Late Preterm Birth, Maternal Depression, and Risk of Preschool Psychiatric Disorders

Abstract

Objective Preterm children are at greater risk for psychiatric disorders than their term-born peers including anxiety disorders and ADHD. Prior research has focused primarily on children born at early gestational ages. Less is known about the rate of psychiatric disorders among late preterm or early term children. Additionally, whether a history of maternal depression, also associated with prematurity, impacts the risk for psychiatric disorders remains underexplored. Method Preschoolers between ages 3 and 6 years (N=306) were recruited for a study examining preschool depression that included healthy and disruptive preschoolers. Preschoolers were placed in the following groups: Late preterm (34–36 weeks, n=39), early term (37–39 weeks, n=78) and full term (40–41 weeks, n=154). DSM-IV psychiatric disorders were assessed via the Preschool Age Psychiatric Assessment. Maternal history of psychiatric disorders was assessed using the Family Interview for Genetic Studies. Results Late preterm children had higher rates of any Axis I psychiatric diagnosis (odds ratio [OR] 3.18, CI 1.09–4.76) and of any anxiety disorder (OR 3.74, CI 1.59–8.78) than full term children after adjusting for gender, ethnicity, family income, and IQ. There were no differences in rates of psychiatric diagnoses between early term and full term children. A history of maternal depression mediated the relationship between late preterm birth and anxiety disorders in preschoolers. Conclusions Late preterm children were at increased risk for anxiety disorders at preschool age. A history of maternal depression mediated this association. Findings confirm the extension of the risk of psychiatric disorders associated with prematurity to the late preterm group, and suggest that maternal depression may play a key role in this risk trajectory.

Late preterm birth, post-term birth, and abnormal fetal growth as risk factors for severe mental disorders from early to late adulthood

“…Correspondingly, a previous study showed that moderate or late preterm birth predicted an increased risk of suicides and/or suicide attempts in young adulthood (Lindström et al 2009) but whether this effect was more pronounced on committed or attempted suicide was not specified. However, in contrast to studies in younger cohorts showing predisposing effects of late preterm birth on any mental disorder and on internalizing disorders in childhood (Talge et al 2010;Rogers et al 2013), or of moderate or late preterm birth on severe mental disorders across diagnostic boundaries in young adulthood (Moster et al 2008;Lindström et al 2009;Nosarti et al 2012), Table 3. Gestational age and severe mental disorders.…”

Altered Gray Matter Volume and School Age Anxiety in Children Born Late Preterm

“…(20,21) We have also previously noted increased rates of psychiatric disorders, including a four-fold risk for anxiety disorders, at preschool age among LP children in the cohort to be examined in the analyses presented here. (22) Elevated rates of generalized anxiety disorder and separation anxiety disorders were found in this group. While we found these early childhood anxiety disorders in LP children were mediated by maternal depression, underlying neurodevelopmental differences could confer additional risk.…”

Behavioural and emotional problems in moderately preterm children with low socioeconomic status: a population-based study

“…Furthermore, in preterm children whose mother experienced the perinatal period as stressful, the impact of early adversities on behavioural problems and psychiatric disorders at preschool age is greater [30,35,36]. Even mothers of children born late preterm (34-37 weeks gestation) experienced significantly higher levels of emotional stress than mothers of term-born children [26].…”