title: Neonatal head ultrasound abnormalities in preterm infants and adolescent psychiatric disorders.
abstract: BACKGROUND
  Infants born prematurely are at risk for a perinatal encephalopathy characterized by white and gray matter injuries that affect subsequent cortical development and neural connectivity and potentially increase risk for later psychiatric disorder.
  
  
  OBJECTIVE
  To determine the relation of perinatal brain injury, as detected by neonatal head ultrasound, to psychiatric disorders in adolescents who were born prematurely.
  
  
  METHODS
  Prospective cohort.
  
  
  METHODS
  Community.
  
  
  METHODS
  Adolescent survivors of a population-based low-birth-weight (<2000 g; 96% preterm; born 1984-1987) cohort (n = 1105) screened as neonates with serial head ultrasounds. Neonatal head ultrasound abnormalities were categorized as either (1) germinal matrix and/or intraventricular hemorrhage or (2) parenchymal lesions and/or ventricular enlargement. Of 862 eligible survivors, 628 (72.9%) were assessed at age 16 years. The sample consisted of 458 nondisabled survivors assessed in person. Main Outcome Measure  Adolescent current and lifetime psychiatric disorders assessed with parent report on the Diagnostic Interview Schedule for Children-IV.
  
  
  RESULTS
  Compared with no abnormality, germinal matrix/intraventricular hemorrhage increased risk for current major depressive disorder (odds ratio, 2.7; 95% confidence interval, 1.0-6.8) and obsessive-compulsive disorder (9.5; 3.0-30.1). Parenchymal lesions/ventricular enlargement increased risk for current attention-deficit/hyperactivity disorder-inattentive type (odds ratio, 7.6; 95% confidence interval, 2.0-26.5), tic disorders (8.4; 2.4-29.6), and obsessive-compulsive disorder (7.6; 1.39-42.0). Parenchymal lesions/ventricular enlargement were not related to lifetime attention-deficit/hyperactivity disorder-inattentive type, but all other relations were similar for lifetime disorders. Control for other early risk factors did not alter these relations. Most of these relations persisted with control for concurrent cognitive or motor problems.
  
  
  CONCLUSIONS
  In preterm infants, 2 distinct types of perinatal brain injury detectable with neonatal head ultrasound selectively increase risk in adolescence for psychiatric disorders in which dysfunction of subcortical-cortical circuits has been implicated.
authors: Division of Adolescent and Child Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York, NY 10032, USA. whitakea@childpsych.columbia.edu
authors: Agnes H
authors: AH
authors: Whitaker
authors: Judith F
authors: JF
authors: Feldman
authors: John M
authors: JM
authors: Lorenz
authors: Fiona
authors: F
authors: McNicholas
authors: Prudence W
authors: PW
authors: Fisher
authors: Sa
authors: S
authors: Shen
authors: Jennifer
authors: J
authors: Pinto-Martin
authors: David
authors: D
authors: Shaffer
authors: Nigel
authors: N
authors: Paneth
mesh_terms: D000293:Adolescent; D001930:Brain Injuries / Q000150:complications / Q000000981:diagnostic imaging*; D004453:Echoencephalography; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000523:psychology*; D008297:Male; D001523:Mental Disorders / Q000209:etiology*; D011446:Prospective Studies; D000297:Psychology, Adolescent; D012307:Risk Factors