Most very low birth weight subjects do well as adults

Gäddlin, P-O; Finnström, Orvar; Sydsjö, Gunilla; Leijon, Ingemar

doi:10.1111/j.1651-2227.2009.01368.x

Cited by 39 publications

(58 citation statements)

References 39 publications

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“…[13][14][15][16] This risk reduction may result from their cautious, shy, risk-avoidant personality style, 11,29 higher parental monitoring earlier in life, 16 or a later manifestation of their tendency to show lower levels of externalizing behavior in childhood and adolescence. 9,15,30 The finding that ELBW survivors were more likely to have a current non-substance use related psychiatric disorder is also in keeping with studies of VLBW survivors in adulthood.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies of very low birth weight (VLBW, ,1500 g) survivors in their 20s suggest that they may be at elevated risk for ADHD, mood disorders, anxiety, and social problems [8][9][10][11][12] but are less likely to have alcohol and substance use disorders. [13][14][15][16] Although few data exist on the adult mental health of ELBW survivors, these individuals may also be at elevated risk for depression, anxiety, and avoidant personality problems in their early to mid-20s. 17 Recent data suggest that people born at VLBW or ELBW may not be a homogeneous group in terms of risk.…”

Section: What This Study Addsmentioning

confidence: 99%

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Mental Health of Extremely Low Birth Weight Survivors in Their 30s

Lieshout¹,

Boyle²,

et al. 2015

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OBJECTIVE: To determine the risk for psychiatric disorders among extremely low birth weight (ELBW) survivors in their early to mid-30s and to determine whether those born small for gestational age or those exposed to a full course of antenatal corticosteroids (ACS) were at particularly high risk.METHODS: A prospective, longitudinal, population-based cohort of 84 ELBW survivors and 90 normal birth weight (NBW) control participants born in Ontario, Canada from 1977 to 1982 were assessed by interviewers naive to birth weight status using the Mini-International Neuropsychiatric Interview.RESULTS: ELBW survivors had lower odds of an alcohol or substance use disorder but higher odds of current non-substance-related psychiatric problems (odds ratio [OR] = 2.47; 95% confidence interval [CI], 1.19-5.14). Those born ELBW and SGA exhibited the same patterns with larger effects. ACS-exposed ELBW survivors had even higher odds of any current non-substance-related psychiatric disorder (OR = 4.41; 95% CI, 1.65-11.82), particularly generalized anxiety disorder (OR = 3.42; 95% CI, 1.06-11.06), the generalized type of social phobia (OR = 5.80; 95% CI,, and the inattentive subtype of attention-deficit/ hyperactivity disorder (OR = 11.45; 95% CI, 2.06-63.50). CONCLUSIONS:In their early to mid-30s, ELBW survivors were less likely to have alcohol or substance use disorders but may be at greater risk for other psychiatric problems. Those exposed to ACS were at especially high risk and manifested no reduction in alcohol or substance use disorders. ELBW survivors exposed to ACS may be a special group at risk for psychopathology in adulthood. WHAT'S KNOWN ON THIS SUBJECT:Little is known about the mental health of extremely low birth weight survivors in their 30s. It is also unclear whether being born small for gestational age or being exposed to antenatal corticosteroids increases risk in this group. WHAT THIS STUDY ADDS:In their 30s, extremely low birth weight survivors are less likely to have substance problems but are at elevated risk for other psychiatric disorders. Those born small for gestational age are at higher risk, but those exposed to antenatal corticosteroids are at the greatest risk of all. Dr Van Lieshout conceived of the study and its design, selected the data collection instruments, supervised data collection, analyzed and interpreted the data, and drafted the initial manuscript; Dr Boyle helped conceive of the study and its design, aided in the analysis and interpretation of the data, and reviewed and revised the manuscript; Drs Saigal, Morrison, and Schmidt helped conceive of the study and its design, aided in the interpretation of data, and reviewed and revised the manuscript; and all authors approved the final manuscript as submitted. [3][4][5][6][7] However, little is known about the extent to which these risks persist into adulthood. Previous studies of very low birth weight (VLBW, ,1500 g) survivors in their 20s suggest that they may be at elevated risk for ADHD, mood disorders, anxiety, and social probl...

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Section: Discussionmentioning

confidence: 99%

Section: What This Study Addsmentioning

confidence: 99%

Mental Health of Extremely Low Birth Weight Survivors in Their 30s

Lieshout¹,

Boyle²,

et al. 2015

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“…4,15,16 They also have lower self-perceived attractiveness or romantic confidence, 5,11 and lower educational attainment. 3,4,11,17 Still, those born very preterm or with very low birth weight perceive themselves as healthy and functioning as their peers, 6,[18][19][20][21] and are less likely to drink alcohol or use illicit drugs. 4,11,13,14 However, very preterm or very low birth weight infants comprise only a small proportion of all preterm births, 22 and thus late preterm births (births $34 weeks' but ,37 weeks' gestation) have a high public health impact despite that the degree of immaturity and risks for morbidity are smaller among individuals born late preterm.…”

