Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Unit for Pediatrics, 6th floor, Kvinne-barn-senteret, Olav Kyrres gt. 11, 7030, Trondheim, Norway.
Children's Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
BMC Psychiatry. 2019 Jul 17;19(1):223. doi: 10.1186/s12888-019-2202-8.
We aimed to examine psychiatric symptoms in adults born preterm with very low birthweight or born at term small for gestational age compared with normal birthweight peers, and examine associations with perinatal factors and childhood motor and cognitive function.
In this longitudinal cohort study, one preterm born group with very low birthweight (VLBW: birthweight ≤1500 g), one term-born Small for Gestational Age (SGA: birthweight <10th percentile) group and one term-born non-SGA control group, were assessed at 26 years of age. Primary outcomes were scores on self-reported questionnaires: Achenbach System of Empirically Based Assessment - Adult Self-Report, The Autism-Spectrum Quotient and Peters et al. Delusions Inventory. Exposure variables were perinatal data, while childhood motor and cognitive function were examined as possible early markers.
Both the preterm VLBW and the term SGA group reported higher levels of attention, internalizing and externalizing problems compared to the control group. In addition, the VLBW participants reported more critical items and a higher proportion had intermediate level autistic traits, while the SGA participants reported more intrusive behavior. Increasing length of respiratory support and hospital stay in the neonatal period, and motor problems in early adolescence, were associated with adult psychiatric symptoms in the VLBW group.
Psychiatric symptoms were frequent in the preterm VLBW group and also in the term-born SGA group. Those who were sickest as babies were most at risk. Motor problems can possibly serve as an early marker of adult psychiatric symptoms in low birthweight individuals.
本研究旨在比较极低出生体重早产儿、足月小于胎龄儿和正常出生体重儿成年后的精神症状,并探讨围产期因素和儿童期运动及认知功能与这些精神症状的相关性。
本纵向队列研究纳入了极低出生体重(VLBW:出生体重≤1500g)、足月小于胎龄(SGA:出生体重<第 10 百分位)和足月非 SGA 对照组各一组早产儿,于 26 岁时进行评估。主要结局指标为自我报告问卷评分:Achenbach 系统的经验性评估 - 成人自评、自闭症谱系商数和彼得斯等幻觉量表。暴露变量为围产期数据,儿童期运动和认知功能作为潜在的早期标志物进行评估。
VLBW 组和 SGA 组报告的注意力、内化和外化问题水平均高于对照组。此外,VLBW 组报告的批判性问题更多,具有中等自闭症特征的比例更高,而 SGA 组报告的侵入性更强。新生儿期呼吸支持和住院时间延长以及青春期早期运动问题与 VLBW 组的成年精神症状相关。
极低出生体重早产儿和足月小于胎龄儿均存在精神症状,且病情越严重的患儿成年后风险越高。运动问题可能是低出生体重儿成年后出现精神症状的早期标志物。