title: Prognostic Factors for Behavioral Problems and Psychiatric Disorders in Children Born Very Preterm or Very Low Birth Weight: A Systematic Review.
abstract: OBJECTIVE
  Risk factors associated with adverse behavioral outcomes in very preterm (VPT) or very low birth weight (VLBW) infants are poorly understood. The aim of this article is to identify prognostic factors for behavioral problems and psychiatric disorders in children born ≤32 weeks gestational age or with birth weight ≤1250 g.
  
  
  METHODS
  A systematic review was conducted using MEDLINE, Embase, and Pyscinfo databases to identify studies published between January 1, 1990 and June 1, 2014 reporting multivariable prediction models for behavioral problems or psychiatric disorders in VPT/VLBW children. Fifteen studies were identified and 2 independent reviewers extracted key information on study design, outcome definition, risk factor selection, model development, reporting, and conducted a risk of bias assessment.
  
  
  RESULTS
  The 15 studies included reported risk factor analyses for the following domains: general behavioral problems (n = 8), any psychiatric disorder (n = 2), autism spectrum symptoms/disorders (n = 5), and attention deficit/hyperactivity disorder (n = 1). Findings were inconclusive because of the following: small number of studies in each domain, heterogeneity in outcome measures, lack of overlap in the risk factors examined, and differences in strategies for dealing with children with neurological impairments.
  
  
  CONCLUSIONS
  There is a lack of evidence concerning risk factors for behavior problems and psychiatric disorders among VPT/VLBW survivors. This review has identified the need for further research examining the etiology of disorders of psychological development in the VPT/VLBW population to refine risk prediction and identify targets for intervention. Large well-conducted studies that use standard diagnostic evaluations to assess psychiatric disorders throughout childhood and adolescence are required.
authors.affiliation: *National Perinatal Epidemiology Unit (NPEU), Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom; †Department of Health Sciences, University of Leicester, Leicester, United Kingdom; ‡Queen Mary University of London, Centre for Environmental and Preventive Medicine, Barts and The London School of Medicine and Dentistry, London, United Kingdom; §Department of Neonatology, Institute of Women's Health, University College London, London, United Kingdom.
authors.forename: Louise
authors.initials: L
authors.lastname: Linsell
authors.forename: Reem
authors.initials: R
authors.lastname: Malouf
authors.forename: Samantha
authors.initials: S
authors.lastname: Johnson
authors.forename: Joan
authors.initials: J
authors.lastname: Morris
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Kurinczuk
authors.forename: Neil
authors.initials: N
authors.lastname: Marlow
mesh_terms: D006801:Humans; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D000066553:Problem Behavior