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Mental health, neurodevelopmental, and family psychosocial profiles of children born very preterm at risk of an early‐onset anxiety disorder
Author(s) -
Morris Alyssa R,
Bora Samudragupta,
Austin Nicola C,
Woodward Lianne J
Publication year - 2021
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/dmcn.14859
Subject(s) - psychosocial , anxiety , pediatrics , medicine , mental health , odds ratio , cohort , psychiatry , psychology
Aim To compare the mental health and neurodevelopmental profiles of school‐age children born very preterm, with and without an anxiety disorder, and to identify neonatal medical, psychosocial, and concurrent neurodevelopmental correlates. Method A regional cohort of 102 (51 males, 51 females) children born very preterm (mean [SD] gestation at birth=28wks [2], range=23–31wks) was studied from birth to age 9 years alongside a comparison group of 109 (58 males, 51 females) children born at term (mean [SD] gestation at birth=40wks [1], range=38–41wks). At age 9 years, all children underwent a neurodevelopmental evaluation while parents were interviewed using the Development and Well‐Being Assessment to diagnose a range of DSM‐IV childhood psychiatric disorders. Detailed information was also available about the children’s neonatal medical course and postnatal psychosocial environment, including maternal mental health and parenting. Results At age 9 years, 21% ( n =21) of very preterm and 13% ( n =14) of term‐born children met diagnostic criteria for an anxiety disorder. Clinically‐anxious children born very preterm were characterized by higher rates of comorbid mental health (odds ratio [OR]=11.5, 95% confidence interval [CI]=3.8–34.7), social (OR=6.2, 95% CI=2.1–18.4), motor (OR=4.4, 95% CI=1.6–12.2), and cognitive (OR=2.6, 95% CI=1.0–7.0) problems than those without an anxiety disorder. Concurrent maternal mental health and child social difficulties were the strongest independent correlates of early‐onset child anxiety disorders. Interpretation Children born very preterm who developed an early‐onset anxiety disorder were subject to high rates of comorbid problems. Findings highlight the importance of addressing both maternal and child mental health issues to optimize outcomes in this high‐risk population.What this paper adds One out of five school‐age children born very preterm are likely to meet DSM‐IV diagnostic criteria for an anxiety disorder. Half of these children born very preterm with an early‐onset anxiety disorder have comorbid attention‐deficit/hyperactivity disorder. Other neurodevelopmental correlates of early‐onset anxiety disorders include lower cognitive ability, motor problems, and peer social difficulties. Concurrent maternal mental health and child social adjustment problems were the strongest correlates of early‐onset anxiety disorder risk among children born very preterm.