Past research has shown that preterm children have an increased risk
of attention problems, hyperactivity, anxiety or depression and
social problems, the authors write in Pediatrics.
“We found that preterm children have higher rates of persistent and
changing emotional and behavioral problems at school entry – between
ages 4 and 5 – than do full-term children, and that their problems
are more persistent,” said lead author Jorijn Hornman of the
University of Groningen in The Netherlands. “The latter is really
new, we did not have evidence on this.”
The researchers used data from a long-term Dutch study of children
born in 2002 and 2003. A full-term pregnancy lasts 39 to 41 weeks,
and the analysis included 401 kids born very early, between 25 and
31 weeks of pregnancy, as well as 653 kids born moderately preterm,
between 32 and 35 weeks, and 389 kids born at full term.
At ages 4 and 5 years, the children were assessed for emotional and
Overall, more than 7 percent of preterm children had emotional or
behavioral problems at both time points, compared with less than 4
percent of full-term children. There was a similar difference
between groups for problems that appeared at age 4 and had resolved
by age 5.
Early pre-term children had the highest rates of persistent
emotional and behavioral problems, at just over 8 percent.
“Persistence of a problem usually indicates a chronic problem and
these have been shown in other research to have higher persistence
into adolescence,” said Dieter Wolke, professor of Developmental
Psychology and Individual Differences at Warwick Medical School
U.K., who was not part of the new study.
Issues that were not present at age 4 but emerged at age 5 were less
common, affecting 4 percent of preterm kids and 2 percent of
The earlier a child was born, the more likely they were to have
emotional or behavioral problems.
“The brain develops very fast in the last weeks of pregnancy,
especially the reorganization and differentiation of newly formed
neural networks,” Hornman told Reuters Health by email. “Preterm
delivery may disrupt this,” and could increase the risk of long-term
emotional and behavioral problems.
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These problems could have a large impact on school performance and
interaction with other children, she said.
“We do not yet have evidence on persistence into adulthood,” Hornman
Early detection, parenting support and timely referral to
specialized care helps give preterm children the best start at
school, she said.
“These findings may help to determine before school entry which
preterm children are likely to have increased risks of emotional and
behavioral problems when attending school,” Hornman said. “The good
news is that 90 percent of the moderately preterm children and 80
percent of the early preterm children are consistently without
emotional and behavioral problems between age 4 and 5.”
“Parents of very preterm kids should be aware that there may be an
increased risk (despite most developing within normal limits) and
indicate to teachers and mental health professionals that their
child was born very preterm to assist them with the right
interventions,” Wolke said.
SOURCE: http://bit.ly/1MKUihk Pediatrics, online April 21, 2016.
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