Among extremely preterm children, cognitive and neurologic impairment is common at school age. A comparison with their classroom peers indicates a level of impairment that is greater than is recognized with the use of standardized norms.

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BackgroundParticipant drop-out occurs in all longitudinal studies, and if systematic, may lead to selection biases and erroneous conclusions being drawn from a study.AimsWe investigated whether drop out in the Avon Longitudinal Study of Parents And Children (ALSPAC) was systematic or random, and if systematic, whether it had an impact on the prediction of disruptive behaviour disorders.MethodTeacher reports of disruptive behaviour among currently participating, previously participating and never participating children aged 8 years in the ALSPAC longitudinal study were collected. Data on family factors were obtained in pregnancy. Simulations were conducted to explain the impact of selective drop-out on the strength of prediction.ResultsDrop out from the ALSPAC cohort was systematic and children who dropped out were more likely to suffer from disruptive behaviour disorder. Systematic participant drop-out according to the family variables, however, did not alter the association between family factors obtained in pregnancy and disruptive behaviour disorder at 8 years of age.ConclusionsCohort studies are prone to selective drop-out and are likely to underestimate the prevalence of psychiatric disorder. This empirical study and the simulations confirm that the validity of regression models is only marginally affected despite range restrictions after selective drop-out.

Bullying is the systematic abuse of power and is defined as aggressive behaviour or intentional harm-doing by peers that is carried out repeatedly and involves an imbalance of power. Being bullied is still often wrongly considered as a ‘normal rite of passage’. This review considers the importance of bullying as a major risk factor for poor physical and mental health and reduced adaptation to adult roles including forming lasting relationships, integrating into work and being economically independent. Bullying by peers has been mostly ignored by health professionals but should be considered as a significant risk factor and safeguarding issue.

Bullying is a serious problem for schools, parents and public policy makers alike. While bullying creates risks of health and social problems in childhood, it is unclear if this risk extends into adulthood. A large cohort of children was assessed for bullying involvement in childhood and then followed up in young adulthood to assess health, risky/illegal behavior, wealth and social relationships. Victims of childhood bullying including those that bullied others (bully-victim) were at increased risk of poor health, wealth and social relationship outcomes in adulthood even after controlling for family hardship and childhood psychiatric disorders. In contrast, pure bullies were not at increased risk of poor adult outcome once other family and childhood risk factors were taken into account. Being bullied is not a harmless rite of passage but throws a long shadow over affected people’s lives. Interventions in childhood are likely to reduce long term health and social costs.

Differences in definitions and methodologies for assessing bullying in primary school children between countries have precluded direct comparisons of prevalence rates and school factors related to bullying. A total of 2377 children in England (6-year-olds/Year 2: 1072; 8-year-olds/Year 4: 1305) and 1538 in Germany (8-year-olds/Year 2) were questioned individually using an identical standard interview. In both countries the types of bullying to victimize others were similar: boys were most often perpetrators, most bullies were also victims (bully/victims), most bullying occurred in playgrounds and the classroom, and SES and ethnicity only showed weak associations with bullying behaviour. Major differences were found in victimization rates with 24% of English pupils becoming victims every week compared with only 8% in Germany. In contrast, fewer boys in England engaged every week in bullying (2.5-4.5%) than German boys (7.5%), while no differences were found between girls. In England, children in smaller classes were more often victimized. Further study of the group of bully/victims, schooling differences in England vs. Germany and implications for prevention of bullying are discussed.

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Objective To investigate the burden of later disease associated with moderate/late preterm (32-36 weeks) and early term (37-38 weeks) birth. Design Secondary analysis of data from the Millennium Cohort Study (MCS).Setting Longitudinal study of infants born in the United Kingdom between 2000 and 2002.Participants 18 818 infants participated in the MCS. Effects of gestational age at birth on health outcomes at 3 (n=14 273) and 5 years (n=14 056) of age were analysed.Main outcome measures Growth, hospital admissions, longstanding illness/disability, wheezing/asthma, use of prescribed drugs, and parental rating of their children's health. ResultsMeasures of general health, hospital admissions, and longstanding illness showed a gradient of increasing risk of poorer outcome with decreasing gestation, suggesting a "dose-response" effect of prematurity. The greatest contribution to disease burden at 3 and 5 years was in children born late/moderate preterm or early term. Population attributable fractions for having at least three hospital admissions between 9 months and 5 years were 5.7% (95% confidence interval 2.0% to 10.0%) for birth at 32-36 weeks and 7.2% (1.4% to 13.6%) for birth at 37-38 weeks, compared with 3.8% (1.3% to 6.5%) for children born very preterm (<32 weeks). Similarly, 2.7% (1.1% to 4.3%), 5.4% (2.4% to 8.6%), and 5.4% (0.7% to 10.5%) of limiting longstanding illness at 5 years were attributed to very preterm birth, moderate/late preterm birth, and early term birth.Conclusions These results suggest that health outcomes of moderate/late preterm and early term babies are worse than those of full term babies. Additional research should quantify how much of the effect is due to maternal/fetal complications rather than prematurity itself.Irrespective of the reason for preterm birth, large numbers of these babies present a greater burden on public health services than very preterm babies.