Significant advances in the neonatal intensive care have resulted in increased survival rates of children who are born at less than 26 weeks of gestation, so termed "extremely preterm children". Notably, however, improved survival rates have been accompanied by a higher risk for later cognitive, neuromotor, and sensory impairments in these children.
An 11-year follow-up study of 219 extremely preterm children by Johnson and colleagues sought to determine the prevalence and risk factors for psychiatric disorders in this population. The researchers discovered that almost one quarter of extremely preterm children had a psychiatric disorder at 11 years of age. The most frequent psychiatric conditions were Attention-Deficit/Hyperactivity Disorder (12%), emotional disorders (9%), and Autism Spectrum Disorders (8%). The investigation also reports a threefold overall greater risk of subsequent mental health problems in those children born prematurely. The findings of the British researchers are reported in May 2010 issue of the Journal of the American Academy of Child and Adolescent Psychiatry.
This is the first study to systematically investigate the prevalence of psychiatric disorders in a contemporary population of extremely preterm survivors. The data were collected as part of the EPICure Study which followed up extremely preterm children born in the United Kingdom and Ireland at 1 year, 2.5 years, 6-8 years, and 10-11 years. The EPICure study, established in 1995, was intended to determine the chances of survival and subsequent health of survivors.
In the journal article titled "Psychiatric Disorders in Extremely Preterm Children: Longitudinal Finding at Age 11 Years in the EPICure Study," Dr. Johnson and colleagues state, "Clinically, the findings suggest that much greater emphasis should be placed on early cognitive and psychological monitoring of extremely preterm children for emerging neuropsychiatric and emotional disorders. Routine cognitive and behavioral screening throughout the preschool period may help to facilitate early psychiatric referral and therefore be beneficial for extremely preterm children and their families."
An accompanying editorial by Dr. Joan J. Luby of the Washington University School of Medicine in St. Louis can be found in the same issue of the Journal of the American Academy of Child and Adolescent Psychiatry. Commenting on the findings Dr. Joan L. Luby states, "New findings from the EPICure study, the largest and longest investigation of psychiatric outcomes in premature infants conducted to date, demonstrate marked increased behavioral risks in this population, thereby shedding some of the brightest and most elucidating light on this area yet available."
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More information: Luby JL. The Neonatal Intensive Care Unit: Attending to Mental Health Outcomes. Journal of the American Academy of Child and Adolescent Psychiatry. 2010;49:439-440.