Children who are born just a few weeks too early are significantly more likely to have behavioural and/or emotional problems in their pre-school years, claims research published online today in the Archives of Disease in Childhood.
Dutch researchers found that children born between 32 and 35 weeks gestation – described as ‘moderately premature’ – were almost twice as likely to have behavioural and emotional problems as children born at the normal time of 38 to 41 weeks.
It is already known that children born very premature (under 32 weeks) tend to have significantly more behavioural and/or emotional problems than children born full term, but it has not been clear what impact there is from being born just a few weeks too early.
Researchers from the University of Groningen, The Netherlands, studied 1,572 children, whose behaviour and emotional development were assessed at the age of 4, using validated tests.
All the children were part of a long term study looking at the growth, development and general health of children born prematurely, known as the Longitudinal Preterm Outcome Project or Lollypop.
In the group, 995 children were born between 32 and 35 weeks of pregnancy, classified as ‘moderately premature’, and 577 were born at term.
The researchers assessed seven behavioural/emotional components including anxiety/depression, aggression, attention disorders, and somatic complaints - conditions with no obvious physiological cause.
The prevalence of behavioural (externalising; acting out), and emotional (internalising), problems, were also assessed.
Results showed that the moderately preterm children had higher scores than their term peers on all the measures used, clocking up an average difference in cumulative score of more than four points.
The tendency to act out was highest among the boys, one in 10 of whom externalised problem behaviours, while a similar proportion of the girls had increased levels of internalising problem behaviours.
Overall, the moderately preterm children were almost 2.5 times as likely to internalise problem behaviours and just under 70% more likely to act them out than kids born at term.
They were also almost twice as likely to have somatic complaints and almost twice as likely to have behavioural and emotional problems, overall.
The researchers said that although the rate of very premature births has remained more or less constant for some time, the rate of moderately premature births has been rising.
“Our results demonstrate that moderately premature children are more likely to already have behavioural and emotional problems before they enter school,” said the authors, who suggested these children could benefit from targeted help.
“Moderately premature children could be a potential target group for the prevention of mental health problems, as behavioural and emotional problems in early childhood tend to persist in later childhood and adolescence.”