Nandakumar Madura, Lewis Gemma, Lewis Glyn, Solmi Francesca, Srinivasan Ramya
Division of Psychiatry, University College London, London, UK.
Division of Psychiatry, University College London, London, UK
BMJ Paediatr Open. 2025 Jan 28;9(1):e003092. doi: 10.1136/bmjpo-2024-003092.
To investigate the associations between neonatal unit admission (NNU) and subsequent emotional and behavioural difficulties during childhood and adolescence.
Longitudinal general population cohort study.
The Millennium Cohort Study: nationally representative UK-based cohort.
All children with exposure, outcome and confounding data.
NNU admission was identified at 9 months by asking parents whether their baby was 'taken to special care or neonatal or intensive care unit after birth'.
Emotional and behavioural problems were assessed using the Strengths and Difficulties Questionnaire when children were 3, 5, 7, 11, 14 and 17 years. We explored the association between NNU admission and trajectories of emotional and behavioural problems using multilevel models with growth curves for outcome data between 3-17 years and adjusted for a broad range of confounders.
14 013 participants (48.9% female, 13.7% ethnic minority) were included in the analytical sample. In the sample, mean gestational age was 275.81 (SD): 13.80) days, and mean birth weight was 3.36 kg (SD=0.58). 1273 (9.1%) participants had an NNU admission. The latter was associated with increased emotional difficulties (mean difference (MD) 0.13, 95% CI 0.045 to 0.22, p=0.003) and peer problems (MD 0.11, 95% CI 0.026 to 0.19, p=0.010) during childhood in fully adjusted models. There was no evidence that NNU admission was associated with conduct problems (MD 0.013, 95% CI -0.062 to 0.088, p=0.732) or hyperactivity symptoms (MD 0.042, 95% CI -0.070 to 0.15, p=0.452).
Children admitted to NNUs at birth are more likely to experience emotional difficulties and peer problems during childhood. These differences are apparent from early childhood continuing into adolescence and strengthen the case for a calm NNU environment with parental visits and mental health support, and early interventions for children admitted to NNUs.
探讨新生儿病房住院（NNU）与儿童及青少年期后续情绪和行为问题之间的关联。
纵向总体人群队列研究。
千禧队列研究：基于英国的具有全国代表性的队列。
所有具备暴露、结局和混杂数据的儿童。
在9个月时，通过询问父母其婴儿“出生后是否被送往特殊护理、新生儿或重症监护病房”来确定NNU住院情况。
当儿童3岁、5岁、7岁、11岁、14岁和17岁时，使用长处与困难问卷评估情绪和行为问题。我们使用多水平模型及3至17岁结局数据的生长曲线，探索NNU住院与情绪和行为问题轨迹之间的关联，并对一系列混杂因素进行了调整。
分析样本纳入了14013名参与者（48.9%为女性，13.7%为少数族裔）。样本中，平均胎龄为275.81（标准差：13.80）天，平均出生体重为3.36千克（标准差=0.58）。1273名（9.1%）参与者有过NNU住院经历。在完全调整模型中，后者与儿童期情绪困难增加（平均差（MD）0.13，95%置信区间0.045至0.22，p=0.003）和同伴问题（MD 0.11，95%置信区间0.026至0.19，p=0.010）相关。没有证据表明NNU住院与品行问题（MD 0.013，95%置信区间-0.062至0.088，p=0.732）或多动症状（MD 0.042，95%置信区间-0.070至0.15，p=0.452）有关。
出生时入住NNU的儿童在童年期更有可能出现情绪困难和同伴问题。这些差异从幼儿期一直持续到青春期，这进一步证明了需要为NNU营造一个安静的环境，允许父母探视并提供心理健康支持，以及对入住NNU的儿童进行早期干预。
