Table 2.

Summary of Studies Reporting Risk Factor Analyses for Psychiatric Disorders in Children Born Very Preterm or with Very Low Birth Weight

Study Reference	Country and Recruitment Period	Age of Assessment (yrs)	GA (wks)/Birth Weight (g)	Design and Participants	Number (%) of Survivors Assesseda	Outcome Measure (Continuous [cts] Unless Otherwise Specified)	Exclusion Criteria and/or Adjustment for Concurrent Neurodevelopmental Delay	Significant Risk Factors for Poorer Outcome (p < .05) in Final Model
Any psychiatric disorder: diagnosis
Treyvaud et al37	Australia, 2001–2003	7	<30 wks or <1250 g	PC study of infants admitted to a single center NICU and enrolled in Victorian Infant Brain Studies (Melbourne)	177 (79%)	DAWBA, parent report; DSM-IV-TR diagnosis assigned using scoring algorithm and clinical judgment of 2 blinded reviewers	None	Brain abnormality at term, female sex, socialemotional problems at 5 yr (SDQ), higher familial social risk at 7 yrb
Johnson et al9	UK and Republic of Ireland, 1995	10–12	<26	wks PC of all live births in the UK and Republic of Ireland (EPICURE Study)	219 (71%)	DAWBA, parent report; DSM-IV-TR diagnosis assigned using scoring algorithm and clinical judgment of 2 blinded reviewers	None	NEC, internalizing behavior problems at 2.5 yr (CBLC), pervasive attentional and conduct problems at 6 yr (SDQ), serious functional disability at 6 yr
Autism spectrum symptoms: dimensional measure
Wong et al39	England, 2010–2012	1.8–2.2	<33 wks	Infants attending routine FUP in 13 centers (London); neonatal data extracted retrospectively	141 (70%)	Q-CHAT score; parent report	Excluded: CP or severe neurosensory impairment (n = 10) Adjusted for: language composite score from BSID-III at 2 yr	Higher deprivation, non-white ethnicity, BSID-III language composite score at 2 yr
Johnson et al12	UK and Republic of Ireland, 1995	10–12	<26 wks	PC of all live births in the UK and Republic of Ireland (EPICURE Study)	219 (71%)	Total score from SCQ; parent report	None	No breast milk, IQ <2 SD at 6 yr, pervasive attentional and peer problems at 6 yr (SDQ), withdrawn (CBCL) at 2.5 yr
Autism spectrum disorder: positive screen
Stephens et al38	United States, 2008–2010	1.5–1.9	<27 wks	PC of infants admitted to the NICU of 15 centers participating in the multicenter NICHD NRN routine FUP	554 (74%)	1+ positive screen on 3 tests: PDDST-II (parent report), Response to Joint Attention and Response to Name (ADOS, direct observation)	Excluded from all: severe CP, blind, deaf (n = 31) Model 1: unadjusted Model 2: adjusted for cognition and language at 18 m Model 3: adjusted for cognition, language, and behavior at 18 m	Model 1: lower BW, non-white ethnicity, male sex Model 2: male sex, lower cognitive and language composite score from BSID-III at 18 m Model 3: lower cognitive and language composite score from BSID-III at 18 m, higher problem and lower competence score from BITSEA at 18 m
Moore et al40,c	England, 2006	2	<27 wks	PC of all live births in England (EPICURE-2 Study)	559 (54%)	Positive M-CHAT screen; parent report	Model 1: full cohort Model 2: excluded neurosensory impairment (n = 72) Model 3: excluded any disability (n = 320)	Model 1: severe BPD, any CUSS abnormality, PN steroids, positive blood culture ≥72 hr, male sex Model 2: positive blood culture ≥72 hr Model 3: any CUSS abnormality, positive blood culture <72 hr and ≥72 hr, male sex
Hack et al11	United States, 1992–1995	8	<1000 g	PC of infants admitted to a single center NICU (Ohio) participating in the multicenter NICHD NRN routine FUP	219 (97%)	CSI-4 based on DSM-IV-TR diagnostic criteria; parent report	Each risk factor was fitted separately and adjusted sex, race, parental SES (p values not reported)	BPD
Autism spectrum disorder: diagnosis
Johnson et al12	UK and Republic of Ireland, 1995	10–12	<26 wks	PC of all live births in the UK and Republic of Ireland (EPICURE Study)	219 (71%)	DAWBA; parent report; DSM-IV-TR diagnosis assigned using scoring algorithm and clinical judgment of 2 blinded reviewers	None	Cognitive impairment at 6 yr, pervasive peer problems at 6 yr (SDQ)
Attention deficit/hyperactivity disorder: positive screen
Hack et al11	United States, 1992–1995	8	<1000 g	PC of infants admitted to a single center NICU (Ohio) participating in the multicenter NICHD NRN routine FUP	219 (97%)	CSI-4 based on DSMIV-TR diagnostic criteria; parent report	Each risk factor was fitted separately and adjusted sex, race, parental SES (p values not reported)	None significant for hyperactive, inattentive, or combined type of ADHD

^aPercentage of survivors assessed for outcome measure specified.

^bFamilial social risk was based on a composite measure of 6 social risk factors: family structure, education of primary caregiver, occupation and employment status of primary income earner, language spoken at home, and maternal age at birth.

^cFive further models were reported: 3 models using only risk factors known at birth for the full cohort, excluding all disability and excluding neurosensory disability; 2 models with more stringent criteria for a positive screen. ADHD, attention deficit/hyperactivity disorder; ADOS, Autism Diagnostic Observation Scales⁵⁰; BPD, bronchopulmonary dysplasia; BSID, Bayley Scales of Infant Development⁴⁴; BW, birth weight; BITSEA, Brief Infant-Toddler Social and Emotional Screening; CBCL, Child Behavior Checklist⁴⁵; CP, cerebral palsy; CSI-4, Parent Child Symptom Inventory⁵¹; CUSS, cranial ultrasound abnormality; DAWBA, Development And Well-Being Assessment⁵²; DSM-IV-TR, Diagnostic and Statistical Manual of Mental Disorders¹⁰; FUP, follow-up; GA, gestational age; M-CHAT, Modified Checklist for Autism in Toddlers⁵³; IQ, intelligence quotient; NICU, neonatal intensive care unit; NICHD NRN, National Institutes of Child Health and Human Development Neonatal Research Network; NEC, necrotizing enterocolitis; PDDST, Pervasive Developmental Disorders Screening Test⁵⁴; PC, prospective cohort; PN, postnatal; Q-CHAT, Quantitative Checklist for Autism in Toddlers⁵⁵; SES, socioeconomic status; SDQ, Strengths and Difficulties Questionnaire⁴⁷; and SCQ, Social Communication Questionnaire.⁵⁶