Psychiatric outcomes at age seven for very preterm children: rates and predictors.
BACKGROUND
Uncertainty remains about the rate of specific psychiatric disorders and associated predictive factors for very preterm (VPT) children. The aims of this study were to document rates of psychiatric disorders in VPT children aged 7 years compared with term born children, and to examine potential predictive factors for psychiatric diagnoses in VPT children.


METHODS
Participants were 177 VPT and 65 term born children. Perinatal medical data were collected, which included brain abnormalities detected using magnetic resonance imaging. The Infant-Toddler Social-Emotional Assessment (ITSEA) and Strengths and Difficulties Questionnaire (SDQ) were administered at 2 and 5 years respectively. At 7 years of age, the Developmental and Well-being Assessment (DAWBA) was used to indicate psychiatric diagnoses.


RESULTS
Compared with term born children, VPT children had three times the odds of meeting criteria for any psychiatric diagnosis at age 7 years (odds ratio 3.03; 95% confidence interval 1.23, 7.47, p = .02). The most common diagnoses were anxiety disorders (11% VPT, 8% term), attention-deficit/hyperactivity disorder (10% VPT, 3% term) and autism spectrum disorder (4.5% VPT, 0% term). For VPT children, those with severe global brain abnormalities (p = .02), those who displayed social-emotional problems at age 5 (p = .000) and those with higher social risk at age 7 (p = .001) were more likely to meet criteria for a psychiatric illness at age 7.


CONCLUSIONS
Compared with term born children, VPT children have higher rates of psychiatric diagnoses at early school age, predicted by neonatal brain abnormalities, prior social-emotional problems and social factors.
Murdoch Childrens Research Institute, The Royal Children’s Hospital, Flemington Road, Parkville, VIC 3052, Australia. karli.treyvaud@mcri.edu.au
Karli
K
Treyvaud
Alexandra
A
Ure
Lex W
LW
Doyle
Katherine J
KJ
Lee
Cynthia E
CE
Rogers
Hiroyuki
H
Kidokoro
Terrie E
TE
Inder
Peter J
PJ
Anderson
D001921:Brain / Q000002:abnormalities / Q000473:pathology; D001925:Brain Damage, Chronic / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D002658:Developmental Disabilities / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000453:epidemiology* / Q000523:psychology*; D019102:Infant, Very Low Birth Weight / Q000523:psychology*; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D009099:Multiple Birth Offspring / Q000523:psychology / Q000706:statistics & numerical data; D016017:Odds Ratio; D012307:Risk Factors; D012959:Socioeconomic Factors; D014739:Victoria