Page 28 - Sample Moderate prematurity, socioeconomic status, and neurodevelopment in early childhood

Chapter 3
ABSTRACT
Objective To compare pre-school moderately preterm-born (MP; 32-35 weeks’ gestation) and term-born (38-41 weeks’ gestation) children regarding the occurrence of behavioural and emotional problems, overall, for separate types of problems, and by gender.
Design Prospective cohort study consisting of a community-based sample of MP and a random sample of term-born children.
Setting Thirteen Preventive Child Health Care centres throughout the Netherlands. Patients We included 995 MP and 577 term-born children, just under age four. Main outcome measures Behavioural and emotional problems were measured using the Child Behavior Checklist (CBCL) 1.5-5 years. Seven syndrome scales, and internalizing, externalizing, and total problems were determined. Higher scores indicate a worse outcome.
Results MP children had higher scores on all syndrome scales, internalizing, externalizing, and total problems than term-born controls. The mean difference on total problems was 4.04 (95% confidence interval [CI] 2.08-6.00). Prevalence rates of elevated externalizing problem scores were highest in boys (10.5%) and internalizing problems were highest in girls (9.9%). MP children were at greater risk for somatic complaints (odds ratio [OR], 95% CI: 1.92, 1.09-3.38), internalizing (OR 2.40, 95% CI 1.48-3.87), externalizing, (OR 1.69, 95% CI 1.07-2.67), and total problems (OR 1.84, 95% CI 1.12-3.00).
Conclusions Moderate preterm birth affects all domains of behavioural and emotional problems, particularly for girls. MP children could be a potential target group for the prevention of mental health problems, because these problems have a great impact on the developmental and social competencies at school and in the community.
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