Psychopathology in young adults born at extremely low birth weight

• Published in: Psychological medicine Vol. 41; no. 8; pp. 1763 - 1774
• Main Authors: Boyle, M. H., Miskovic, V., Van Lieshout, R., Duncan, L., Schmidt, L. A., Hoult, L., Paneth, N., Saigal, S.
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.08.2011
• Subjects: Adolescent; Adult; Antisocial personality disorder; Anxiety-Depression; Attention deficit hyperactivity disorder; Biological and medical sciences; Birth weight; Case-Control Studies; Chi-Square Distribution; Diseases of mother, fetus and pregnancy; Externalizing problems; Family - psychology; Female; Gestational age; Gynecology. Andrology. Obstetrics; Humans; Infant, Extremely Low Birth Weight - psychology; Infant, Newborn; Internalization; Internalizing problems; Linear Models; Logistic Models; Low birth weight; Male; Medical sciences; Mental depression; Mental Disorders - etiology; Mental Disorders - psychology; Mental health; Personality problems; Pregnancy. Fetus. Placenta; Psychiatric Status Rating Scales; Psychological Tests; Psychology. Psychoanalysis. Psychiatry; Psychopathology; Psychopathology. Psychiatry; Research subjects; Self report; Sex Factors; Social background; Socioeconomic Factors; Survivor; Survivors; Young Adult; Young adults; Canada, Ontario; psychopathology; Extremely low birth weight; longitudinal studies; Human; Newborn diseases; Pregnancy disorders; Prematurity; Follow up study; Young adult; Low birth weight; Psychopathology
• ISSN: 0033-2917; 1469-8978; 1469-8978
• DOI: 10.1017/S0033291710002357

Little is known about the long-term mental health of extremely low birth weight (ELBW) (<1000 g) survivors. We test whether young adults aged 22 to 26 years born at ELBW differ from normal birth weight (NBW) controls in self-reported levels of psychopathology. Participants included 142 ELBW survivors (86% response) born between 1977 and 1982 to residents of central-west Ontario, Canada and 133 NBW control subjects (92% response). The Young Adult Self-Report measure was used to create five DSM-IV oriented scales aggregated to form internalizing (depressive problems, anxiety problems, avoidant personality problems) and externalizing (attention deficit-hyperactivity disorder problems and antisocial personality problems) scales. After adjusting for family background characteristics, mean scores for ELBW survivors were 3.02 [95% confidence interval (CI) 0.78-5.26] points higher for internalizing problems and no different, i.e. 0.00 (95% CI -1.17 to 1.17), for externalizing problems. There was a sex × group statistical interaction such that being male muted the risk for externalizing problems among those born at ELBW: -2.11 (95% CI -4.21 to -0.01). Stratifying ELBW adults as born small for gestational age (SGA) versus appropriate weight for gestational age (AGA) revealed a significant gradient of risk for levels of internalizing problems that was largest for SGA, i.e. 4.75 (95% CI 1.24-8.26), and next largest for AGA, 2.49 (95% CI 0.11-4.87), compared with NBW controls. Depression, anxiety and avoidant personality problems (internalizing problems) are elevated in young adulthood among ELBW survivors. This effect is relatively small overall but noticeably larger among ELBW survivors born SGA.