title: Gestational Age at Birth and 'Body-Mind' Health at 5 Years of Age: A Population Based Cohort Study.
abstract: Numerous studies have identified the effects of prematurity on the neonate's physical health, however few studies have explored the effects of prematurity on both the physical and mental health of the child as they develop. Secondary analysis of data from the Millennium Cohort Study, a longitudinal study of infants (n = 18 818, born 2000-2002 in the United Kingdom) was performed. Effects of gestational age at birth on health outcomes at 5 years were measured using parental rating of their children's general health and severity of behavior problems. The association between parent's general health ratings and behavior problem ratings was low: 86% of those reporting serious behavior problems (5% of the sample, n = 764) rated their child as being in excellent, very good, or good health. Still, a gradient of increasing risk of poorer outcome with decreasing gestational age was observed for a composite health measure (poor/fair health and/or serious behavior problems), suggesting an association with prematurity for this composite assessment of health status. The greatest contribution to the childhood composite health measure at 5 years was for children born at 32-36 weeks gestation: population attributable fractions for having poor outcomes was 3.4% (Bonferroni-adjusted 95% confidence interval 1.1%-6.2%), compared to 1% (0.2-2.3) for birth at less than 32 weeks. Results suggest that preterm children, by school entry, are not only at high risk of physical health problems, but also of behavioral health problems. The recognition of, and response to comprehensive health and well-being outcomes related to prematurity are important in order to correctly plan and deliver adequate paediatric health services and policies.
authors.affiliation: School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.
authors.forename: Frances M
authors.initials: FM
authors.lastname: Cronin
authors.affiliation: UCD CSTAR, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Segurado
authors.affiliation: UCD Obstetrics and Gynaecology, School of Medicine and Medical Science, University College Dublin, National Maternity Hospital, Dublin, Ireland.
authors.forename: Fionnuala M
authors.initials: FM
authors.lastname: McAuliffe
authors.affiliation: School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.
authors.forename: Cecily C
authors.initials: CC
authors.lastname: Kelleher
authors.affiliation: School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.|Departments of Pediatrics and Psychology, University of Montreal, Montreal, Canada.
authors.forename: Richard E
authors.initials: RE
authors.lastname: Tremblay
mesh_terms: D002657:Child Development; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008603:Mental Health