Psychiatric Disorders in Extremely Preterm Children

Abstract

Objective To investigate the prevalence and risk factors for psychiatric disorders in extremely preterm children. Method All babies born Results Extremely preterm children were more than three times more likely to have a psychiatric disorder than classmates (23% vs. 9%; odds ratio [OR] = 3.2; 95% confidence interval [CI] = 1.7, 6.2). Risk was significantly increased for: attention-deficit/hyperactivity disorder (ADHD; 11.5% vs. 2.9%; OR=4.3; CI=1.5 to 13.0), with increased risk for ADHD inattentive subtype (OR = 10.5; CI=1.4 to 81.1) but not ADHD combined subtype (OR = 2.1; CI=0.5 to 7.9); emotional disorders (9.0% vs. 2.1%; OR=4.6; CI=1.3 to 15.9), with increased risk for anxiety disorders (OR = 3.5; CI=1.0 to 12.4); and autism spectrum disorders (8.0% vs. 0%; p=.000). Psychiatric disorders were significantly associated with cognitive impairment (OR = 3.5; CI=1.8 to 6.4). Parent-reported behavioral problems at 2.5 and 6 years were independent predictors of psychiatric disorders at 11 years. Conclusions Extremely preterm children are at increased risk for ADHD, emotional disorders, and autism spectrum disorders at 11 years of age. The mechanism of association with psychiatric disorder may include both cognitive impairment and early traumatic experiences that have an impact on both child and parent. Early screening for cognitive and behavioral problems may identify those at greatest risk.