Do healthy preterm children have behavior problems?
Background/Objective. In this study, the behavior problems of healthy preterm and full-term children will be compared. The effect of environmental and neonatal conditions on the rate of behavior problems, with special attention to maternal depression and parental stress, will also be studied.
Previous studies found significantly higher prevalence rates of total problems in preterm children. Most of these studies were carried out with preterm children under 32 weeks of gestational age. In contrast, some studies carried out with moderately preterm children found no significant difference.
Method. We assessed 108 low risk preterm children and 33 full-term children through the Child Behavior Checklist when they were 5 years-old. Their mothers` stress and depression were also assessed.
Results. No significant difference was found between the preterm and the full-term groups for overall, internalizing or externalizing behavior problems, or for more fine-grained behavior problems such as anxiety, attention or aggression problems. No effect of gestational age on the rate of behavior problems was found. In contrast maternal stress, but not maternal depression, was a strong predictor of behavior problems.
Conclusions. These results indicate that behavior problems are not characteristic of preterm children as a group, but only of very or extremely preterm children.
Abidin, R. R. (1995). Parenting Stress Index. Third Edition. Professional manual. Odessa, FL: Psychological Assessment Resources.
Achembach, T. M., & Rescorla, L. A. (2000). Manual for the ASEBA Preschool Forms & Profiles. Burlington, VT: University of Vermont, Research Center for Children, Youth, & Families.
Arpi, E., & Ferrari, F. (2013). Preterm birth and behaviour problems in infants and preschool-age children: a review of the recent literature. Developmental Medicine and Child Neurology, 55(9), 788-796. doi: 10.1111/dmcn.12142.
Blencowe, H., Cousens, S., Chou, D., Oestergaard, M., Say, L., Moller, A., Kinney, M., Lawn, J., & Born Too Soon Preterm Birth Action Group. (2013). Born Too Soon: The global epidemiology of 15 million preterm births. Reproductive Health, 10 (Suppl 1)(S2), 1-16. doi: 10.1186/1742-4755-10-S1-S2.
Cassiano, R. G. M., Gaspardo, C. M., & Linhares, M. B. M. (2016). Prematurity, neonatal health status, and later child behavioral/emotional problems: A systematic review. Infant Mental Health Journal, 37(3), 274-288. doi: 10.1002/imhj.21563.
Cassiano, R. G. M., Gaspardo, C. M., Faciroli, R. A. D., Martinez, F. E., & Linhares, M. B. M. (2017). Temperament and behavior in toddlers born preterm with related clinical problems. Early Human Development, 112, 1-8. doi: 10.1016/j.earlhumdev.2017.06.003
Cosentino-Rocha, L., Klein, V. C., & Martins-Linhares, M. B. (2014). Effects of preterm birth and gender on temperament and behavior in children. Infant Behavior & Development, 37(3), 446-456. doi: 10.1016/j.infbeh.2014.04.003.
de Jong, M., Verhoeven, M., Lasham, C. A., Meijssen, C. B., & van Baar, A. L. (2015). Behaviour and development in 24-month-old moderately preterm toddlers. Archives of Disease in Childhood, 100(6), 548-553. doi: 10.1136/archdischild-2014-307016.
de Laat, S. A. A., Essink-Bot, M.-L., van Wassenaer-Leemhuis, A. G., & Vrijkotte, T. G. (2016). Effect of socioeconomic status on psychosocial problems in 5-to 6-year-old preterm- and term-born children: the ABCD study. European Child & Adolescent Psychiatry, 25(7), 757-767. doi: 10.1007/s00787-015-0791-4.
Delobel-Ayoub, M., Arnaud, C., White-Koning, M., Casper, C., Pierrat, V., Garel, M., Burguet A., Roze J., Matis J., Picaud J., Kaminski M., & Larroque B. (2009). Behavioral problems and cognitive performance at 5 years of age after very preterm birth: the EPIPAGE Study. Pediatrics, 123(6), 1485-1492. doi: 10.1542/peds.2008-1216.
Díaz-Herrero, Á., López-Pina, J A., Pérez-López, J., Brito, A., & Martínez-Fuentes, M. T. (2011). Validity of the Parenting Stress Index-Short Form in a Sample of Spanish Fathers. The Spanish Journal of Psychology, 14(02), 990-997. doi: 10.5209/rev_SJOP.2011.v14.n2.44.
Gerstein, E. D., Woodman, A. C., Burnson, C., Cheng, E. R., & Poehlmann-Tynan, J. (2017). Trajectories of Externalizing and Internalizing Behaviors in Preterm Children Admitted to a Neonatal Intensive Care Unit. Journal of Pediatrics, 187, 111-118. doi: 10.1016/j.jpeds.2017.04.047
Goldenberg, R. L., Culhane, J. F., Iams, J. D., & Romero, R. (2008). Preterm birth 1 - Epidemiology and causes of preterm birth. Lancet, 371(9606), 75-84. doi: 10.1016/s0140-6736(08)60074-4.
Gray, P. H., Edwards, D. M., O'Callaghan, M. J., & Cuskelly, M. (2012). Parenting stress in mothers of preterm infants during early infancy. Early Human Development, 88(1), 45-49. doi: 10.1016/j.earlhumdev.2011.06.014.
Gray, P. H., Edwards, D. M., O'Callaghan, M. J., Cuskelly, M., & Gibbons, K. (2013). Parenting stress in mothers of very preterm infants - Influence of development, temperament and maternal depression. Early Human Development, 89(9), 625-629. doi: 10.1016/j.earlhumdev.2013.04.005.
