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 Researchers examined data from previously published studies of
mental health in 747 adults who were underweight preemies and 1,512
who were full-term infants in five different countries. They found
that former preemies reported more avoidant behaviors and more
so-called "internalizing" issues like depression, anxiety,
withdrawal and loneliness than adults who were full term infants.
Those who were among the smallest of the preemies reported fewer
so-called "externalizing" issues like physical aggression,
disobeying rules, cheating, stealing, and property destruction than
the adults who were born full term.
"We have been able to show that adults born preterm at very low
birth weight reported more internalizing and socially avoidant
personality problems, and less externalizing problems than their
peers born full term," said lead study author Riikka Pyhala of the
University of Helsinki in Finland.
"This means that they are more withdrawn and experience more
emotional problems which often manifest as depressive or anxiety
problems, and they (are also less likely to express) socially
unacceptable behavior such as rule-breaking and intrusive behavior,"
Pyhala added by email.
Pregnancy normally lasts about 40 weeks, and babies born after 37
weeks are considered full term. In the weeks immediately after
birth, premature babies often have difficulty breathing and
digesting food. They can also encounter longer-term challenges such
as impaired vision, hearing, and cognitive skills as well as social
and behavioral problems.
Most full term babies weigh around 6 to 9 pounds - 2,700 to 4,000
grams. The study looked at babies considered very low birth weight -
no more than about 1,500 grams or 3.3 pounds - or extremely low
birth weight - no more than about 2.2 pounds or 1,000 grams.
For the study, researchers examined data on mental health issues
reported when the preemies and full term babies were about 23 years
old on average.
The full term babies weighted about 7.7 pounds (3,500 grams) on
average, while the preemies in the study typically weighed around
2.5 pounds (1,120 grams).
While the study didn't examine why preemies might grow up to be more
prone to certain psychiatric problems as adults, it's possible that
this might be explained by neurobiological, hormonal or social and
psychological processes that are impacted by an early birth, the
authors conclude.
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One limitation of the study is that researchers relied on data that
adults reported about their own feelings and symptoms, which isn't
always as reliable as medical records or details verified by a
doctor's diagnosis, the authors note in Pediatrics. Researchers also
lacked data on childhood or adolescent mental health.
Most of the results in the current also appear tied to just one of
the studies in the analysis, noted Dr. Margaret Kern, a psychology
researcher at the University of Melbourne in Australia who wasn't
involved in the study.
"While they claim their findings point to a universal effect,
evidence for this is weak at best," Kern said by email.
It's also possible that parents of the preemies in the study were
extra protective of their children and helped buffer them from some
of the potential mental health effects of an early arrival, Kern
said.
"Early development and risk for mental health illnesses are a
combination of both nature and nurture," Kern added.
Very preterm birth can disrupt normal development of the brain and
other physiological systems that support emotional and behavioral
regulation, however, and in that respect the study findings make
sense, said Dr. Bob Joseph, a neurobiology researcher at Boston
University School of Medicine.
"As the authors note, one of the main lines of current research is
to understand how damaging neural inflammation in the very preterm
neonate operates and can be controlled and tempered immediately
after birth," Joseph, who wasn't involved in the study, said by
email.
SOURCE: http://bit.ly/2lLSlsN Pediatrics, online March 10, 2017.
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