Psychiatric risk increased in very preterm infants

Children born very preterm (VPT) are at increased risk for psychiatric disorders in early childhood, study results suggest.

The researchers found that VPT infants (<32 weeks' gestation) were a significant 3.13 times more likely to have a psychiatric disorder at the age of 7 years than those born at term (>36 weeks' gestation).

"Not only are VPT children at higher risk for psychiatric morbidity compared with term born children, but this study has identified several factors that predict the likelihood that a VPT child will meet criteria for a psychiatric diagnosis at age 7 years," comment Karli Treyvaud (The Royal Children's Hospital, Parkville, Australia) and team.

"Importantly, the risk factors can be identified early in a child's life, increasing the opportunities for monitoring and early intervention," they add.

The findings come from a study of 177 VPT children and 65 children born at term who were followed up until the age of 7 years.

Overall, 24% of VPT children met criteria for a DSM-IV disorder at the age of 7 years compared with just 9% of those born at term. The most common psychiatric conditions among VPT children were anxiety disorders (11%), attention-deficit hyperactivity disorder (10%), and autism spectrum disorder (4.5%).

Factors significantly associated with an increased risk for psychiatric disorders in VPT children included higher familial social risk (eg, poor family structure, low levels of parental education, younger maternal age at birth), brain abnormalities on perinatal scans, and clinically significant levels of social-emotional problems at 5 years of age.

Compared with children born at term, the risk for psychiatric disorders among VPT children remained significant after adjustment for familial social risk (odds ratio [OR]=2.55) and neurodevelopmental disability (OR=2.35).

Treyvaud et al conclude in the Journal of Child Psychology and Psychiatry: "With the growing literature highlighting the increased risk for psychiatric morbidity in VPT children and identifying the specific biological and environmental factors contributing to this risk, effort is needed to provide appropriate monitoring, screening and intervention for VPT children and their families."

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