As part of a longitudinal study of the outcomes of very low birth weight children (<1.5 kg), we sought to examine the perinatal, childhood, and young adult predictors of internalizing symptoms among very low birth weight young women and their normal birth weight controls. The cohort included 125 very low birth weight and 124 normal birth weight 20-year-old subjects. Perinatal, childhood, and young adult predictors were examined via stepwise multivariate analyses. Results revealed very low birth weight to be a significant predictor of parent-reported internalizing symptoms of their daughters but only among white subjects who had mothers with high levels of psychological distress. Additional significant predictors of 20-year internalizing symptoms included child I.Q. and internalizing symptoms at age 8 years and family expressiveness. When the results were analyzed according to the young adult self-report, additional predictors of internalizing symptoms included a history of asthma and exposure to violence. Perinatal risk factors were not found to be predictive of internalizing symptoms at age 20 years. Future studies should prospectively examine social and environmental factors associated with the neonatal intensive care experience that might explain the effect of very low birth weight on later psychopathology.
1Department of Pediatrics, Case Western Reserve University, Cleveland
2Department of Justice Studies, Kent State University, Kent, Ohio
3Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio
Received April 2004; accepted November 2004.
Address for reprints: Maureen Hack, M.B., Ch.B., Rainbow Babies and Children's Hospital of University Hospitals of Cleveland, 11100 Euclid Avenue, Cleveland, OH 44106; e-mail: email@example.com.