Physical Activity, Mental Health, and Well-Being in Very Pre-Term and Term Born Adolescents: An Individual Participant Data Meta-Analysis of Two Accelerometry Studies.

Asteria Brylka,Serge Brand,Alexander Grob,Peter Weber,Juliane Spiegler,Ayten Bilgin,Hayley Trower,Anna Gkiouleka,Katri Räikkönen,Sebastian Ludyga,Dieter Wolke,Eero Kajantie,Kati Heinonen,Sakari Lemola,Markus Gerber

doi:10.3390/ijerph18041735

Abstract

This study examined whether physical activity is associated with better mental health and well-being among very preterm (≤32 weeks) and term born (≥37 weeks) adolescents alike or whether the associations are stronger in either of the groups. Physical activity was measured with accelerometry in children born very preterm and at term in two cohorts, the Basel Study of Preterm Children (BSPC; 40 adolescents born ≤32 weeks of gestation and 59 term born controls aged 12.3 years) and the Millennium Cohort Study (MCS; 45 adolescents born ≤32 weeks of gestation and 3137 term born controls aged 14.2 years on average). In both cohorts, emotional and behavioral problems were mother-reported using the Strengths and Difficulties Questionnaire. Subjective well-being was self-reported using the Kidscreen-52 Questionnaire in the BSPC and single items in the MCS. Hierarchical regressions with ‘preterm status × physical activity’-interaction effects were subjected to individual participant data (IPD) meta-analysis. IPD meta-analysis showed that higher levels of physical activity were associated with lower levels of peer problems, and higher levels of psychological well-being, better self-perception/body image, and school related well-being. Overall, the effect-sizes were small and the associations did not differ significantly between very preterm and term born adolescents. Future research may examine the mechanisms behind effects of physical activity on mental health and wellbeing in adolescence as well as which type of physical activity might be most beneficial for term and preterm born children.

Highlights

Children and adults born very preterm or with very low birth weight have an increased risk of neurodevelopmental and mental health problems [1,2]
Very preterm adolescents were more likely to belong to ethnic minority groups in the Millennium Cohort Study (MCS) sample
Pooled mean differences based on random effects meta-analysis revealed significantly higher levels of emotional problems in very preterm compared to term born children (Std. mean difference = 0.26, p = 0.03; Supplementary Table S1)

Summary

Introduction

Children and adults born very preterm or with very low birth weight have an increased risk of neurodevelopmental and mental health problems [1,2]. While prematurity increases the risk of adverse outcomes, many very preterm born children and adolescents do not have any symptoms of mental health problems, showing resilience in the face of complications and adversity [4]. Existing research has identified sensitive parenting in childhood [5] as a potential resilience factor for academic achievement among very preterm children (i.e., in very preterm children sensitive parenting was more strongly associated with academic outcomes than in term born children). A recent study reported that very preterm children may be more strongly affected by risk factors for mental health such as family dysfunction, parental mental health problems, and peer victimisation while not benefitting as much from potential resilience factors such as number of close friends or sensitive parental care compared to term born children [6]

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