Behavior problems of 9–16year old preterm children: Biological, sociodemographic, and intellectual contributions

Abstract

Background Preterm children are at risk for behavior problems. Studies examining contributions of intellectual and environmental factors to behavior outcomes in preterm children are mixed. Aims (1) To identify the nature of maladaptive behaviors in preterm children age 9 to 16 years born across the spectrum of gestational age and birth weight (BW). (2) To examine contributions of BW as a biological factor, socioeconomic status as an environmental factor, and intelligence quotient (IQ) as indicative of intellectual ability to behavior outcomes. Method Using the Child Behavior Checklist, parent reports of behavior for 63 preterm children (gestational age 24 to < 36 weeks) were compared to 29 full term children of similar age, gender and socioeconomic status. Multiple regression models evaluated effects of prematurity, socioeconomic status, and intellectual ability on behavioral symptom scores. Results Preterm children had higher total and internalizing problem scores compared to full term children. They also had lower IQ. BW was a significant predictor of total and internalizing behavior problems. Among the syndrome scales, anxious/depressed and attention problems were elevated. Socioeconomic status did not contribute to behavior scores. IQ contributed to total, but not to internalizing or externalizing, scores. IQ contributed to attention problems, but not to anxious/depressed scores. Conclusion Preterm children had increased behavior problems, especially symptoms of inattention and anxiety. Lower BW predicted more behavior problems. IQ acted as a mediator between BW and attention scores, but not anxiety scores. These findings alert health care providers to assess anxiety in all preterm children regardless of intellectual ability and to assess attention in those with learning problems. Additional study on the influence of intellectual ability on behavioral outcomes in preterm children is needed.

Towards reducing variations in infant mortality and morbidity: a population-based approach

“…Recent studies have suggested that the constellation of health and developmental problems associated with very preterm birth extends across birth at LMPT gestations, exerting a significant but smaller impact on long-term outcomes. [174][175][176][177] However, results are inconsistent; some have reported no difference from term-born controls 178 and there appears to be a significant moderating effect of socioeconomic risk among this group of children. 175 To further existing knowledge and guide the provision of evidence-based long-term care for children in the UK, we sought to identify the range and prevalence of adverse outcomes following LMPT birth.…”

Tertiary first step to success : a process evaluation of the home component.

“…Even more so, research suggests children's unmitigated negative behavior fuses into undesirable adult responses that often lead to adverse outcomes. Loe, Lee, Luna, & Feldman, 2011).…”

“…A child's academic and education goals suffer immensely, social relationships become damaging, and many other important life variables are impacted due to the child's challenging behavior (Hay, Hudson, & Liang, 2010;Henry & Thornberry, 2010;Lane, Barton-Arwood, Nelson, & Wehby, 2008;Loe et al 2011). In fact, data on academic achievement are dismal for school age children with challenging behavior.…”

“…Years of social and behavior research has taught us how differing theories add to the understanding of children's negative socio-behaviors (Figure 2.3). Loe et al (2011) suggest the understanding of biological factors (e.g., poor health, physical disabilities) as a means to understanding the negative behavioral epistemology of young children. In addition, a consideration of pervasive childhood disorders (e.g., ADHD, autism, learning disabilities) enlightens our understanding of the increasing number of behaviorally challenged children.…”

“…Those advocating for healthy communities note the importance of developing healthy neighborhoods to nurture healthy families and well-behaved children (Loe et al 2011;Whipple, Evans, Barry, & Maxwell, 2010). The exposure to criminal activity, illegal substances, or alcohol abuse erodes the protective covering of the young and exposes them to risks that influence their social growth and moral development.…”