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Premature babies may have higher risk of mental health problems

Higher risk runs from childhood into at least 30s, says study

Adrian O'Dowd

Tuesday, 14 February 2017

Babies born with extremely low birth weight appear to be more likely to experience mental health problems later in life as well as being at higher risk of physical problems, suggests a study* appearing today in Psychological Bulletin, the journal published by the American Psychological Association.

Premature births have been increasing over the last two decades and around 60,000 babies are born prematurely in the UK every year but because of improvements in neonatal intensive care, babies born at extremely low birth weight (less than 1,000 grams or just over 2 pounds) have a greater chance of surviving than before.

Canadian researchers led by Dr Karen Mathewson of McMaster University in Hamilton, Ontario, conducted meta-analyses using 41 studies that followed 2,712 individuals who were extremely low birth weight babies and 11,127 who were normal birth weight babies.

The studies took place over a 26-year period (1990-2016) in 12 different countries, including the UK, US and Canada and were from developed countries in Europe, North America, or Australia.

Their analysis showed that extremely low birth weight babies were at increased risk for particular mental health problems, beginning in childhood and extending at least into their 30s.

As children, they were significantly more likely to have attention deficit hyperactivity disorder (ADHD) in almost every study included in the review, while adolescents were also at greater risk for ADHD and social problems.

Adults born with extremely low birth weight reported significantly higher levels of anxiety, depression and shyness, as well as significantly lower levels of social functioning.

These risks did not seem to vary according to where or when extremely low birth weight survivors were born, or whether they had significant neurosensory impairments, such as cerebral palsy or blindness.

Lead author Dr Mathewson said the findings could stem from biological responses of the infant to difficult prenatal conditions and postnatal stresses following early birth.

“The consistency of the findings across geographical regions suggests that these attentional, behavioural and social outcomes may be contributed to by developmentally programmed, biological factors,” she said.

The researchers stressed that even though the risk for mental health problems in extremely low birth weight survivors was higher compared to normal birth weight individuals, many of the former would not develop mental disorders.

Dr Mathewson added: “Our findings provide evidence that individuals born at extremely low birth weight are at higher overall risk for psychological difficulties than their normal birth weight peers. These difficulties most frequently involve attention, anxiety-related and social problems.”

The findings highlighted the need to continue to provide services to these individuals throughout their lives, she added.

“It is important that families and health care providers be aware of the potential for early-emerging mental health problems in extremely low birth weight survivors, and that some of these individuals may not grow out of these problems as they get older.

“As a result, it is essential that appropriate treatment be made available to those who require it as early in life as possible.”


* Mathewson K, et al. Mental Health of Extremely Low Birth Weight Survivors: A Systematic Review and Meta-Analysis. Psychological Bulletin: 2017. DOI: 10.1037/bul0000091.

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