Peer Victimization in Extremely Low Birth Weight Survivors

Social Functioning in Adults Born Very Preterm: Individual Participant Meta-analysis

CONTEXT

There is a lack of research on individual perceptions of social experiences and social relationships among very preterm (VP) adults compared with term-born peers.

OBJECTIVE

To investigate self-perceived social functioning in adults born VP (<32 weeks' gestation) and/or with very low birth weight (VLBW) (<1500g) compared with term-born adults (≥37 weeks' gestation) using an individual participant data (IPD) meta-analysis.

DATA SOURCES

Two international consortia: Research on European Children and Adults born Preterm and Adults Born Preterm International Collaboration.

STUDY SELECTION

Cohorts with outcomes assessed by using the Adult Self-Report Adaptive Functioning scales (friends, spouse/partner, family, job, and education) in both groups.

DATA EXTRACTION

IPD from 5 eligible cohorts were collected. Raw-sum scores for each scale were standardized as z scores by using mean and SD of controls for each cohort. Pooled effect size was measured by difference (Δ) in means between groups.

RESULTS

One-stage analyses (1285 participants) revealed significantly lower scores for relationships with friends in VP/VLBW adults compared with controls (Δ -0.37, 95% confidence interval [CI]: -0.61 to -0.13). Differences were similar after adjusting for sex, age, and socioeconomic status (Δ -0.39, 95% CI: -0.63 to -0.15) and after excluding participants with neurosensory impairment (Δ -0.34, 95% CI: -0.61 to -0.07). No significant differences were found in other domains.

LIMITATIONS

Generalizability of research findings to VP survivors born in recent decades.

CONCLUSIONS

VP/VLBW adults scored their relationship with friends lower but perceived their family and partner relationships, as well as work and educational experiences, as comparable to those of controls.

Relationships of bullying involvement with intelligence, attention, and executive function in children and adolescents with attention-deficit/hyperactivity disorder

This study investigated the relationship of bullying victimization and perpetration with the levels of intelligence, attention, and executive function in children who had received a diagnosis of attention-deficit/hyperactivity disorder (ADHD). The experiences of bullying involvement in 105 children with ADHD were assessed using the Chinese version of the School Bullying Experience Questionnaire. Their scores for four intelligence indexes on the Wechsler Intelligence Scale for Children 4th Edition-Chinese version were determined. Their levels of attention and executive function were assessed using the Comprehensive Nonverbal Attention Test Battery. The results of logistic regression analyses indicated that a high Perceptual Reasoning Index was significantly associated with a decreased risk of being victims of bullying. A high level of executive function was significantly associated with a decreased risk of being victims and perpetrators of bullying. Bullying victimization and perpetration in children with ADHD having a low PRI and low executive function should be routinely surveyed.

Adults born preterm: a review of general health and system-specific outcomes

In this review of 126 publications, we report that an overwhelming majority of adults born at preterm gestations remain healthy and well. However, a small, but a significant fraction of them remain at higher risk for neurological, personality and behavioural abnormalities, cardio-pulmonary functional limitations, systemic hypertension and metabolic syndrome compared to their term-born counterparts. The magnitude of increased risk differed across organ systems and varied across reports. The risks were proportional to the degree of prematurity at birth and seemed to occur more frequently among preterm infants born in the final two decades of the 20th century and later. These findings have considerable public health and clinical practice relevance.

CONCLUSION

Preterm birth needs to be considered a chronic condition, with a slight increase in the risk for long-term morbidities among adults born preterm. Therefore, obtaining a history of gestational age and weight at birth should be a routine part of care for patients of all age groups.

Long-term effects of peer victimization on social outcomes through the fourth decade of life in individuals born at normal or extremely low birthweight

Exposure to early adversity is known to have deleterious effects on brain-behaviour relations across the lifespan and across a range of domains. Here, we tested a cumulative risk hypothesis of adult social functioning and health outcomes in the fourth decade of life, using the oldest known longitudinally followed cohort of survivors of extremely low birthweight (ELBW; <1,000 g). We investigated the additional impact of peer victimization in youth on social outcomes at age 29-36 years in ELBW survivors and matched normal birthweight (NBW; >2,500 g) participants. In the combined sample, peer victimization was associated with lower likelihood of having children and household income, poorer family functioning and self-esteem, more loneliness and chronic health conditions, less social support, and increased likelihood for contact with police. Moderation analyses indicated that among ELBW survivors, compared to their NBW counterparts, victimization was more strongly associated with being convicted of a crime and with having chronic health conditions. These findings highlight the negative long-term impact of peer victimization on all children and that some outcomes may be differentially affected by prenatal and early post-natal environments. Statement of contribution What is already known on this subject Exposure to early adversity has deleterious effects on brain-behaviour relations across the lifespan. Extremely premature children have higher rates of exposure to adversities, including peer victimization. Peer victimization is associated with adverse outcomes in adulthood in those born at term. What does this study add? Victimization negatively impacts the social outcomes of those born extremely premature and at term into adulthood. Associations appear to be affected by individual differences in prenatal and early post-natal environments. Intervention is crucial when peer victimization occurs in children at risk, as well as those typically developing.

Long-term Psychiatric Impact of Peer Victimization in Adults Born at Extremely Low Birth Weight

BACKGROUND

While children born at extremely low birth weight (ELBW; <1000 g) are at elevated risk for peer victimization, no research has examined its effects on mental health in adulthood.

METHODS

ELBW survivors and matched normal birth weight (NBW; >2500 g) controls were part of a prospective, population-based study in Ontario, Canada. Peer victimization before age 16 was self-reported at age 22 to 26 years by using a 10-point measure. Presence of psychiatric disorders was examined at age 22 to 26 years (ELBW n = 142, NBW n = 133) and age 29 to 36 years (ELBW n = 84, NBW n = 90).

RESULTS

After adjustment for confounding variables, for each 1-point increase in the peer victimization score, ELBW survivors had increased odds of current depressive (odds ratio [OR] = 1.67, 95% confidence interval [CI], 1.23-2.28), anxiety (OR = 1.36, 95% CI, 1.05-1.76), avoidant (OR = 1.39, 95% CI, 1.08-1.79), antisocial (OR = 1.92, 95% CI, 1.06-2.87), and attention-deficit/hyperactivity (OR = 1.39, 95% CI, 1.06-1.83) problems at age 22 to 26 years. At age 29 to 36 years, peer victimization score predicted increased odds of current panic disorder (OR = 1.69, 95% CI, 1.01-2.83) and obsessive-compulsive disorder (OR = 3.56, 95% CI, 1.25-10.09). For NBW controls, peer victimization predicted increased odds of antisocial problems at age 22 to 26 years.

CONCLUSIONS

ELBW survivorsand NBW participants are vulnerable to the adverse psychiatric effects of childhood peer victimization in adulthood.