Gray, R. F., Indurkhya, A., & McCormick, M. C. (2004). Prevalence, stability, and predictors of clinically significant behavior problems in low birth weight children at 3, 5, and 8 years of age. Pediatrics, 114(3), 736-743. doi: 10.1542/peds.2003-1150-L.
Gurka, M. J., LoCasale-Crouch, J., & Blackman, J. A. (2010). Long-term cognition, achievement, socioemotional, and behavioral development of healthy late-preterm infants. Archives of Pediatrics and Adolescent Medicine, 164(6), 525-532. doi: 10.1001/archpediatrics.2010.83.
Hille, E. T. M., den Ouden, A. L., Saigal, S., Wolke, D., Lambert, M., Whitaker, A., Pinto-Martin, J. A., Hoult, L., Meyer, R., Feldman, J. F., Verloove-Vanhorick, S. P., & Paneth, N. (2001). Behavioural problems in children who weigh 1000 g or less at birth in four countries. Lancet, 357(9269), 1641-1643. doi: 10.1016/s0140-6736(00)04818-2.
Hornman, J., de Winter, A. F., Kerstjens, J. M., Bos, A. F., & Reijneveld, S. A. (2016). Emotional and Behavioral Problems of Preterm and Full-Term Children at School Entry. Pediatrics, 137(5). doi: 10.1542/peds.2015-2255
Ketharanathan, N., Lee, W., & de Mol, A. C. (2011). Health-related quality of life, emotional and behavioral problems in mild to moderate prematures at (pre-)school age. Early Human Development, 87, 705-709. doi: 10.1016/j.earlhumdev.2011.05.011.
Loe, I. M., Lee, E. S., Luna, B., & Feldman, H. M. (2011). Behavior problems of 9 to 16 year-old preterm children: Biological, sociodemographic, and intellectual contributions. Early Human Development, 87(4), 247-252. doi:10.1016/j.earlhumdev.2011.01.023
Mansson, J., Stjernqvist, K., & Backstrom, M. (2014). Behavioral outcomes at corrected age 2.5 years in children born extremely preterm. Journal of Developmental and Behavioral Pediatrics, 35(7), 435-442. doi: 10.1097/dbp.0000000000000082.
Miceli, P. J., Goeke-Morey, M. C., Whitman, T. L., Kolberg, K. S., Miller-Loncar, C., & White, R. D. (2000). Brief report: Birth status, medical complications, and social environment: Individual differences in development of preterm, very low birth weight infants. Journal of Pediatric Psychology, 25(5), 353-358. doi: 10.1093/jpepsy/25.5.353
Miller, M., Bowen, J. R., Gibson, F. L., Hand, P. J., & Ungerer, J. A. (2001). Behaviour problems in extremely low birthweight children at 5 and 8 years of age. Child: Care, Health and Development, 27(6), 569-581.
Monte Cassiano, R. G., Gaspardo, C. M., Bucker Furini, G. C., Martinez, F. E., & Martins Linhares, M. B. (2016). Impact of neonatal risk and temperament on behavioral problems in toddlers born preterm. Early Human Development, 103, 175-181. doi: 10.1016/j.earlhumdev.2016.09.015.
Polic, B., Bubic, A., Mestrovic, J., Markic, J., Kovacevic, T., Furlan, I. A., et al. (2017). Emotional and behavioral outcomes and quality of life in school-age children born as late preterm: retrospective cohort study. Croatian Medical Journal, 58(5), 332-341. doi: 10.3325/cmj.2017.58.332
Potijk, M. R., de Winter, A. F., Bos, A. F., Kerstjens, J. M., & Reijneveld, S. A. (2015). Behavioural and emotional problems in moderately preterm children with low socioeconomic status: a population-based study. European Child & Adolescent Psychiatry, 24(7), 787-795. doi: 10.1007/s00787-014-0623-y.
Radloff L.S. (1977). The CES-D Scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1(3), 385-401.
Reijneveld, S. A., de Kleine, M. J. K., van Baar, A. L., Kollee, L. A. A., Verhaak, C. M., Verhulst, F. C., & Verloove-Vanhorick, S. P. (2006). Behavioural and emotional problems in very preterm and very low birthweight infants at age 5 years. Archives of Disease in Childhood-Fetal and Neonatal Edition, 91(6), F423-F428. doi: 10.1136/adc.2006.093674
Rose, S. A., Feldman, J., Susan L. Rose, Wallace, I. F., & McCarton, C. (1992). Behavior problems at 3 and 6 years: Prevalence and continuity in full-terms and preterms. Development and Psychopathology, 4, 361-374.
Samara, M., Marlow, N., Wolke, D., & Grp, (2008). Pervasive behavior problems at 6 years of age in a total-population sample of children born at <= 25 weeks of gestation. Pediatrics, 122(3), 562-573. doi: 10.1542/peds.2007-3231
Shah, P. E., Robbins, N., Coelho, R. B., & Poehlmann, J. (2013). The paradox of prematurity: The behavioral vulnerability of late preterm infants and the cognitive susceptibility of very preterm infants at 36 months post-term. Infant Behavior & Development, 36(1), 50-62. doi: 10.1016/j.infbeh.2012.11.003
Solis, M. L., & Abidin, R. R. (1991). The Spanish version Parenting Stress Index: A psychometric study. Journal of Clinical and Child Psychology, 20(4), 372-378.
Vederhus, B. J., Eide, G. E., Natvig, G. K., Markestad, T., Graue, M., & Halvorsen, T. (2015). Health-related quality of life and emotional and behavioral difficulties after extreme preterm birth: developmental trajectories. PeerJ 3:e738; DOI 10.7717/peerj.738
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