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Perinatal Risk and Psychiatric Outcome in Adolescents Born Preterm With Very Low Birth Weight or Term Small for Gestational Age

Indredavik, Marit S. Dr med*†; Vik, Torstein Dr med; Evensen, Kari Anne I. Cand san‡§; Skranes, Jon Dr med‡∥; Taraldsen, Gunnar PhD; Brubakk, Ann-Mari Dr med‡∥

Journal of Developmental & Behavioral Pediatrics: May 2010 - Volume 31 - Issue 4 - p 286-294
doi: 10.1097/DBP.0b013e3181d7b1d3
Original Article

Objective: To study perinatal risk factors for psychiatric symptoms in adolescents born preterm with very low birth weight or at term, but small for gestational age (GA).

Method: Mental health was assessed in 65 adolescents born with very low birth weight (VLBW) (birth weight ≤1500 g), 59 born term small for GA (birth weight <10th centile) and 81 control adolescents using Schedule for Affective Disorders and Schizophrenia for School-Age Children, Children's Global Assessment Scale, Autism Spectrum Screening Questionnaire, Attention-Deficit Hyperactivity Disorder-Rating Scale IV and Achenbach System of Empirically Based Assessment. Perinatal data included birth weight, GA, head circumference, Apgar scores, intraventricular hemorrhage, days in neonatal intensive care unit, and days on mechanical ventilation.

Results: In the very low birth weight group, lower birth weight was associated with inattention (p < .01), psychiatric diagnoses, and reduced psychosocial function (p ≤ .05). Intraventricular hemorrhage increased the risk for a high inattention score (odds ratio = 7.5; 95% confidence intervals: 1.2–46.8). Lower Apgar score at 1 min was associated with a high Autism Spectrum Screening Questionnaire score and lower Apgar score at 5 min with a high internalizing score (p ≤ .05). In the subgroup born appropriate for GA, internalizing symptoms were also associated with lower GA. In the term small for GA group, perinatal events were not associated with psychiatric problems. In contrast, low socioeconomic status was associated with externalizing symptoms.

Conclusion: Lower birth weight, shorter gestation, and intraventricular hemorrhage were risk factors for psychiatric problems in the very low birth weight group. Lower Apgar score increased the risk for autism spectrum symptoms and internalizing symptoms. Among adolescents born term small for GA, the main risk factor for psychiatric symptoms was low socioeconomic status.

From the *Department of Neuroscience, Norwegian University of Science and Technology; †Department of Child and Adolescent Psychiatry, St. Olav's University Hospital; ‡Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology; §Department of Physical Medicine and Rehabilitation; ∥Department of Pediatrics, St. Olav's University Hospital; and ¶SINTEF Information and Communication Technology, Trondheim, Norway.

Received September 14, 2009; accepted February 4, 2010.

The investigation was funded by Regional Centre for Child and Adolescent Mental Health, Norwegian University of Science and Technology, and Research Funds at St. Olav's University Hospital.

Part of the study population was recruited from a multicenter study sponsored by the US National Institute of Child Health and Human Development, NIH (NICHD contract No. 1-HD-4-2803 and No. 1-HD-1-3127).

The authors report no conflicts of interest.

Address for reprints: Marit S. Indredavik, Dr med, RBUP, Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, NO-7489 Trondheim, Norway; e-mail: marit.s.indredavik@ntnu.no.

© 2010 Lippincott Williams & Wilkins, Inc.