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Archives of Disease in Childhood. Fetal and Neonatal Edition logoLink to Archives of Disease in Childhood. Fetal and Neonatal Edition
. 1999 Jul;81(1):F5–F9. doi: 10.1136/fn.81.1.f5

Longitudinal study of behaviour disorders in low birthweight infants

C Stevenson, P Blackburn, P Pharoah
PMCID: PMC1720964  PMID: 10375354

Abstract

AIM—To compare the prevalence of childhood and adolescent behavioural problems in low birthweight infants with matched controls.
METHODS—A cohort study of a geographically defined population of survivors of ⩽1500 g birthweight born in 1980 and 1981 and age, sex, and school matched controls was undertaken. Children with a clinical disability were excluded. Data from Rutter questionnaires, completed by parents and teachers when the children were aged 8 and again at age 14 years, were assessed.
RESULTS—From an initial 40 321 births in 1980-81 there were 399 of birthweight ⩽1500 g, of whom 219 survived to age 8. After exclusion of the 42 children with clinical disability, 177 cases comprised the sample. Of these, 10 (6%) refused or could not be contacted, leaving 167 cases for each of whom a matched control was obtained. At age 14 years, both parent and teacher questionnaires showed an increased prevalence of behavioural problems in cases compared with controls. The presence of a pervasive behavioural problem, when the responses of parents and teachers were concordant, was present in 9% of cases and 3% of controls. There were 132 pairs where the cases and controls were the same at ages 8 and 14 years and provided longitudinal data. The parental questionnaire showed there was a significant decrease in the prevalence of behavioural problems for cases and controls between the ages of 8 and 14 years. There was almost no longitudinal change in the prevalence of behavioural problems as shown by the teacher questionnaires.
CONCLUSION—Although low birthweight infants are at increased risk of behavioural problems, because they comprise only a small proportion of all births, their population attributable risk for behavioural disorder is around 2-3%. 



