Children born small for gestational age are not at special risk for preschool emotion and behaviour problems

Abstract

Despite the wealth of literature examining long term outcomes of preterm low birthweight children, few studies have directly assessed the developmental impact of being born full term but small for gestational age (SGA). We aim to determine whether (i) being SGA increases preschool behavioural problems and (ii) other risk factors operate differently in SGA and appropriate for gestational age (AGA) controls. 550 New Zealand European mothers and their 3.5 year old children participated in this study. All children were born at full term (> 37 weeks' gestation) and approximately half were SGA (≤ sex specific 10 th percentile for gestation) the remainder were AGA controls. Extensive data were collected at the child's birth, 1 year and 3.5 years. Behavioural problems were measured when children were 3.5 years, using the Strengths and Difficulties Questionnaire (SDQ). Multiple regression analyses were used to examine the associations between risk factors and behavioural problems; statistical weighting was used for analyses of the total study group. There was no significant difference in behavioural problems between SGA and AGA groups. In the total sample the significant predictors of behavioural problems included: mothers' school leaving age; smoking during pregnancy; maternal alcohol use during pregnancy; and absence of the father.Predictors of behavioural problems were found to be the same for SGA and AGA groups.These results do not support the view that SGA is a risk for behavioural preschool difficulties or that SGA children are sensitized to risks known to be associated with such difficulties in the preschool years.

Psychiatric symptoms and risk factors in adults born preterm with very low birthweight or born small for gestational age at term

“…Emotional problems were prevalent in the SGA group, supporting the results of Berle et al [41] who found increased risk of anxiety and depressive symptoms in term-born SGA adults. Emotional and behavioral problems were however not seen by Cornforth et al [42] in preschool children, possibly indicating that other aspects, such as genetics or environmental factors, are influential for adult psychiatric symptoms in this group, or perhaps an age specific expression of problems. Almost one in four had borderline/clinical level of Somatic Complaints in the SGA group, and a higher level of self-reported pain compared to normal birthweight peers has been reported [43].…”

Antibiotics in the first year of life and subsequent neurocognitive outcomes

“…Although previously published papers from our sample have reported no significant difference in outcome between SGA and AGA children, SGA status was adjusted for in the analysis (22). If univariable analyses were statistically significant at the 10% level or below, then these outcomes were analysed in multivariable models by adding SGA status, sex, maternal school leaving age, method of delivery, maternal smoking in pregnancy and duration of breastfeeding.…”

“…If univariable analyses were statistically significant at the 10% level or below, then these outcomes were analysed in multivariable models by adding SGA status, sex, maternal school leaving age, method of delivery, maternal smoking in pregnancy and duration of breastfeeding. Although previously published papers from our sample have reported no significant difference in outcome between SGA and AGA children, SGA status was adjusted for in the analysis (22). Results were considered significant if the p-value was less than 5% in the Ethics Each phase of the study received ethical approval from the Auckland Regional Ethics Committee.…”

Angiogenic, neurotrophic, and inflammatory system SNPs moderate the association between birth weight and ADHD symptom severity

“…Contrary to previous work, lower birth weight centile was not independently associated with increased ADHD symptom severity in our data set. In general, literature demonstrates there is an association between restricted fetal growth and ADHD symptom severity [Bhutta et al, 2002;Indredavik et al, 2004;Lahti et al, 2006], however, null findings have also been reported [Cornforth et al, 2012]. In this sample largely consisting of ADHD cases, levels of inattention and hyperactivity-impulsivity were elevated and represented the upper end of the ADHD risk spectrum.…”

“…The strength of this association, however, varies across studies [Nigg, 2006] and is not always replicated [Cornforth et al, 2012]. Consistent with the dimensional nature of ADHD [Levy et al, 1997;Coghill and Sonuga-Barke, 2012], the association between lower birth weight and ADHD-related phenotypes is continuous and extends into the normal birth weight range [Boulet et al, 2009;Phua et al, 2012;Qiu et al, 2012;Walhovd et al, 2012].…”