Section: What This Study Addsmentioning

confidence: 99%

Independent Living and Romantic Relations Among Young Adults Born Preterm

et al. 2015

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BACKGROUND: Young adults born preterm at very low birth weight start families later. Whether less severe immaturity affects adult social outcomes is poorly known. METHODS: The study “Preterm birth and early life programming of adult health and disease” (ESTER, 2009–2011) identified adults born early preterm (<34 weeks’ gestation, N = 149), late preterm (≥34 to <37 weeks’ gestation, N = 248), and at term (≥37 weeks’ gestation, N = 356) from the Northern Finland Birth Cohort 1986 and the Finnish Medical Birth Register (1987–1989), with perinatal data, medical and family history, socioeconomic status, and lifestyle from routine visits or questionnaires. Cox, logistic, and ordinal regressions estimated the hazard and odds ratios (HR and OR) with 95% confidence intervals of outcomes related to preterm birth. RESULTS: Compared with term-born subjects, those born early and late preterm were less likely to have cohabited with a romantic partner (HR, 0.79; [0.61–1.03] and HR, 0.80; [0.65–0.99], respectively) or experienced sexual intercourse (HR, 0.83; [0.66–1.05] and HR, 0.76; [0.63–0.92], respectively) by young adulthood. They also had higher odds of obtaining a 1-point lower score in a visual analog scale of self-perceived sexual attractiveness (OR, 1.45; [1.09–1.98] and OR, 1.44; [1.06–1.97] for early and late preterm birth, respectively). No difference was observed in the likelihood of departing from childhood home and number of individuals having their own families. CONCLUSIONS: Young adults born preterm experience more social challenges, which may affect their romantic relationships and future family planning.

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“…As compared with orally fed controls, animals receiving TPN had a lower body weight, weaker spontaneous physical activity, and poorer glucose tolerance. These characteristics are also reported in young adults 20 y of age who were born very low birth weight (7)(8)(9) and in whom the use of TPN was a frequent occurrence. This early life origin of adult metabolic perturbations suggests a reprogramming of metabolism following epigenetic modifications induced by a change in the pattern of DNA expression.…”

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confidence: 67%

Total parenteral nutrition induces sustained hypomethylation of DNA in newborn guinea pigs

et al. 2013

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Background: Neonatal total parenteral nutrition (TPN) is associated with animals with low glucose tolerance, body weight, and physical activity at adulthood. The early life origin of adult metabolic perturbations suggests a reprogramming of metabolism following epigenetic modifications induced by a change in the pattern of DNA expression. We hypothesized that peroxides contaminating TPN inhibit the activity of DNA methyltransferase (DNMT), leading to a modified DNA methylation state. Methods: Three groups of 3-d-old guinea pigs with catheters in their jugular veins were compared: (i) control: enterally fed with regular chow; (ii) TPN: fed exclusively with TPN (dextrose, amino acids, lipids, multivitamins, contaminated with 350 ± 29 μmol/l peroxides); (iii) H 2 O 2 : control + 350 μmol/l H 2 O 2 intravenously. After 4 d, infusions were stopped and animals enterally fed. Half the animals were killed immediately after treatments and half were killed 8 wk later (n = 4-6 per group) for hepatic determination of DNMT activities and of 5′-methyl-2′-deoxycytidine (5MedCyd) levels, a marker of DNA methylation. results: At 1 wk, DNMT and 5MedCyd were lower in the TPN and H 2 O 2 groups as compared with controls. At 9 wk, DNMT remained lower in the TPN group, whereas 5MedCyd was lower in the TPN and H 2 O 2 groups. conclusion: Administration of TPN or H 2 O 2 early in life in guinea pigs induces a sustained hypomethylation of DNA following inhibition of DNMT activity. t otal parenteral nutrition (TPN) may be required in neonates with impaired oral feeding capability following intestinal surgery or in premature newborns with immature gastrointestinal tract. Even if this mode of nutrition enables sustained growth and development, its contamination by oxidant molecules such as peroxides (1) is associated with oxidative stress (2). The neonatal impacts of this stress have been demonstrated in an animal model of TPN (3) as well as in premature neonates (2). An oxidative stress early in life is also suspected to modulate the health status into adulthood (4,5).Administration of TPN or H 2 O 2 during the first week of life in guinea pig pups has been shown to induce, 3 mo later, a modification in energy metabolism that was associated with a phenotype of energy deficiency (6). As compared with orally fed controls, animals receiving TPN had a lower body weight, weaker spontaneous physical activity, and poorer glucose tolerance. These characteristics are also reported in young adults 20 y of age who were born very low birth weight (7-9) and in whom the use of TPN was a frequent occurrence. This early life origin of adult metabolic perturbations suggests a reprogramming of metabolism following epigenetic modifications induced by a change in the pattern of DNA expression. We suspect that this might take place through a permanent effect of TPN on DNA methylation.Metabolic activities are dependent of the expression of genes. Transcription of genes is dependent on their availability to interact with transcription factors and other componen...

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Most very low birth weight subjects do well as adults

Abstract: The 20-year old VLBW subjects reported perceived health and managed transition to adulthood similar to controls. Handicapped subjects had poorer self-perceived physical function. ELBW and severe neonatal complications were associated with poorer self-perceived physical health.

Cited by 39 publications

References 39 publications

Mental Health of Extremely Low Birth Weight Survivors in Their 30s

Mental Health of Extremely Low Birth Weight Survivors in Their 30s

Independent Living and Romantic Relations Among Young Adults Born Preterm

Total parenteral nutrition induces sustained hypomethylation of DNA in newborn guinea pigs

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