Abstract

Problems in behavioural and emotional outcome are amongst the long-term sequelae of preterm birth. The exact prevalence and associations with perinatal risk factors are unknown. Minimal research has been performed in pre-school aged children, compared to school age. The primary aim of this study was to determine the prevalence of parent-reported behavioural and emotional problems at the age of two in children born at less than 30 weeks' gestational age and/or birth weight less than 1000 g. The secondary aim was to determine whether perinatal factors were associated with the behavioural and emotional outcome.Perinatal characteristics of 144 preterm-born children from the NeoLiFeS cohort were collected retrospectively. Of these children, 101 parents filled out a Childs Behaviour Checklist (CBCL) at the corrected age of two. The results of the CBCL tests were presented as Z-scores, a Z-score of 0 indicating the mean of behavioural scores in the norm population. A Z-score higher than zero indicates less behavioural problems than average, a negative Z-score indicates more problems. Associations between perinatal risk factors and CBCL-scores were analysed using linear regression analyses.Prevalences of clinically relevant CBCL scores were low, 4%, 2% and 5% for total score, internalizing score or externalizing score, respectively. Being part of a twin was associated with higher internalizing Z-scores, indicating less problems in emotional behaviour. Bronchopulmonary dysplasia was associated with lower Z-scores in total and externalizing behaviour. In conclusion, in our cohort generally very few problems in behavioural and emotional outcome were reported at the age of two.

Highlights

  • Problems in behaviour are part of the long term sequalae of pretermborn children [1,2,3,4,5,6,7,8], these problems occur significantly more in pretermborn infants, compared with their term-born peers [2,3]

  • Length of stay in the NICU, lower birth weight, prolonged ventilation, treatment with corticosteroids, and intraventriculair hemmorhage (IVH) are risk factors that have been associated with behavioural problems [9,10]

  • Our study indicated that the prevalence of parent-reported behav­ ioural problems was low in this cohort of very preterm born children at the age of two

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Summary

Introduction

Problems in behaviour are part of the long term sequalae of pretermborn children [1,2,3,4,5,6,7,8], these problems occur significantly more in pretermborn infants, compared with their term-born peers [2,3]. A meta-analysis has shown that behavioural problems occur in both internalizing (within the self) and externalizing (conflicts with others) spectra [5]. These problems can be described as for instance withdrawn, shy, and inat­ tentive behaviour and a lack of social skills [6]. No clear evidence was found for the prognostic value of other risk factors [11]

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