Roles of perinatal problems on adolescent antisocial behaviors among children born after 33 completed weeks: a prospective investigation.
BACKGROUND
There is uncertainty about the extent to which mildly sub-optimal perinatal characteristics among individuals born near-term (>33 weeks of gestation) are associated with various subsequent childhood problems, including antisocial behavior. There is even more uncertainty about whether the pathway to antisocial behavior differs by gender.


METHODS
A sample of 1689 infants, born near-term, was followed from birth for over 30 years. Using structural equation modeling (SEM), the study evaluated hypothesized mechanisms linking perinatal problems to antisocial behavior, mediated through the following variables in early and later childhood: neurological abnormalities at age 1; hearing, speech, and language problems at age 3; cognitive function at age 4; and academic performance at age 7. Childhood problems were assessed by trained research clinicians, blind to perinatal status. An 'antisocial behavior' variable was created, based on retrospective self-report of six antisocial incidences assessed in adulthood.


RESULTS
Path coefficients showed that birthweight, head circumference, and Apgar scores were indirectly associated with antisocial behavior in the presence of one or more of the following: neurological abnormalities, abnormality in language, speech, and hearing, cognitive function, or academic performance. We found gender differences only in the associations between hearing and IQ and between language perception and IQ. Poor academic performance was associated with antisocial behavior in both boys and girls.


CONCLUSIONS
Our hypothesis, that perinatal problems may progress to antisocial behavior when mediated by various markers of early childhood problems, was confirmed. Adverse perinatal events need to be considered in identifying infants who are at risk for academic problems and antisocial behavior, even when the infant is born relatively close to term (i.e., >33 weeks). Poor academic performance, which is indirectly influenced by a variety of neurological and cognitive problems during the perinatal period, infancy, and early childhood appear to increase antisocial behavioral problems in both girls and boys.
Nomura
Yoko
Y
Mount Sinai School of Medicine, Department of Psychiatry, New York, NY 10029USA. Yoko.Nomura@mssm.edu
Rajendran
Khushmand
K
Brooks-Gunn
Jeanne
J
Newcorn
Jeffrey H
JH
D000293:Adolescent; D000987:Antisocial Personality Disorder / Q000453:epidemiology*; D001034:Apgar Score; D015142:Baltimore / Q000453:epidemiology; D001724:Birth Weight; D002508:Cephalometry; D002653:Child Behavior Disorders / Q000453:epidemiology*; D003147:Communication Disorders / Q000453:epidemiology; D002658:Developmental Disabilities / Q000453:epidemiology*; D004522:Educational Status; D005260:Female; D006311:Hearing Disorders / Q000453:epidemiology; D006801:Humans; D007231:Infant, Newborn; D007360:Intelligence; D008297:Male; D015997:Neonatal Screening; D011446:Prospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D016037:Single-Blind Method