrics and Gynecology, Division of Obstetrics and Fetal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Jacqueline Lagendijk
- Department of Obstetrics and Gynecology, Division of Obstetrics and Fetal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Hein Raat
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Eric A P Steegers
- Department of Obstetrics and Gynecology, Division of Obstetrics and Fetal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Marlou L A de Kroon
- Department of Obstetrics and Gynecology, Division of Obstetrics and Fetal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Health Sciences, University Medical Center, Groningen, The Netherlands
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12
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Liu GXH, Harding JE. Caregiver-reported health-related quality of life of New Zealand children born very and extremely preterm. PLoS One 2021; 16:e0253026. [PMID: 34101760 PMCID: PMC8186812 DOI: 10.1371/journal.pone.0253026] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 05/26/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Children born preterm, particularly at earlier gestations, are at increased risk for mortality and morbidity, but later health-related quality of life (HRQoL) is less well described. Neurodevelopmental impairment and socio-economic status may also influence HRQoL. Our aim was to describe the HRQoL of a cohort of New Zealand children born very and extremely preterm, and how this is related to neurodevelopmental impairment, gestational age, and socio-economic deprivation. METHODS Children born <30 weeks' gestation or <1500 g birthweight were assessed at 7 years' corrected age. Caregivers completed the Child Health Questionnaire Parent Form (CHQ-PF50), and the Health Utilities Index Mark 2 (HUI-2). Neurodevelopmental impairment was defined as Wechsler full scale intelligence quotient below -1 standard deviation (SD), Movement Assessment Battery for Children total score ≤15 percentile, cerebral palsy, deafness, or blindness. RESULTS Data were collected for 127 children, of whom 60 (47%) had neurodevelopmental impairment. Overall, HRQoL was good: mean (SD) CHQ-PF50 physical summary score = 50.8 (11.1), psychosocial summary score = 49.3 (9.1) [normative mean 50 (10)]; HUI-2 dead-healthy scale = 0.92 (0.09) [maximum 1.0]. Neurodevelopmental impairment, lower gestational age, and higher socio-economic deprivation were all associated with reduced HRQoL. However, on multivariable analysis, only intelligence quotient and motor function were associated with psychosocial HRQoL, while intelligence quotient was associated with physical HRQoL. CONCLUSIONS Most seven-year-old children born very and extremely preterm have good HRQoL. Further improvements will require reduced neurodevelopmental impairment.
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Affiliation(s)
- Gordon X. H. Liu
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Jane E. Harding
- Liggins Institute, University of Auckland, Auckland, New Zealand
- * E-mail:
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13
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Lown EL, Radley KC, Dart EH, Dufrene BA, Tingstrom DH, Hayes L, Tannehill J. A comparison of real‐time and delayed visual performance feedback on teacher praise. PSYCHOLOGY IN THE SCHOOLS 2020. [DOI: 10.1002/pits.22469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Elizabeth L. Lown
- School of Psychology University of Southern Mississippi Hattiesburg Mississippi USA
| | - Keith C. Radley
- Department of Educational Psychology University of Utah Salt Lake City Utah USA
| | - Evan H. Dart
- Department of Educational and Psychological Studies University of South Florida Tampa Florida USA
| | - Brad A. Dufrene
- School of Psychology University of Southern Mississippi Hattiesburg Mississippi USA
| | - Daniel H. Tingstrom
- School of Psychology University of Southern Mississippi Hattiesburg Mississippi USA
| | - Lynda Hayes
- School of Psychology University of Southern Mississippi Hattiesburg Mississippi USA
| | - Jennifer Tannehill
- School of Psychology University of Southern Mississippi Hattiesburg Mississippi USA
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14
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Marleau I, Vona M, Gagner C, Luu TM, Beauchamp MH. [Formula: see text] Social cognition, adaptive functioning, and behavior problems in preschoolers born extremely preterm. Child Neuropsychol 2020; 27:96-108. [PMID: 32716689 DOI: 10.1080/09297049.2020.1797656] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Despite medical advances, prematurity is associated with a higher risk of neurodevelopmental problems. Although social impairments are commonly reported in preterm children, their origins are not clearly determined though they may be associated with the integrity of social cognitive skills, such as theory of mind. This study aimed to assess social cognitive, social adaptive, and social behavior functioning in children born extremely prematurely. Thirty children born between 22 and 28 weeks of gestation and 30 children born at term completed measures of social cognition (theory of mind, affect recognition) between 4:6, 5:11 years of age (mean = 5.29, standard deviation = 0.28 years). Parents completed questionnaires measuring their child's adaptive social functioning and social behavior. Analyses of covariance controlling for cognitive, attentional, executive, sociodemographic, and perinatal characteristics were performed. Children born between 22 and 28 weeks displayed poorer theory of mind (p < 0.01) and affect recognition (p < 0.01) than term controls, and their parents reported lower adaptive social functioning (p < 0.01) and prosocial behavior (p = 0.04). Social cognitive, adaptive, and behavior functioning appear to be affected by extreme preterm birth. These findings may explain the social challenges experienced by extremely preterm children and provide potential loci for targeted interventions to optimize social functioning.