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Selected References

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  1. Alberman E., Botting B. Trends in prevalence and survival of very low birthweight infants, England and Wales: 1983-7. Arch Dis Child. 1991 Nov;66(11):1304–1308. doi: 10.1136/adc.66.11.1304. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Conners C. K. A teacher rating scale for use in drug studies with children. Am J Psychiatry. 1969 Dec;126(6):884–888. doi: 10.1176/ajp.126.6.884. [DOI] [PubMed] [Google Scholar]
  3. Cooke R. W. Trends in preterm survival and incidence of cerebral haemorrhage 1980-9. Arch Dis Child. 1991 Apr;66(4 Spec No):403–407. doi: 10.1136/adc.66.4_spec_no.403. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Dammann O., Walther H., Allers B., Schroder M., Drescher J., Lutz D., Veelken N., Schulte F. J. Development of a regional cohort of very-low-birthweight children at six years: cognitive abilities are associated with neurological disability and social background. Dev Med Child Neurol. 1996 Feb;38(2):97–106. doi: 10.1111/j.1469-8749.1996.tb12081.x. [DOI] [PubMed] [Google Scholar]
  5. Hack M., Merkatz I. R., Jones P. K., Fanaroff A. A. Changing trends of neonatal and postneonatal deaths in very-low-birth-weight infants. Am J Obstet Gynecol. 1980 Aug 1;137(7):797–800. doi: 10.1016/0002-9378(80)90888-1. [DOI] [PubMed] [Google Scholar]
  6. Khadilkar V., Tudehope D., Burns Y., O'Callaghan M., Mohay H. The long-term neurodevelopmental outcome for very low birthweight (VLBW) infants with 'dystonic' signs at 4 months of age. J Paediatr Child Health. 1993 Dec;29(6):415–417. doi: 10.1111/j.1440-1754.1993.tb03011.x. [DOI] [PubMed] [Google Scholar]
  7. Mutch L., Leyland A., McGee A. Patterns of neuropsychological function in a low-birthweight population. Dev Med Child Neurol. 1993 Nov;35(11):943–956. doi: 10.1111/j.1469-8749.1993.tb11576.x. [DOI] [PubMed] [Google Scholar]
  8. Neeleman J., Wessely S., Wadsworth M. Predictors of suicide, accidental death, and premature natural death in a general-population birth cohort. Lancet. 1998 Jan 10;351(9096):93–97. doi: 10.1016/S0140-6736(97)06364-2. [DOI] [PubMed] [Google Scholar]
  9. Ornstein M., Ohlsson A., Edmonds J., Asztalos E. Neonatal follow-up of very low birthweight/extremely low birthweight infants to school age: a critical overview. Acta Paediatr Scand. 1991 Aug-Sep;80(8-9):741–748. doi: 10.1111/j.1651-2227.1991.tb11943.x. [DOI] [PubMed] [Google Scholar]
  10. Pharoah P. O., Alberman E. D. Mortality of low birthweight infants in England and Wales 1953 to 1979. Arch Dis Child. 1981 Feb;56(2):86–89. doi: 10.1136/adc.56.2.86. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Pharoah P. O., Stevenson C. J., West C. R. Association of blood pressure in adolescence with birthweight. Arch Dis Child Fetal Neonatal Ed. 1998 Sep;79(2):F114–F118. doi: 10.1136/fn.79.2.f114. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Powell T. G., Pharoah P. O., Cooke R. W. Survival and morbidity in a geographically defined population of low birthweight infants. Lancet. 1986 Mar 8;1(8480):539–543. doi: 10.1016/s0140-6736(86)90893-7. [DOI] [PubMed] [Google Scholar]
  13. Rosenbaum P., Saigal S., Szatmari P., Hoult L. Vineland Adaptive Behavior Scales as a summary of functional outcome of extremely low-birthweight children. Dev Med Child Neurol. 1995 Jul;37(7):577–586. doi: 10.1111/j.1469-8749.1995.tb12046.x. [DOI] [PubMed] [Google Scholar]
  14. Roussounis S. H., Hubley P. A., Dear P. R. Five-year-follow-up of very low birthweight infants: neurological and psychological outcome. Child Care Health Dev. 1993 Jan-Feb;19(1):45–59. doi: 10.1111/j.1365-2214.1993.tb00712.x. [DOI] [PubMed] [Google Scholar]
  15. Rutter M. A children's behaviour questionnaire for completion by teachers: preliminary findings. J Child Psychol Psychiatry. 1967 May;8(1):1–11. doi: 10.1111/j.1469-7610.1967.tb02175.x. [DOI] [PubMed] [Google Scholar]
  16. Rutter M., Cox A., Tupling C., Berger M., Yule W. Attainment and adjustment in two geographical areas. I--The prevalence of psychiatric disorder. Br J Psychiatry. 1975 Jun;126:493–509. doi: 10.1192/bjp.126.6.493. [DOI] [PubMed] [Google Scholar]
  17. Rutter M., Tizard J., Yule W., Graham P., Whitmore K. Research report: Isle of Wight Studies, 1964-1974. Psychol Med. 1976 May;6(2):313–332. doi: 10.1017/s003329170001388x. [DOI] [PubMed] [Google Scholar]
  18. Sommerfelt K., Troland K., Ellertsen B., Markestad T. Behavioral problems in low-birthweight preschoolers. Dev Med Child Neurol. 1996 Oct;38(10):927–940. doi: 10.1111/j.1469-8749.1996.tb15049.x. [DOI] [PubMed] [Google Scholar]
  19. Taylor E., Sandberg S. Hyperactive behavior in English schoolchildren: a questionnaire survey. J Abnorm Child Psychol. 1984 Mar;12(1):143–155. doi: 10.1007/BF00913466. [DOI] [PubMed] [Google Scholar]
  20. Wariyar U., Richmond S., Hey E. Pregnancy outcome at 24-31 weeks' gestation: neonatal survivors. Arch Dis Child. 1989 May;64(5):678–686. doi: 10.1136/adc.64.5.678. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Weisglas-Kuperus N., Koot H. M., Baerts W., Fetter W. P., Sauer P. J. Behaviour problems of very low-birthweight children. Dev Med Child Neurol. 1993 May;35(5):406–416. [PubMed] [Google Scholar]

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