title: Behavior problems of 9-16 year old preterm children: biological, sociodemographic, and intellectual contributions.
abstract: BACKGROUND
  Preterm children are at risk for behavior problems. Studies examining contributions of intellectual and environmental factors to behavior outcomes in preterm children are mixed.
  
  
  OBJECTIVE
  (1) To identify the nature of maladaptive behaviors in preterm children age 9 to 16 years born across the spectrum of gestational age and birth weight (BW). (2) To examine contributions of BW as a biological factor, socioeconomic status as an environmental factor, and intelligence quotient (IQ) as indicative of intellectual ability to behavior outcomes.
  
  
  METHODS
  Using the Child Behavior Checklist, parent reports of behavior for 63 preterm children (gestational age 24 to <36 weeks) were compared to 29 full term children of similar age, gender and socioeconomic status. Multiple regression models evaluated effects of prematurity, socioeconomic status, and intellectual ability on behavioral symptom scores.
  
  
  RESULTS
  Preterm children had higher total and internalizing problem scores compared to full term children. They also had lower IQ. BW was a significant predictor of total and internalizing behavior problems. Among the syndrome scales, anxious/depressed and attention problems were elevated. Socioeconomic status did not contribute to behavior scores. IQ contributed to total, but not to internalizing or externalizing, scores. IQ contributed to attention problems, but not to anxious/depressed scores.
  
  
  CONCLUSIONS
  Preterm children had increased behavior problems, especially symptoms of inattention and anxiety. Lower BW predicted more behavior problems. IQ acted as a mediator between BW and attention scores, but not anxiety scores. These findings alert health care providers to assess anxiety in all preterm children regardless of intellectual ability and additional study on the influence of intellectual ability on behavioral outcomes in preterm children is needed.
authors.affiliation: Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA 94304, United States. iloe@stanford.edu
authors.forename: Irene M
authors.initials: IM
authors.lastname: Loe
authors.forename: Eliana S
authors.initials: ES
authors.lastname: Lee
authors.forename: Beatriz
authors.initials: B
authors.lastname: Luna
authors.forename: Heidi M
authors.initials: HM
authors.lastname: Feldman
mesh_terms: D000293:Adolescent; D001724:Birth Weight; D002648:Child; D002653:Child Behavior Disorders / Q000209:etiology*; D006801:Humans; D007360:Intelligence; D007361:Intelligence Tests; D047928:Premature Birth; D012959:Socioeconomic Factors