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Affiliation(s)
- Isabelle Marleau
- Department of Psychology, University of Sherbrooke , Sherbrooke, Canada.,Department of Pediatrics, Ste-Justine University Hospital , Montreal, Canada
| | - Mélissa Vona
- Department of Psychology, University of Montreal , Montreal, Canada
| | - Charlotte Gagner
- Department of Psychology, University of Montreal , Montreal, Canada
| | - Thuy Mai Luu
- Department of Pediatrics, Ste-Justine University Hospital , Montreal, Canada.,Research Center, Sainte-Justine Hospital , Montreal, Canada
| | - Miriam H Beauchamp
- Department of Psychology, University of Montreal , Montreal, Canada.,Research Center, Sainte-Justine Hospital , Montreal, Canada
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15
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Sociodemographic and medical influences on neurobehavioral patterns in preterm infants: A multi-center study. Early Hum Dev 2020; 142:104954. [PMID: 32007912 PMCID: PMC7115752 DOI: 10.1016/j.earlhumdev.2020.104954] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 12/06/2019] [Accepted: 01/13/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Among preterm infants, neurodevelopmental outcomes are influenced by both medical and sociodemographic factors. Less is known about the impact on these factors on neonatal neurobehavioral patterns. OBJECTIVE To determine associations between demographic, psychosocial and medical risk factors and neonatal neurobehavior. METHODS Multi-center observational study of infants born <30 weeks enrolled in the Neonatal Neurobehavior and Outcomes in Very Preterm Infants (NOVI) Study between April 2014-May 2016. Maternal medical, demographic, and psychological variables and infant medical variables were prospectively collected. Demographic, substance, psychological and medical risk indices were developed. Neurobehavioral assessment was performed using the NICU Network Neurobehavioral Scale (NNNS) at NICU discharge. RESULTS 709 infants were enrolled in the NOVI study, and for 679 infants with neurobehavioral assessments, 6 NNNS behavioral profiles were calculated using latent profile analysis. Profile 6 infants (n = 47/679, 7%) were atypical, having poor attention, self-regulation and movement quality, hypertonia and increased stress signs. After adjustment for site, profile 6 infants had significantly smaller head circumferences at birth (β -0.87; -1.59, -0.14), and higher rates of late sepsis (OR 3.38; CI 1.66, 6.92) compared to Profiles 1-5 infants. There were no significant differences in other neonatal morbidities between the two groups. Profile 6 infants had a higher prenatal demographic risk score (1.46 vs 1.07;β 0.34; CI 0.06, 0.61) compared to Profiles 1-5 infants. CONCLUSION NNNS behavioral profiles identify an atypical behavioral pattern that is associated with early influences of demographic and medical variables. Such behavioral patterns may be seen as early as NICU discharge.
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Ross GS, Rescorla LA, Perlman JM. Patterns and prediction of behavior problems during the toddler and preschool periods in preterm children. INTERNATIONAL JOURNAL OF BEHAVIORAL DEVELOPMENT 2020. [DOI: 10.1177/0165025420906467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
There are few studies of behavior problems in preterm children prior to 2 years old and the changes that occur over time. The aims of this study were to examine the patterns and prediction of behavior problems and the effects of gender and socioeconomic status (SES) on behavior problems in preterm children at the toddler and preschool periods. Parents of 124 very low birthweight preterm children completed a standardized behavior questionnaire at 18 months corrected age and 3 years old. At both times, scores were significantly higher on Attention and Withdrawn Problems than on other behavior problem syndromes. There was a significant overall increase in Externalizing and Internalizing behavior problem scores between 18 months and 3 years, particularly in Internalizing problems. Overall prediction for normal versus not-normal categorization (≥1 standard deviation) on behavior problem and broad-spectrum scales ranged from 77% to 90% and was higher for children in the normal than not-normal categories. Boys had higher Internalizing Problems at 18 months and higher Externalizing Problems at 3 years. Children from low SES families had higher Internalizing and Total Behavior problems at 18 months and higher Internalizing, Externalizing, and Total Behavior problems at 3 years. Screening preterm children for behavior problems before 2 years old appears useful for early intervention of such problems.
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Affiliation(s)
- Gail S. Ross
- Department of Pediatrics, Weill Cornell Medical College, USA
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17
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Domellöf E, Johansson AM, Farooqi A, Domellöf M, Rönnqvist L. Risk for Behavioral Problems Independent of Cognitive Functioning in Children Born at Low Gestational Ages. Front Pediatr 2020; 8:311. [PMID: 32676487 PMCID: PMC7333186 DOI: 10.3389/fped.2020.00311] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 05/14/2020] [Indexed: 11/28/2022] Open
Abstract
This study aimed to investigate cognitive and behavioral outcomes in relation to gestational age (GA) in school-aged children born preterm (PT). Results from the Wechsler Intelligence Scale for Children, 4th edition (WISC-IV), and the Child Behavior Checklist (CBCL) were analyzed in 51 children (mean age: 7.8 years [range: 7.0-8.7]) born PT (mean GA: 31 weeks [range: 23-35]; birth weight, mean: 1,637 g [range: 404-2,962]) with the majority (96%) having no diagnosed cognitive, sensory, or motor impairments. The control group included 57 age-matched typically developing children (mean age: 7.9 years [range: 6.2-8.7]) born full-term (FT). Children born PT, extremely PT (GA < 28) in particular, showed significantly lower cognitive performance and higher behavioral problem scores compared with children born FT. GA was found to predict aspects of both cognitive functioning and behavioral problems within the PT group, with lower GA being related to both poorer cognitive outcomes and elevated affective and attention-deficit/hyperactivity problems. Global cognitive functioning did not independently predict aspects of behavioral outcomes. Findings demonstrate that, even in children born PT without severe perinatal and/or postnatal complications and receiving active perinatal care, a short gestation is an evident risk factor for long-term negative effects on mental health independent of cognitive functioning. Additional findings suggest that both reduced growth and lower parental educational level may contribute to increased risk for poorer cognitive and behavioral functioning in children born PT.
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Affiliation(s)
- Erik Domellöf
- Department of Psychology, Umeå University, Umeå, Sweden
| | | | - Aijaz Farooqi
- Division of Pediatrics, Department of Clinical Sciences, Umeå University, Umeå, Sweden
| | - Magnus Domellöf
- Division of Pediatrics, Department of Clinical Sciences, Umeå University, Umeå, Sweden
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Reyes LM, Jaekel J, Heuser KM, Wolke D. Developmental cascades of social inhibition and friendships in preterm and full‐term children. INFANT AND CHILD DEVELOPMENT 2019. [DOI: 10.1002/icd.2165] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Lucia M. Reyes
- Department of Child & Family StudiesUniversity of Tennessee Knoxville Knoxville Tennessee
| | - Julia Jaekel
- Department of Child & Family StudiesUniversity of Tennessee Knoxville Knoxville Tennessee
- Department of PsychologyUniversity of Warwick Coventry UK
| | | | - Dieter Wolke
- Department of PsychologyUniversity of Warwick Coventry UK
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Reducing growth and developmental problems in children: Development of an innovative postnatal risk assessment. PLoS One 2019; 14:e0217261. [PMID: 31166964 PMCID: PMC6550373 DOI: 10.1371/journal.pone.0217261] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 05/09/2019] [Indexed: 12/18/2022] Open
Abstract
Introduction Globally, awareness of the relevance of both medical and non-medical risk factors influencing growth and development of children has been increasing. The aim of our study was to develop an innovative postnatal risk assessment to be used by the Preventive Child Healthcare (PCHC) to identify at an early stage children at risk for growth (catch-up growth, overweight and obesity) and developmental problems (such as motor, cognitive, psychosocial and language/ speech problems). Methods We used the first four steps of the Intervention Mapping process. Step 1: Review of the literature and focus group discussions. Step 2: Identification of program objectives on how to develop and implement a risk assessment in PCHC daily practice. Step 3: Application of the ASE model to initiate behavioral change in the target group. Step 4: Development of the postnatal R4U and a program plan for the implementation in PCHC organizations. Results Subsequently in 2015, the 41 item postnatal R4U (the postnatal Rotterdam Reproduction Risk Reduction checklist) was developed according to steps one until four of the Intervention Mapping process and was implemented in four PCHC organizations. Conclusions It was feasible to design and implement a postnatal risk assessment identifying both medical and non-medical risks for growth and developmental problems, using the Intervention Mapping process.
