O-12 - Mental health among children born extremely premature: a national population based study

Abstract

Objective: To compare mental health at 5 years in children born extremely preterm and at term and assess associations between functional abilities and mental health within the preterm group. Design: In a national Norwegian cohort with gestational age (GA) 22-27 weeks or birthweight 500-999g mental health was assessed with The Strengths and Difficulties Questionnaire (SDQ), cognitive function with WPPSI-R, motor function with ABC movement test and severity of cerebral palsy (CP) with the Gross Motor Function Classification for CP (GMFCS). Neurodevelopmental disabilities (NDD) were described as mild and moderate/severe. SDQ of the preterm children was compared with that of a non-selected reference group born at term. SDQ sub-scores ≥90 th percentile were defined as a mental health problem and a total difficulty score ≥90 th percentile (TDS90) as suggestive of psychiatric disorder. Results: Of 361 eligible preterm children parents completed SDQ for 255 (71 %). 28 (11%) had TDS90 compared to 10 of 758 (1%) of the reference group (OR: 8.4, 95% CI 4.0 to 17.0). For the preterms the rate of TDS90 was higher for those with moderate/severe NDD (12/37 vs. 6/116, OR: 9. 3.0;26.0), but not for those with mild NDD (10/102 vs. 6/116) compared with those with no NDD. For preterms with no NDD TDS90 was more common than for the term reference group (6/116 vs. 10/758, OR:3.7, 1.3;10.0), and the most distinguishing features were emotional and peer problems. Conclusion: Extreme prematurity is associated with increased risk of later mental health problems, particularly if they have other functional impairments.

Development and predictors of childhood mental health problems in former extremely preterm infants

“…Each item is scored on a three point scale "not true", "somewhat true", and "certainly true". Two unselected Norwegian populations, one at five and one at eleven years of age served as reference populations [2,8,9]. The total subscale scores range from 0 to10 and TDS from 0 to 40.…”

“…The SDQ is widely used and validated, has good psychometric properties [24], with a sensitivity of 0.58 and specificity of 0.88 for parent reported TDS90 in comparison to a psychiatric diagnosis [25]. The SDQ scores at five and eleven years of age has been reported previous [2,8,9].…”

“…Children born extremely preterm (EP-born before 28 weeks gestation) are at increased risk of later mental health problems such as inattention, peer problems and emotional problems, both at preschool [1][2][3] and middle school age [4][5][6][7][8][9].…”

“…to the Gross Motor Function Classification for CP (GMFCS), k Total Difficulties Score ≥ 90th percentile (TDS90) for a reference group according to the SDQ at five years of age[2].…”