A comparison of prematurity and small for gestational age as risk factors for age 6–13year emotional problems
Early Human Development
This is the author accepted manuscript. The final version is available from Elsevier via the DOI in this record.
Background Although both very preterm (VP) and small for gestational age (SGA) births are suggested to increase the likelihood of childhood emotional problems, there has been a lack of research comparing these effects. Aims To investigate levels of emotional problems between 6–13 years of age and contrast the impact of being born either very premature (irrespective of birth weight) or small for gestational age. Study design Prospective longitudinal cohort study. Subjects 654 Bavarian children (born 1985–1986) who were followed from birth to age 12/13 years. Outcome measures Emotional problems at ages 6.3 and 8.5 years were measured via the Child Behavior Check List (CBCL). Emotional problems were measured at age 12/13 years via the Strengths and Difficulties Questionnaire (SDQ). Trajectories of emotional problems were derived between 6.3 and 13 years. Results Two distinctive patterns of age 6–13 year emotional problems were found: 1) a low and stable level of problems in 76% of children; 2) a high and stable level of problems in 24% of children. The high and stable pattern of emotional problems was significantly associated with a VP but not an SGA birth. Consistent additional determinants included male child gender and lower family socioeconomic status. Conclusions The disparity between VP and SGA births as a predictor of age 6–13 year old emotional problems is considered in terms of fetal and/or glucocorticoid programming. The stability of emotional problems between 6 and 13 years reinforces the need for early childhood interventions aimed at children born very preterm.
This study was supported by grants PKE24, JUG14, 01EP9504 and 01ER0801 from the German Federal Ministry of Education and Science (BMBF). The contents are solely the responsibility of the authors and do not necessarily represent the official view of BMBF. Information on BMBF is available on http://www.bmbf.de/en/.
Early Human Development, 2012, Vol. 88, Issue 10, pp. 797 - 804