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Fajardo-Bullón F, Rasskin-Gutman I, León-Del Barco B, Ribeiro Dos Santos EJ, Iglesias Gallego D. International and Spanish Findings in Scientific Literature about Minors' Mental Health: Predictive Factors Using the Strengths and Difficulties Questionnaire. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E1603. [PMID: 31071907 PMCID: PMC6539595 DOI: 10.3390/ijerph16091603] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 04/30/2019] [Accepted: 05/05/2019] [Indexed: 11/24/2022]
Abstract
Minors' mental health is a subject of high global concern. Understanding the factors that influence their mental health is essential to improving the health of future generations. In this study, an analysis of the Strengths and Difficulties Questionnaire's usefulness is carried out, as a validated tool, recognized in Spain and internationally, for the measurement of minors' mental health. In turn, the influence of the variables of gender, age, and physical health, along with the occupational social class of parents on Spanish minors' mental health, has been analyzed. Spanish minors with good physical health and of parents with middle and higher education, as well as in an occupational social class, are less likely to suffer mental health problems. On the other hand, it seems that internalizing symptoms are more likely in girls, and externalizing symptoms are more likely in boys. However, when a global measure of mental health is made without specific subscales, the effects of gender and age diverge greatly, according to the studies. Although there are examples of current research using the same measurement tool, there is still a need for many more international studies that are coordinated using the same methodology. This study identifies the factors which the international and Spanish scientific literature has revealed as being determinants in minors' mental health. Finally, it is essential that the influence of these factors be assessed in the areas of primary care and mental health to facilitate better detection, intervention, or prevention of mental health problems in today's children, as well as the children of future generations.
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Affiliation(s)
- Fernando Fajardo-Bullón
- Department of Psychology, Faculty of Education and Psychology, University of Extremadura, 06006 Badajoz, Spain.
| | - Irina Rasskin-Gutman
- Department of Psychology, Teacher Training College, University of Extremadura, 10003 Cáceres, Spain.
| | - Benito León-Del Barco
- Department of Psychology, Teacher Training College, University of Extremadura, 10003 Cáceres, Spain.
| | - Eduardo João Ribeiro Dos Santos
- Scientific Coordinator R&D Unit Institute of Cognitive Psychology (IPCDHS/FPCE), University of Coimbra, 3000-115 Coimbra, Portugal.
| | - Damián Iglesias Gallego
- Department of Didactics of Music, Plastic and Body Expression, Teacher Training College, University of Extremadura, 10003 Cáceres, Spain.
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21
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den Haan PJ, de Kroon MLA, van Dokkum NH, Kerstjens JM, Reijneveld SA, Bos AF. Risk factors for emotional and behavioral problems in moderately-late preterms. PLoS One 2019; 14:e0216468. [PMID: 31048855 PMCID: PMC6497297 DOI: 10.1371/journal.pone.0216468] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Accepted: 04/23/2019] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To assess which factors, including maternal, lifestyle, pregnancy- and delivery-related, fetal and neonatal factors adjusted for socio-economic status, are related to emotional and behavioral problems in moderately-late preterm born children (MLPs; gestational age 32.0-35.9 weeks) at 4 years of age. MLPs are at greater risk of emotional and behavioral problems than full-term born children. Especially for MLPs, knowledge about factors that increase or decrease the risk of emotional and behavioral problems is scarce. DESIGN AND SETTING We assessed emotional and behavioral problems in 809 MLPs between ages 41 and 49 months from the prospective community-based Longitudinal Preterm Outcome Project (LOLLIPOP), using the parent-reported Child Behavior Checklist (CBCL). We collected potential risk factors from hospital records and parental questionnaires. Univariable and multiple logistic regression analyses were applied. MAIN OUTCOME MEASURES (Sub)clinical CBCL scores. RESULTS Perinatal infection increased the risk of CBCL total problem scores with an OR 2.22 (p<0.01). Perinatal infection, maternal smoking, and male gender increased the risk of CBCL externalizing problem scores with ORs between 1.64 and 2.46 (all p<0.05). Multiple birth decreased the risk of CBCL internalizing problem scores with an OR 0.63 (p<0.05). CONCLUSIONS Risk factors for behavioral problems in MLPs are male gender, perinatal infection and maternal smoking, the latter two being potentially modifiable. Multiple birth is a protective factor for emotional problems in MLPs. These results suggest potential factors for targeting preventive intervention in MLPs, comprising the large majority of all preterm born children.
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Affiliation(s)
- Pauline J. den Haan
- Department of Pediatrics, Division of Neonatology, Beatrix Children’s Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- * E-mail:
| | - Marlou L. A. de Kroon
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Nienke H. van Dokkum
- Department of Pediatrics, Division of Neonatology, Beatrix Children’s Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Jorien M. Kerstjens
- Department of Pediatrics, Division of Neonatology, Beatrix Children’s Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Sijmen A. Reijneveld
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Arend F. Bos
- Department of Pediatrics, Division of Neonatology, Beatrix Children’s Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Abstract
There is increasing evidence of ongoing changes occurring in short-term and long-term motor and language outcomes in former premature infants. As rates of moderate to severe cerebral palsy (CP) have decreased, there has been increased awareness of the impact of mild CP and of developmental coordination disorder on the preterm population. Language delays and disorders continue to be among the most common outcomes. In conjunction with medical morbidities, there is increased awareness of the negative impact of family psycho-socioeconomic adversities on preterm outcomes and of the importance of intervention for these adversities beginning in the neonatal ICU.
