title: Higher rates of behavioural and emotional problems at preschool age in children born moderately preterm.
abstract: OBJECTIVE
  To compare preschool children born moderately preterm (MP; 32-35 weeks' gestation) and children born at term (38-41 weeks' gestation) regarding the occurrence of behavioural and emotional problems, overall, for separate types of problems and by gender.
  
  
  METHODS
  Prospective cohort study consisting of a community-based sample of MP and a random sample of term-born children in 13 Preventive Child Healthcare centres throughout the Netherlands.
  
  
  METHODS
  995 MP and 577 term-born children just under age 4 were included.
  
  
  METHODS
  Behavioural and emotional problems were measured using the Child Behavior Checklist 1.5-5 years. Seven syndrome scales, internalising, externalising and total problems were determined. Higher scores indicate worse outcomes.
  
  
  RESULTS
  MP children had higher scores on all syndrome scales, internalising, externalising and total problems than term-born controls. The mean difference on total problems was 4.04 (95% CI 2.08 to 6.00). Prevalence rates of elevated externalising problem scores were highest in boys (10.5%) and internalising problems were highest in girls (9.9%). MP children were at greater risk for somatic complaints (OR 1.92, 95% CI 1.09 to 3.38), internalising (OR 2.40, 95% CI 1.48 to 3.87), externalising (OR 1.69, 95% CI 1.07 to 2.67) and total problems (OR 1.84, 95% CI 1.12 to 3.00).
  
  
  CONCLUSIONS
  Moderate preterm birth affects all domains of behavioural and emotional problems, particularly for girls. MP children should be targeted for the prevention of mental health problems as they have a great impact on developmental and social competencies at school and in the community.
authors.affiliation: Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, PO Box 196, 9700 AD Groningen, The Netherlands. m.r.potijk01@umcg.nl
authors.forename: Marieke R
authors.initials: MR
authors.lastname: Potijk
authors.forename: Andrea F
authors.initials: AF
authors.lastname: de Winter
authors.forename: Arend F
authors.initials: AF
authors.lastname: Bos
authors.forename: Jorien M
authors.initials: JM
authors.lastname: Kerstjens
authors.forename: Sijmen A
authors.initials: SA
authors.lastname: Reijneveld
mesh_terms: D000342:Affective Symptoms / Q000453:epidemiology / Q000209:etiology*; D002653:Child Behavior Disorders / Q000453:epidemiology / Q000209:etiology*; D002675:Child, Preschool; D005191:Family Characteristics; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000523:psychology*; D007389:Internal-External Control; D008137:Longitudinal Studies; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D011594:Psychometrics; D017678:Sex Distribution