CHICAGO, Aug. 26 (Xinhua) -- Researchers at Washington University School of Medicine in St. Louis have found that the mental health of preemies (premature babies) may be related less to medical challenges they face after birth than to the environment the babies enter once they leave the newborn intensive care unit (NICU).
The researchers evaluated 125 5-year-old children. Of them, 85 had been born at least 10 weeks before their due dates. The other 40 children in the study were born full-term, at 40 weeks' gestation.
The children completed standardized tests to assess their cognitive, language and motor skills. Parents and teachers also were asked to complete checklists to help determine whether a child might have issues indicative of attention-deficit/hyperactivity disorder (ADHD) or autism spectrum disorder, as well as social or emotional problems or behavioral issues.
It turned out the children who had been born at 30 weeks of gestation or sooner tended to fit into one of four groups. One group, representing 27 percent of the very preterm children, was found to be particularly resilient.
"They had cognitive, language and motor skills in the normal range, the range we would expect for children their age, and they tended not to have psychiatric issues," said first author Rachel E. Lean, a postdoctoral research associate in child psychiatry. "About 45 percent of the very preterm children, although within the normal range, tended to be at the low end of normal. They were healthy, but they weren't doing quite as well as the more resilient kids in the first group."
The other two groups had clear psychiatric issues such as ADHD, autism spectrum disorder or anxiety. A group of about 13 percent of the very preterm kids had moderate to severe psychiatric problems. The other 15 percent of children displayed a combination of problems with inattention and with hyperactive and impulsive behavior.
The children in those last two groups weren't markedly different from other kids in the study in terms of cognitive, language and motor skills, but they had higher rates of ADHD, autism spectrum disorder and other problems.
"The children with psychiatric problems also came from homes with mothers who experienced more ADHD symptoms, higher levels of psychosocial stress, high parenting stress, just more family dysfunction in general," said senior investigator Cynthia E. Rogers, an associate professor of child psychiatry. "The mothers' issues and the characteristics of the family environment were likely to be factors for children in these groups with significant impairment."
The researchers believe the findings may indicate good news because maternal psychiatric health and family environment are modifiable factors that can be targeted with interventions that have the potential to improve long-term outcomes for children who are born prematurely.
Children who were born at least 10 weeks before their due dates are at risk for attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder and anxiety disorders as they grow and develop. They also have a higher risk than children who were full-term babies for other neurodevelopmental issues, including cognitive problems, language difficulties and motor delays.
The researchers are continuing to follow the children from the study.
The findings were published on Monday in The Journal of Child Psychology and Psychiatry.