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Muganthan T, Boyle EM. Early childhood health and morbidity, including respiratory function in late preterm and early term births. Semin Fetal Neonatal Med 2019; 24:48-53. [PMID: 30348617 DOI: 10.1016/j.siny.2018.10.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Late preterm (LP) and early term (ET) infants have generally been considered in the same way as their healthy full term (FT) counterparts. It is only in the last decade that an increased risk of later poor health in children born LP has been recognised; evidence for health outcomes following ET birth is still emerging. However, reports are largely consistent in highlighting an increased risk, which lessens approaching FT but is measurable and persists into adolescence and beyond. The most thoroughly explored area to date is respiratory morbidity. This article reviews the body of available evidence for effects of LP birth on pulmonary function and ongoing morbidity, and other areas where an increased risk of health problems has been identified in this population. Implications for delivery of health care are considered and areas for further research are highlighted.
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Affiliation(s)
- Trishula Muganthan
- Neonatal Unit, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Elaine M Boyle
- Department of Health Sciences, University of Leicester, Leicester, UK.
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Dotinga BM, de Winter AF, Bocca-Tjeertes IFA, Kerstjens JM, Reijneveld SA, Bos AF. Longitudinal growth and emotional and behavioral problems at age 7 in moderate and late preterms. PLoS One 2019; 14:e0211427. [PMID: 30703154 PMCID: PMC6355004 DOI: 10.1371/journal.pone.0211427] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 01/14/2019] [Indexed: 11/27/2022] Open
Abstract
Objectives Moderately and late preterm children (MLPs, 32.0–36.9 weeks gestational age) have a greater risk of poorer growth. This seems to be associated with poorer neuropsychological functioning. Evidence is limited on whether this also holds for emotional and behavioral (EB) problems. Therefore, we assessed whether longitudinal growth from birth until age 7 was associated with EB problems at age 7 in MLPs. Study design This study was part of the Longitudinal Preterm Outcome Project, a prospective cohort study. Data on growth (height, weight, head circumference, and extent of catch-up growth) were obtained from assessments from birth until age 7. EB problems were assessed at age 7 with the Child Behavior Checklist. We assessed whether growth and EB problems were associated using logistic regression analyses, adjusting for multiple birth, parity, and socioeconomic status. Results We included 248 MLPs. Median gestational age was 34 weeks (interquartile range: 33–35 weeks). Mean birth weight was 2.2 kg (standard deviation: 0.5 kg). Postnatal growth measures were below the Dutch reference norm. EB problems were more prevalent in MLPs than in the general Dutch population. Generally, we found no associations between growth and EB problems; odds ratios ranged from 0.20 to 2.72. Conclusions In MLPs, postnatal growth from birth until age 7 was not associated with EB problems at age 7. Poorer growth thus seems to relate to neuropsychological problems, but not to EB problems. This suggests that the etiologies of these problems differ at least partially.
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Affiliation(s)
- Baukje M. Dotinga
- Division of Neonatology, Department of Pediatrics, Beatrix Children’s Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- * E-mail:
| | - Andrea F. de Winter
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Inger F. A. Bocca-Tjeertes
- Division of Neonatology, Department of Pediatrics, Beatrix Children’s Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Jorien M. Kerstjens
- Division of Neonatology, Department of Pediatrics, Beatrix Children’s Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Sijmen A. Reijneveld
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Arend F. Bos
- Division of Neonatology, Department of Pediatrics, Beatrix Children’s Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Sanghera RS, Boyle EM. Outcomes of infants born near term: not quite ready for the "big wide world"? Minerva Pediatr 2018; 71:47-58. [PMID: 30299031 DOI: 10.23736/s0026-4946.18.05406-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Until recently, there has been a strongly held belief on the part of neonatal and pediatric clinicians that outcomes for infants born close to term are not different from those of babies born at full term. In the last decade, however, this assumption has been challenged by reports suggesting that this is not correct, and highlighting differences in morbidity and mortality both in the short and long term. This has led to development of new terminology to more accurately reflect the impact of immaturity associated with birth at 32-33 weeks (moderately preterm) and 34-36 weeks (late preterm) of gestation. These babies account for around 5-7% of all births and more than 75% of the preterm births in developed countries, so this new recognition of the associated increase in adverse outcomes may have a substantial impact on health care services. This review article will discuss the changing perceptions and concepts of gestational age in the preterm population, and explore the recent and emerging evidence around neonatal, early childhood, school-age, adolescent and adult outcomes for babies who are born moderately preterm and late preterm. It highlights important neonatal and childhood morbidities and will summarize associated health care, developmental and educational problems of affected children. The implications for the provision of ongoing primary and secondary health care, educational and social support to this large and heterogeneous group of individuals will be discussed.
