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Overdue babies more prone to behavioural problems

Post-term children twice as likely to have behavioural/emotional problems

Adrian O'Dowd

Thursday, 03 May 2012

Babies born late are almost twice as likely as term born children to have behavioural and emotional problems, claims a study published online today in the International Journal of Epidemiology.

Post-term children are also more likely to show problems in the clinical range on the Attention Deficit/Hyperactivity Disorder (ADHD) scale.

Long-term health problems associated with pre-term birth are already well known, but a team of researchers from The Netherlands set out to find if babies born post-term – defined as being born after a 42 week pregnancy – also had problems in early childhood.

Researchers studied 5,145 babies born in Rotterdam between 2002 and 2006 to women who were already enrolled in the Generation R Study, a large population-based prospective cohort study from fetal life onwards.The researchers measured gestational age using ultrasound and found that of the total 5,145 babies, 382 (7%) were born post-term and 226 (4%) were born pre-term.

A standardised and validated behavioural checklist (Child Behaviour Checklist, CBCL/1.5-5) was used to assess the children.The parents were asked to complete a postal questionnaire when their babies were 18 and 36 months old. Both post-term and pre-term babies were at higher risk of behavioural and emotional problems at 18 and 36 months.

Overall, the researchers found that post-term children were almost twice as likely as term born children to have behavioural and emotional problems. The babies born late were also two and a half times more likely to have ADHD problem behaviour.

Further analysis found similar results when children whose gestational age was measured in the second or third trimester were excluded and the results were not affected when factors such as mother’s weight/height, ethnicity, family income, alcohol consumption, smoking, education level or maternal psychopathology in mid-pregnancy were taken into account.

The authors said there could be several potential explanations for their findings such as the fact that there was a higher risk of perinatal problems known to be associated with larger babies. However, excluding babies that weighed over 4,000 grams at birth and babies that were induced did not alter their findings.

The authors said longer follow-up was necessary to establish whether the relationship between post-term birth and behavioural problems persisted beyond 36 months.

However, they also advised that health practitioners involved in the management of prolonged pregnancy should take note of their findings.

Lead study author Dr Hanan El Marroun, from the Department of Child and Adolescent Psychiatry, Erasmus MC-Sophia, Rotterdam, said: “Post-term children have a considerably higher risk of clinically relevant problem behaviour and are more than twice as likely as term born children to have clinical ADHD.

“Further research is needed in order to determine the causes of post-term birth and to minimise the long-term consequences. It is also important that further research is carried out in order to demonstrate a causal relation between post-term birth and behavioural problems and longer follow ups would also be advantageous.”

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