Hospitalization in the first years of life and development of psychiatric disorders at age 6 and 11: a birth cohort study in Brazil.

Vera Lucia Schmidt Da Silva,Tyago N Munhoz,Iná S Santos,Giovanny Vinícius Araújo De França,Aluísio J D Barros,Fernando C Barros,Alícia Matijasevich

doi:10.1590/0102-311x00064517

Abstract

This study aimed to evaluate the medium-term effects that hospitalization in the first 48 months of life has on the development of psychiatric disorders at 6 and 11 years of age among individuals in a birth cohort in a middle-income country. We analyzed data from a 2004 birth cohort (N = 4,231) in the city of Pelotas, Rio Grande do Sul State, Brazil. The frequency of hospitalization was investigated at 12, 24 and 48 months of life. When the children were 6 and 11 years old, psychiatric disorders were investigated with the Development and Well-Being Assessment. We used logistic regression to adjust for potential confounders. The overall frequency of hospitalization during the first 48 months of life was 33.1% (95%CI: 31.4; 34.7). Among the hospitalized children 25.6% (95%CI: 24.1; 27.1), 4.7% (95%CI: 4.0; 5.5) and 2.8% (95%CI: 2.3; 3.5) were hospitalized 1, 2 or ≥ 3 times during this period, respectively. After adjustment for potential confounders, the chance of presenting any psychiatric disorder at 6 and 11 years of age was higher for the children who had been hospitalized during the first 48 months of life than for those who had not, with OR of 1.50 (95%CI: 1.19; 1.88) and 1.63 (95%CI: 1.28; 2.07), respectively. Our results support the hypothesis that hospitalization in the early stages of life has an effect on the subsequent mental health of children. Preventive measures are needed in order to minimize the negative experiences of children who are hospitalized during infancy.

Highlights

IntroductionHospitalization is defined as being admitted to a hospital (for medical care or observation) and remaining there for at least 24 hours 1
Hospitalization is defined as being admitted to a hospital and remaining there for at least 24 hours 1
We studied a birth cohort comprising all live births occurring between January 1 and December 31, 2004, among mothers living in the urban area of Pelotas, Rio Grande do Sul State, Brazil

Summary

Introduction

Hospitalization is defined as being admitted to a hospital (for medical care or observation) and remaining there for at least 24 hours 1 It can be considered a stressful, traumatic event in the life of an individual, because it implies a rupture in family and social relations [2,3,4,5,6,7,8]. This process is even more intense and marked in childhood, given that children have limited mechanisms to cope with stressful experiences. Stress in childhood can affect the structural and functional systems of the developing brain, making an individual more vulnerable to psychological problems [11,12]. There is evidence that long-term exposure to stress in general, as well as to specific environmental stresses during sensitive periods of development, produces structural and functional disturbances, leading to a wide variety of physical and mental deficits in the short, medium and long term [13,14,15]

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