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Affiliation(s)
- Ranveer S Sanghera
- Neonatal Unit, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Elaine M Boyle
- Neonatal Unit, University Hospitals of Leicester NHS Trust, Leicester, UK - .,Department of Health Sciences, College of Life Sciences, University of Leicester, Leicester, UK
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de Laat SAA, Huizink AC, Hof MH, Vrijkotte TGM. Socioeconomic inequalities in psychosocial problems of children: mediating role of maternal depressive symptoms. Eur J Public Health 2018; 28:1062-1068. [DOI: 10.1093/eurpub/cky125] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Sanne A A de Laat
- Department of Public Health, Amsterdam Public Health Research Institute, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
- Department Youth Health Care, GGD Hart voor Brabant, ‘s-Hertogenbosch, The Netherlands
| | - Anja C Huizink
- Department of Clinical, Neuro- & Developmental Psychology, Vrije Universiteit, Amsterdam, The Netherlands
| | - Michel H Hof
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam Public Health Research Institute, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Tanja G M Vrijkotte
- Department of Public Health, Amsterdam Public Health Research Institute, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
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27
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León-Del-Barco B, Fajardo-Bullón F, Mendo-Lázaro S, Rasskin-Gutman I, Iglesias-Gallego D. Impact of the Familiar Environment in 11⁻14-Year-Old Minors' Mental Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1314. [PMID: 29937491 PMCID: PMC6069230 DOI: 10.3390/ijerph15071314] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 06/09/2018] [Accepted: 06/20/2018] [Indexed: 12/22/2022]
Abstract
The analysis of the mental health in children under 14 years has become a research topic of global interest where the family can be a key factor for protection or risk against mental health problems. With this work, we intend to determine, employing binary logistic regression analysis, whether parental acceptance-rejection perceived by boys and girls can predict their mental health. Seven hundred sixty-two students participated, the average age was 12.23 years; 53.8% (n = 410) girls and 46.2% (n = 352) boys. We have used the Strengths and Difficulties Questionnaire (SDQ), self-reported version and the Affection Scale children version (EA-H) for parental acceptance-rejection to assess mental health. The odds ratio (OR) of the logistic models reports that there is a greater probability of having mental health problems in boys and girls when they perceive that they are highly criticized and rejected by their parents. With our work, we highlight the importance of the environment and family affection on mental health. The perception of the children about the rejection, aversion, and criticism of their parents constitutes a risk factor in the manifestation of mental health problems.
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Affiliation(s)
- Benito León-Del-Barco
- Department of Psychology, Teacher Training College, University of Extremadura, 10071 Cáceres, Spain.
| | - Fernando Fajardo-Bullón
- Department of Psychology, Faculty of Education and Psychology, University of Extremadura, 06006 Badajoz, Spain.
| | - Santiago Mendo-Lázaro
- Department of Psychology, Teacher Training College, University of Extremadura, 10071 Cáceres, Spain.
| | - Irina Rasskin-Gutman
- Department of Psychology, Teacher Training College, University of Extremadura, 10071 Cáceres, Spain.
| | - Damián Iglesias-Gallego
- Department of Didactics of Music, Plastic and Body Expression. Teacher Training College, University of Extremadura, 10071 Cáceres, Spain.
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Fajardo-Bullón F, Rasskin-Gutman I, Felipe-Castaño E, Ribeiro Dos Santos EJ, León-Del Barco B. Analysis of Predictive Factors on Minors' Mental Health According to the Spanish National Health Survey. Brain Sci 2017; 7:E135. [PMID: 29065447 PMCID: PMC5664062 DOI: 10.3390/brainsci7100135] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 10/16/2017] [Accepted: 10/17/2017] [Indexed: 01/09/2023] Open
Abstract
Research on minors' mental health is an increasingly developing area. Given the increased prevalence of disorders, it seems necessary to analyze the factors that can affect poor mental health. This study analyzes the influence of occupational class, educational level, age, sex and perceived mental health of Spanish children, which is measured through the Strengths and Difficulties Questionnaire. The sample consists of 3599 minors between 4 and 14 years old, who were interviewed through the Spanish National Health Survey 2011. Our results indicating the significant (p < 0.05) relationship between mental health, occupational class (OR 0.533) and minors' health in the last year (OR 0.313) are shown. However, gender (OR 1.187) and educational level of Pre-School Education in relation to Secondary Education (OR 1.174) and Primary Education (OR 0.996) do not generate significant differences. In conclusion, we consider it necessary to design and implement public policies aimed at improving the care system for children who have had poor or regular health in the last year, and whose parents are positioned in the lowest part of the occupational scale.
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Affiliation(s)
- Fernando Fajardo-Bullón
- Department of Psychology, Faculty of Education and Psychology, University of Extremadura, Badajoz 06006, Spain.
| | - Irina Rasskin-Gutman
- Department of Psychology, Faculty of Teacher Training College, University of Extremadura, Cáceres 10071, Spain.
| | - Elena Felipe-Castaño
- Department of Psychology, Faculty of Teacher Training College, University of Extremadura, Cáceres 10071, Spain.
| | - Eduardo João Ribeiro Dos Santos
- Scientific Coordinator R&D Unit Institute of Cognitive Psychology (IPCDHS/FPCE), University of Coimbra, Coimbra 3000-115, Portugal.
| | - Benito León-Del Barco
- Department of Psychology, Faculty of Teacher Training College, University of Extremadura, Cáceres 10071, Spain.
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Iguacel I, Michels N, Fernández-Alvira JM, Bammann K, De Henauw S, Felső R, Gwozdz W, Hunsberger M, Reisch L, Russo P, Tornaritis M, Thumann BF, Veidebaum T, Börnhorst C, Moreno LA. Associations between social vulnerabilities and psychosocial problems in European children. Results from the IDEFICS study. Eur Child Adolesc Psychiatry 2017; 26:1105-1117. [PMID: 28500384 DOI: 10.1007/s00787-017-0998-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Accepted: 05/08/2017] [Indexed: 11/26/2022]
Abstract
The effect of socioeconomic inequalities on children's mental health remains unclear. This study aims to explore the cross-sectional and longitudinal associations between social vulnerabilities and psychosocial problems, and the association between accumulation of vulnerabilities and psychosocial problems. 5987 children aged 2-9 years from eight European countries were assessed at baseline and 2-year follow-up. Two different instruments were employed to assess children's psychosocial problems: the KINDL (Questionnaire for Measuring Health-Related Quality of Life in Children and Adolescents) was used to evaluate children's well-being and the Strengths and Difficulties Questionnaire (SDQ) was used to evaluate children's internalising problems. Vulnerable groups were defined as follows: children whose parents had minimal social networks, children from non-traditional families, children of migrant origin or children with unemployed parents. Logistic mixed-effects models were used to assess the associations between social vulnerabilities and psychosocial problems. After adjusting for classical socioeconomic and lifestyle indicators, children whose parents had minimal social networks were at greater risk of presenting internalising problems at baseline and follow-up (OR 1.53, 99% CI 1.11-2.11). The highest risk for psychosocial problems was found in children whose status changed from traditional families at T0 to non-traditional families at T1 (OR 1.60, 99% CI 1.07-2.39) and whose parents had minimal social networks at both time points (OR 1.97, 99% CI 1.26-3.08). Children with one or more vulnerabilities accumulated were at a higher risk of developing psychosocial problems at baseline and follow-up. Therefore, policy makers should implement measures to strengthen the social support for parents with a minimal social network.
