Page 39 - Sample Moderate prematurity, socioeconomic status, and neurodevelopment in early childhood

Finally, in Table 4, ORs are given of the risk of MP children for clinical CBCL problem scores. Compared with term-born children, MP children were at significantly greater risk for clinical CBCL scores for total problems (OR 1.84, 95% CI 1.12-3.00), internalizing problems (OR 2.40, 95% CI 1.48-3.87), externalizing problems (OR 1.69, 95% CI 1.07-2.67), and somatic complaints (OR 1.92, 95% CI 1.09-3.38).
Table 4 Risk for clinical problem scores term-born children
on the Child Behavior Checklist in moderately preterm versus
Prevalence of behavioural and emotional problems
CBCL problems scale
Preterm (n=916) (%)
Term (n=543) (%)
uOR*
aOR (95% CI)†
Total problems Externalizing problems Internalizing problems
Emotionally reactive Anxious/depressed Somatic complaints Withdrawn
Sleep problems Attention problems Aggressive behaviour
72 (7.9) 87 (8.5) 89 (9.7)
34 (3.7) 11 (1.2) 54 (5.9) 21 (2.3) 22 (2.4) 38 (4.1) 31 (3.4)
25 (4.6) 28 (5.2) 25 (4.6)
14 (2.6) 4 (0.7) 18 (3.3) 11 (2.0) 8 (1.5) 13 (2.3) 10 (1.8)
1.77 1.84 (1.12-3.00)‡ 3 1.71 1.69 (1.07-2.67)‡
2.23 2.40 (1.48-3.87)‡
1.46 1.70 (0.86-3.34) 1.64 2.50 (0.68-9.19) 1.83 1.92 (1.09-3.38)‡ 1.14 1.38 (0.62-3.09) 1.65 1.88 (0.79-4.49) 1.76 1.80 (0.90-3.59) 1.87 2.03 (0.95-4.36)
* unadjusted odds ratio
† adjusted odds ratio with 95% confidence interval; adjustment for gender, family composition, number of siblings, maternal age, and maternal educational level
‡ significant differences (P<0.05)
DISCUSSION
In this study, we have provided evidence that behavioural and emotional problems occur more frequently in MP than in term-born children at pre-school age. The syndrome scales emotionally reactive, anxious/depressed, somatic complaints, withdrawn behaviour, sleep problems, attention problems, and aggressive behaviour were all associated with moderate prematurity. Furthermore, we found that MP children were at greater risk for clinical CBCL scores on total problems, internalizing and externalizing problems, and on somatic complaints.
Our finding that MP children have more behavioural and emotional problems confirms the findings of most previous studies, but in a much larger sample, and at a different age.12-16 In this study MP children had significantly worse scores than term-born children on all subscales, internalizing, externalizing, and total problems. Two previous studies also reported more internalizing behaviour
53