Emotional and behavioral problems in late preterm and early term births: outcomes at child age 36 months.

Kim Stene-Larsen,Beatrice Latal,Margarete E Vollrath,Astri M Lang,Markus A Landolt

doi:10.1186/s12887-016-0746-z

Abstract

BackgroundRecent findings has shown that late preterm births (gestational weeks 34–36) and early term births (gestational weeks 37–38) is associated with an increased risk of several psychological and developmental morbidities. In this article we investigate whether late preterm and early term births is associated with an increased risk of emotional and behavioral problems at 36 months of age and whether there are gender differences in risk of these outcomes.MethodsForty-three thousand, two hundred ninety-seven children and their mothers participating in the Norwegian Mother and Child Cohort Study (MoBa). One thousand, eight hundred fifty-three (4.3%) of the children in the sample were born late preterm and 7,835 (18.1%) were born early term. Information on gestational age and on prenatal and postnatal risk factors was retrieved from the Medical Birth Registry of Norway. Information on emotional and behavioral problems was assessed by standardized questionnaires (CBCL/ITSEA) filled out by the mothers. Gender-stratified logistic regression analyses were used to explore the association between late preterm / early term and emotional and behavioral problems at 36 months of age.ResultsWe found a gender-specific increased risk of emotional problems in girls born late preterm (OR 1.47 95%CI 1.11–1.95) and in girls born early term (OR 1.21 95%CI 1.04–1.42). We did not find an increased risk of emotional problems in boys born late preterm (OR 1.09 95%CI 0.82–1.45) or early term (OR 0.93 95%CI 0.79–1.10). Behavioral problems were not increased in children born late preterm or early term.ConclusionGirls born late preterm and early term show an increased risk of emotional problems at 36 months of age. This finding suggests that gender should be taken into account when evaluating children born at these gestational ages.

Highlights

Recent findings has shown that late preterm births and early term births is associated with an increased risk of several psychological and developmental morbidities
We present a case cohort study including more than 43 000 children, in which we addressed whether late preterm and early term births are associated with an increased risk of emotional and behavioral problems at age 36 months
Children born late preterm and early term differed from term born children on a variety of characteristics

Summary

Introduction

Recent findings has shown that late preterm births (gestational weeks 34–36) and early term births (gestational weeks 37–38) is associated with an increased risk of several psychological and developmental morbidities. In this article we investigate whether late preterm and early term births is associated with an increased risk of emotional and behavioral problems at 36 months of age and whether there are gender differences in risk of these outcomes. With the rapidly increasing population of early term and late preterm births [14,15,16], it is of clinical and public health importance to map the potential genderspecific psychological outcomes in this large population. An important issue in research on psychological sequalae in children born preterm is whether shorter gestation length is a risk factor per se or whether health risks associated with preterm birth—confounders—are responsible for later adverse outcomes. Many children born preterm are small for their gestational age, which in turn is a risk factor for later neurobehavioral problems. [20] it is necessary to carefully control for all known risk factors associated with both preterm birth and psychological problems in the child

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