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Affiliation(s)
- Isabel Iguacel
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Edificio del SAI, C/Pedro Cerbuna s/n, 50009, Saragossa, Spain.
- Instituto Agroalimentario de Aragón (IA2), Saragossa, Spain.
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), Saragossa, Spain.
| | | | - Juan M Fernández-Alvira
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Edificio del SAI, C/Pedro Cerbuna s/n, 50009, Saragossa, Spain
- Fundación Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain
| | - Karin Bammann
- Institute for Public Health and Nursing Sciences (IPP), University of Bremen, Bremen, Germany
- Leibniz Institute for Prevention Research and Epidemiology, BIPS, Bremen, Germany
| | | | - Regina Felső
- Department of Paediatrics, University of Pécs, Pécs, Hungary
| | | | - Monica Hunsberger
- Section for Epidemiology and Social Medicine (EPSO), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Paola Russo
- Institute of Food Sciences, National Research Council, Avellino, Italy
| | | | | | - Toomas Veidebaum
- Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia
| | - Claudia Börnhorst
- Leibniz Institute for Prevention Research and Epidemiology, BIPS, Bremen, Germany
| | - Luis A Moreno
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Edificio del SAI, C/Pedro Cerbuna s/n, 50009, Saragossa, Spain
- Instituto Agroalimentario de Aragón (IA2), Saragossa, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), Saragossa, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Saragossa, Spain
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Santos IS, Barros FC, Munhoz T, Matijasevich A. Gestational age at birth and behavioral problems from four to 11 years of age: birth cohort study. BMC Pediatr 2017; 17:184. [PMID: 28835237 PMCID: PMC5569485 DOI: 10.1186/s12887-017-0936-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 08/17/2017] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Studies conducted mainly in high-income countries have shown that preterm births are associated with increased risk of behavioral problems and psychiatric disorders. The aim of this study was to assess the prevalence of behavioral problems from middle-childhood to early-adolescence according to gestational age at birth in a middle-income setting. METHODS A population-based birth cohort (n = 4231) in Pelotas, Brazil, was followed-up in several occasions from birth to 11 years. Estimated GA was based on last menstrual period or, when unknown or inconsistent, on the Dubowitz method. Behavioral problems were assessed at 4 (Child Behavior Checklist - CBCL), and at 6 and 11 years (Development and Well-Being Assessment - DAWBA) tool. Maternal socio-economic characteristics and depression at 2, 4 and 6 years post-partum, child perinatal characteristics and breastfeeding duration were used as confounders. Analyses were run by linear and logistic regression. RESULTS Three thousand two hundred four children had full information on gestational age, CBCL and DAWBA. At 4 years, mean total (42.9 ± 24.0) and mean externalizing (18.8 ± 9.1) CBCL scores were higher among preterm girls born at <34 weeks than among full term girls (33.2 ± 15.1 and 15.0 ± 6.6, respectively). After controlling for confounders the association was no longer significant. At the age of 6 years there was no association between gestational age and behavior, neither in crude nor in adjusted analyses. Odds ratio for any psychiatric disorders at 11 years was 60% (1.6; 1.1-2.1) higher among those born at 34-36 weeks than in full-term children, but the association disappeared in adjusted analyses. CONCLUSION At this large cohort, behavioral problems from middle-childhood to early-adolescence are more related to family socio-economic characteristics and to other child perinatal conditions than to gestational age at birth.
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Affiliation(s)
- Iná S Santos
- Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro 1160, 3o piso, Pelotas, RS, 96020220, Brazil.
| | - Fernando C Barros
- Program in Epidemiology, Federal University of Pelotas and Postgraduate Program in Health and Behaviour, Catholic University of Pelotas, Pelotas, RS, Brazil
| | - Tiago Munhoz
- Faculty of Psychology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Alicia Matijasevich
- Department of Preventive Medicine, University of São Paulo, São Paulo, SP, Brazil
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Becker-Grünig T, Schneider S, Sonntag D, Jarczok MN, Philippi H, De Bock F. [Parental Social Status and other determinants of quality of life and behavioral problems: An analysis of German preterm births between 1987-2004]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2017; 59:166-80. [PMID: 26637387 DOI: 10.1007/s00103-015-2276-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Knowledge of the factors affecting the development of preterm children in Germany is limited. We analysed the prevalence of preterm birth in Germany using the German Health Interview and Examination Survey for Children and Adolescents 2003-2006 and assessed factors associated with quality of life (QOL) and behavioural development in preterm children (< 37 weeks' gestational age). METHODS Data were weighted and preterm prevalence was calculated by socioeconomic status (SES) and year of birth for 1,106 preterm children. Using linear regression models, the relationship between sociodemographic, pre- and perinatal, lifestyle, and contextual determinants on the one hand, and the QOL (KINDL® parent questionnaire) and behavioural problems (the total problem behaviour scale, the Strengths and Difficulties Questionnaire [SDQ]) on the other was calculated. RESULTS Prevalence of preterm birth (mean 7.5 %) was higher in families with low compared with high SES (8.4 versus 7.0 %). In the final regression models, preterm children with high SES had higher QOL scores (+ 3.3 KINDL points, p = 0.024) compared with children with low SES, and adolescents (aged 14-17 years) had a higher QOL than children aged 7-13 years. All other variables (contextual, pre- and perinatal) were not related to QOL. In contrast, there were many determinants of behavioural development in preterms: the SDQ total score was lower in girls, children with older mothers, those from high SES and those with a high level of physical activity. However, both very low birth weight (< 1,500 g) and birth at > 34 weeks' gestation were associated with a higher SDQ total score. CONCLUSION Given its high prevalence, preterm birth is a relevant public health issue in Germany. While SES may be the most important determinant of QOL in preterms, determinants of behavioural problems are the same as those in term children and also encompass perinatal factors.
