title: Antenatal and early postnatal antecedents of parent-reported attention problems at 2 years of age.
abstract: OBJECTIVE
  To assess antenatal and early postnatal antecedents of attention problems identified by the Child Behavior Checklist in extremely preterm children.
  
  
  METHODS
  In a cohort of 826 children born between 23 and 27 weeks' gestation, we collected demographic, birth, and postnatal information. We then identified behavior problems by using parent ratings from the Child Behavior Checklist at 2 years' adjusted age. We created time-oriented logistic regression risk models to identify significant risk factors for attention problems and Diagnostic and Statistical Manual of Mental Disorders-compatible attention deficit/hyperactivity problems (ADHP(DSM)).
  
  
  RESULTS
  Children were at increased risk of both attention problems if they were born to a woman who had no formal education beyond high school and/or a woman who was exposed to secondhand smoke. Recovery of a single organism from the placenta was associated with increased risk of an attention problem, and fetal stem vessel thrombosis and recovery of Mycoplasma species were associated with increased risk of ADHP(DSM). Infants of multifetal gestations were at reduced risk of both attention problems. The only postnatal risk factor for an attention problem was recovery of bacteria from a tracheal aspirate.
  
  
  CONCLUSIONS
  Among extremely preterm infants, several potentially modifiable antenatal and perinatal antecedents are associated with increased risk for attention problems and ADHP(DSM) at 2 years adjusted age.
authors.affiliation: Division of Neonatology, Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC.
authors.forename: L Corbin
authors.initials: LC
authors.lastname: Downey
authors.affiliation: Division of Neonatology, Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC.
authors.forename: T Michael
authors.initials: TM
authors.lastname: O'Shea
authors.affiliation: Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA.
authors.forename: Elizabeth N
authors.initials: EN
authors.lastname: Allred
authors.affiliation: Division of Pediatric Neurology, Department of Pediatrics, Boston University, Boston, MA.
authors.forename: Karl
authors.initials: K
authors.lastname: Kuban
authors.affiliation: Division of Maternal-Fetal Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, MA.
authors.forename: Thomas F
authors.initials: TF
authors.lastname: McElrath
authors.affiliation: Division of Neonatology, Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC.
authors.forename: Diane D
authors.initials: DD
authors.lastname: Warner
authors.affiliation: Division of Developmental Medicine, Boston Children's Hospital and Harvard Medical School, Boston, MA.
authors.forename: Janice
authors.initials: J
authors.lastname: Ware
authors.affiliation: Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
authors.forename: Jonathan L
authors.initials: JL
authors.lastname: Hecht
authors.affiliation: Department of Pathology, Brigham & Women's Hospital, Harvard Medical School, Boston, MA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Onderdonk
authors.affiliation: Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA.
authors.forename: Alan
authors.initials: A
authors.lastname: Leviton
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis*; D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis*; D002675:Child, Preschool; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D007223:Infant; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases; D016015:Logistic Models; D008297:Male; D010290:Parents; D011181:Postnatal Care; D011247:Pregnancy; D011296:Prenatal Diagnosis; D012307:Risk Factors