Longitudinal growth and emotional and behavioral problems at age 7 in moderate and late preterms.

Baukje M Dotinga,Andrea F De Winter,Sijmen A Reijneveld,Arend F Bos,Inger F A Bocca-Tjeertes,Jorien M Kerstjens

doi:10.1371/journal.pone.0211427

Baukje M Dotinga, Andrea F De Winter + Show 4 more

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https://doi.org/10.1371/journal.pone.0211427

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Abstract

ObjectivesModerately and late preterm children (MLPs, 32.0–36.9 weeks gestational age) have a greater risk of poorer growth. This seems to be associated with poorer neuropsychological functioning. Evidence is limited on whether this also holds for emotional and behavioral (EB) problems. Therefore, we assessed whether longitudinal growth from birth until age 7 was associated with EB problems at age 7 in MLPs.Study designThis study was part of the Longitudinal Preterm Outcome Project, a prospective cohort study. Data on growth (height, weight, head circumference, and extent of catch-up growth) were obtained from assessments from birth until age 7. EB problems were assessed at age 7 with the Child Behavior Checklist. We assessed whether growth and EB problems were associated using logistic regression analyses, adjusting for multiple birth, parity, and socioeconomic status.ResultsWe included 248 MLPs. Median gestational age was 34 weeks (interquartile range: 33–35 weeks). Mean birth weight was 2.2 kg (standard deviation: 0.5 kg). Postnatal growth measures were below the Dutch reference norm. EB problems were more prevalent in MLPs than in the general Dutch population. Generally, we found no associations between growth and EB problems; odds ratios ranged from 0.20 to 2.72.ConclusionsIn MLPs, postnatal growth from birth until age 7 was not associated with EB problems at age 7. Poorer growth thus seems to relate to neuropsychological problems, but not to EB problems. This suggests that the etiologies of these problems differ at least partially.

Highlights

Worldwide, approximately 10% of all children are born preterm [1]
In Moderately and late preterm (MLP), postnatal growth from birth until age 7 was not associated with emotional and behavioral (EB) problems at age 7
Poorer growth seems to relate to neuropsychological problems, but not to EB problems

Summary

Introduction

Moderate (32.0–33.9 weeks gestational age, GA) and late (34.0–36.9 weeks GA) prematurity accounts for approximately 80% of all preterm births [1]. And late preterm (MLP) birth leads to a greater risk of adverse childhood outcomes, including growth restraint [2], impaired neuropsychological functioning [3], and emotional and behavioral (EB) problems [4,5,6,7,8]. Previous studies have shown that in preterm-born children, these adverse outcomes co-occur and may be interrelated: poorer growth seems to be associated with poorer neuropsychological functioning [9,10] and children with poorer neuropsychological functioning often have more EB problems [11,12]. Gaining more insight into the etiology of EB problems in childhood may improve detection, intervention strategies, and outcomes of these problems

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