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Affiliation(s)
- Tabea Becker-Grünig
- Klinik für Kinder- und Jugendmedizin, Universitätsklinik Mannheim, Mannheim, Deutschland
- Mannheimer Institut für Public Health, Sozial-, und Präventivmedizin, Medizinische Fakultät Mannheim der Universität Heidelberg, Rudolph-Krehl-Straße 7-11, 68167, Mannheim, Deutschland
| | - Sven Schneider
- Mannheimer Institut für Public Health, Sozial-, und Präventivmedizin, Medizinische Fakultät Mannheim der Universität Heidelberg, Rudolph-Krehl-Straße 7-11, 68167, Mannheim, Deutschland
| | - Diana Sonntag
- Mannheimer Institut für Public Health, Sozial-, und Präventivmedizin, Medizinische Fakultät Mannheim der Universität Heidelberg, Rudolph-Krehl-Straße 7-11, 68167, Mannheim, Deutschland
| | - Marc N Jarczok
- Mannheimer Institut für Public Health, Sozial-, und Präventivmedizin, Medizinische Fakultät Mannheim der Universität Heidelberg, Rudolph-Krehl-Straße 7-11, 68167, Mannheim, Deutschland
| | - Heike Philippi
- Sozialpädiatrisches Zentrum Frankfurt Mitte, Frankfurt am Main, Deutschland
| | - Freia De Bock
- Mannheimer Institut für Public Health, Sozial-, und Präventivmedizin, Medizinische Fakultät Mannheim der Universität Heidelberg, Rudolph-Krehl-Straße 7-11, 68167, Mannheim, Deutschland.
- Sozialpädiatrisches Zentrum Frankfurt Mitte, Frankfurt am Main, Deutschland.
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Impact of neonatal risk and temperament on behavioral problems in toddlers born preterm. Early Hum Dev 2016; 103:175-181. [PMID: 27701040 DOI: 10.1016/j.earlhumdev.2016.09.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 09/14/2016] [Accepted: 09/21/2016] [Indexed: 02/02/2023]
Abstract
Children born preterm are at risk for later developmental disorders. The present study examined the predictive effects of neonatal, sociodemographic, and temperament characteristics on behavioral outcomes at toddlerhood, in children born preterm. The sample included 100 toddlers born preterm and with very-low-birth-weight, and their mothers. Neonatal characteristics were evaluated using medical records. The mothers were interviewed using the Early Childhood Behavior Questionnaire for temperament assessment, and the Child Behavior Checklist for behavioral assessment. Multiple linear regression analyses were performed. Predictors of 39% of the variability of the total behavioral problems in toddlers born prematurely were: temperament with more Negative Affectivity and less Effortful Control, lower family socioeconomic status, and younger mothers at childbirth. Temperament with more Negative Affectivity and less Effortful Control and lower family socioeconomic status were predictors of 23% of the variability of internalizing behavioral problems. Additionally, 37% of the variability of externalizing behavioral problems was explained by temperament with more Negative Affectivity and less Effortful Control, and younger mothers at childbirth. The neonatal characteristics and stressful events in the neonatal intensive care unit did not predict behavioral problems at toddlerhood. However, temperament was a consistent predictor of behavioral problems in toddlers born preterm. Preventive follow-up programs could assess dispositional traits of temperament to provide early identification of preterm infants at high-risk for behavioral problems.
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Prescott SL, Logan AC. Transforming Life: A Broad View of the Developmental Origins of Health and Disease Concept from an Ecological Justice Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13111075. [PMID: 27827896 PMCID: PMC5129285 DOI: 10.3390/ijerph13111075] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 10/21/2016] [Accepted: 10/28/2016] [Indexed: 12/20/2022]
Abstract
The influential scientist Rene J. Dubos (1901–1982) conducted groundbreaking studies concerning early-life environmental exposures (e.g., diet, social interactions, commensal microbiota, housing conditions) and adult disease. However, Dubos looked beyond the scientific focus on disease, arguing that “mere survival is not enough”. He defined mental health as fulfilling human potential, and expressed concerns about urbanization occurring in tandem with disappearing access to natural environments (and elements found within them); thus modernity could interfere with health via “missing exposures”. With the advantage of emerging research involving green space, the microbiome, biodiversity and positive psychology, we discuss ecological justice in the dysbiosphere and the forces—financial inequity, voids in public policy, marketing and otherwise—that interfere with the fundamental rights of children to thrive in a healthy urban ecosystem and learn respect for the natural environment. We emphasize health within the developmental origins of health and disease (DOHaD) rubric and suggest that greater focus on positive exposures might uncover mechanisms of resiliency that contribute to maximizing human potential. We will entrain our perspective to socioeconomic disadvantage in developed nations and what we have described as “grey space”; this is a mental as much as a physical environment, a space that serves to insidiously reinforce unhealthy behavior, compromise positive psychological outlook and, ultimately, trans-generational health. It is a dwelling place that cannot be fixed with encephalobiotics or the drug-class known as psychobiotics.
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Affiliation(s)
- Susan L Prescott
- International Inflammation (in-FLAME) Network, Worldwide Universities Network (WUN), 35 Stirling Hwy, Crawley 6009, Australia.
- School of Paediatrics and Child Health Research, University of Western Australia, P.O. Box D184, Princess Margaret Hospital, Perth 6001, Australia.
| | - Alan C Logan
- International Inflammation (in-FLAME) Network, Worldwide Universities Network (WUN), 35 Stirling Hwy, Crawley 6009, Australia.
- PathLight Synergy, 23679 Calabassas Road, Suite 542, Calabassas, CA 91302, USA.
