Neurobehavioral Symptoms in Children Born Extremely Preterm: A Swedish National Study.

Abstract

To determine the prevalence of neurobehavioral problems at 6.5 years in children born extremely preterm (EPT, <27 weeks' gestation). Population-based cohort study of infants born EPT in Sweden from 2004 to 2007. Of 486 survivors 375 were assessed and compared with 369 matched term-born controls. EPT children free from neurosensory and intellectual disabilities (NDD-free, n=236) were compared separately. Standardized questionnaires were used to assess parental ratings of hyperactivity and attention, emotional, peer-relation, conduct, and social problems; and deficits in perception, language and memory. EPT children had more reported problems in all assessed neurobehavioral domains than controls, with more than 3 times greater odds for most outcomes. Except for conduct problems, increased problems were identified also in NDD-free children. The odds of having neurobehavioral problems in ≥3 co-occurring domains were five (whole EPT group) and three (NDD-free group) times higher than in controls. EPT children with or without NDD have more neurobehavioral problems in multiple domains than term peers. Ongoing assessments of behavior until school age or beyond should recognize early symptoms of attention, everyday social problems, perceptual, emotional or language difficulties.