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de Laat SAA, Essink-Bot ML, van Wassenaer-Leemhuis AG, Vrijkotte TG. Effect of socioeconomic status on psychosocial problems in 5- to 6-year-old preterm- and term-born children: the ABCD study. Eur Child Adolesc Psychiatry 2016; 25:757-67. [PMID: 26564020 PMCID: PMC4932131 DOI: 10.1007/s00787-015-0791-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 10/27/2015] [Indexed: 01/18/2023]
Abstract
This study aimed at analysing the association between socioeconomic status (SES) and psychosocial problems in preterm- and term-born children. Scores of mothers and teachers on the Strengths and Difficulties Questionnaire (SDQ) regarding 217 preterm-born children (<37 weeks' gestation, mean 34 weeks) were compared with 4336 term-born children in the Amsterdam Born Children and their Development (ABCD) cohort at age 5-6 years. Associations between SDQ scores and SES (maternal education and perceived income adequacy) were examined with multivariate linear regression analysis. The mean mother-reported total difficulties score was significantly higher for preterm children (6.1 ± 4.7) than for term children (5.2 ± 4.1). After covariate adjustment, this difference was 0.5 (95 % CI 0.0-1.0). For preterm children 16.1 % of the mothers reported psychosocial problems compared with 10.1 % for term children. Lower maternal education and lower income adequacy were significantly related to higher SDQ scores of mothers and teachers. Differences in mothers' SDQ score between preterm and term children were larger in the high-education (Δ0.9, 95 % CI 0.2-1.5) and high-income group (Δ0.9, 95 % CI 0.3-1.6). No significant differences were found between preterm and term children in the SDQ scores reported by teachers. Low level of maternal education and inadequate income showed a much stronger association with psychosocial problems than preterm birth. No combined effect of low SES and preterm birth was found. This study corroborates the evidence for the strength of the disadvantageous effects of low SES on early psychosocial development.
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Affiliation(s)
- Sanne A. A. de Laat
- Department of Public Health, Academic Medical Center (AMC), Amsterdam, The Netherlands ,Youth Health Care, GGD Hart voor Brabant, ‘s-Hertogenbosch, The Netherlands
| | | | | | - Tanja G. Vrijkotte
- Department of Public Health, Academic Medical Center (AMC), Amsterdam, The Netherlands
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Abstract
OBJECTIVE To assess behavioral outcomes and social competence at 2 years of age in infants born late and moderately preterm (LMPT; 32-36 wk gestation). METHOD One thousand one hundred and thirty LMPT infants and 1255 term-born (≥37 wk) controls were recruited at birth to a prospective geographical population-based study. Parents completed the Brief Infant and Toddler Social Emotional Assessment (BITSEA) at 2 years corrected age to assess infants' behavior problems and social competence. Cognitive development was assessed using the Parent Report of Children's Abilities-Revised. Parent questionnaires at 2 years were completed for 638 (57%) LMPT and 765 (62%) term-born infants. Group differences in the prevalence of behavior problems and delayed social competence between LMPT infants and term-born controls were adjusted for age, sex, small-for-gestational-age, socioeconomic status and cognitive impairment. RESULTS Late and moderately preterm infants were at significantly increased risk of delayed social competence compared with term-born controls (26.4% vs. 18.4%; adjusted-relative risk [RR] 1.28; 95% CI, 1.03-1.58), but there was no significant group difference in the prevalence of behavior problems (21.0% vs. 17.6%; adjusted-RR 1.13, 0.89-1.42). Non-white ethnicity (RR 1.68, 1.26-2.24), medium (RR 1.60, 1.14-2.24) and high (RR 1.98, 1.41-2.75) socioeconomic risk and recreational drug use during pregnancy (RR 1.70, 1.03-2.82) were significant independent predictors of delayed social competence in LMPT infants. CONCLUSION Birth at 32 to 36 weeks of gestation confers a specific risk for delayed social competence at 2 years of age. This may be indicative of an increased risk for psychiatric disorders later in childhood.
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van Klink JMM, Lindenburg ITM, Inklaar MJ, Verduin E, Koopman HM, van Kamp IL, Schonewille H, Oepkes D, Lopriore E, Walther FJ, Kanhai HH, Doxiadis II, Brand A. Health-Related Quality of Life and Behavioral Functioning after Intrauterine Transfusion for Alloimmune Anemia. J Pediatr 2015; 167:1130-5.e2. [PMID: 26342721 DOI: 10.1016/j.jpeds.2015.07.065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Revised: 07/09/2015] [Accepted: 07/30/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To assess health-related quality of life (HRQOL) and behavioral functioning in children and adolescents treated before birth with intrauterine intravascular blood transfusion for alloimmune anemia. STUDY DESIGN Cross-sectional cohort study conducted at the Dutch referral center for the management of fetal alloimmune anemia. Follow-up data were available for 285 children at a mean age of 10.5 years (range, 3-21.5 years) with a response rate for questionnaires of 97%. Child-, adolescent-, and parent-rated HRQOL was evaluated with The Netherlands Organization for Applied Scientific Research Child/Adult Quality of Life Questionnaire (TACQOL/TAAQOL). Parents reported on behavioral functioning with the Strengths and Difficulties Questionnaire. Scores were compared with Dutch norm data. RESULTS Significantly lower scores were reported by parents of children 6-11 years of age compared with Dutch norms on 3 scales: cognitive functioning, social functioning, and positive emotions (P < .00, P = .02, and P = .04). In children aged 8-11 years only the cognitive functioning scale score was significantly lower compared with Dutch norms (P = .01). The children aged 12-15 years reported higher scores on the negative emotions scale (P = .02). When corrected for multiple testing, only the parent-rated cognitive functioning scale remained significant (P < .001). Regarding the HRQOL scores of adolescents aged ≥16 years, no differences were detected. Overall, behavioral difficulties were reported in 37/246 (15%) children aged 3-16 years, and were associated with maternal educational levels (P < .001). CONCLUSION Parents reported lower scores on cognitive functioning in their children aged 6-11 years compared with norms. Behavioral difficulties were more prevalent than norms, and were associated with maternal educational level. Outcomes of children after intrauterine intravascular blood transfusion were quite good overall.
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Affiliation(s)
- Jeanine M M van Klink
- Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands.
| | - Irene T M Lindenburg
- Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Marloes J Inklaar
- Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Esther Verduin
- Jon J. van Rood Center for Clinical Transfusion Research, Sanquin-Leiden University Medical Center, Leiden, The Netherlands
| | - Hendrik M Koopman
- Clinical Psychology, Faculty of Social Sciences, Leiden University, Leiden, The Netherlands
| | - Inge L van Kamp
- Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Henk Schonewille
- Jon J. van Rood Center for Clinical Transfusion Research, Sanquin-Leiden University Medical Center, Leiden, The Netherlands
| | - Dick Oepkes
- Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Enrico Lopriore
- Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands
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