Behavioural problems in children who weigh 1000 g or less at birth in four countries

The increased survival chances of extremely low-birthweight (ELBW) infants (weighing ≤1000 g at birth) has led to concern about their behavioural outcome in childhood. In reports from several countries with different assessments at various ages, investigators have noted a higher frequency of behavio...

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Bibliographic Details
Published in:Lancet (British edition) 2001-05, Vol.357 (9269), p.1641-1643
Main Authors: Hille, Elysée TM, den Ouden, A Lya, Saigal, Saroj, Wolke, Dieter, Lambert, Michael, Whitaker, Agnes, Pinto-Martin, Jennifer A, Hoult, Lorraine, Meyer, Renate, Feldman, Judith F, Verloove-Vanhorick, S Pauline, Paneth, Nigel
Format: Article
Language:English
Subjects:
Behavior disorders
Biological and medical sciences
Birth weight
Canada - epidemiology
Child
Child Behavior Disorders - diagnosis
Child Behavior Disorders - epidemiology
Child Behavior Disorders - psychology
Child, Preschool
Cross cultural studies
Cross-Cultural Comparison
Delivery. Postpartum. Lactation
Female
Germany - epidemiology
Gynecology. Andrology. Obstetrics
Humans
Infant
Infant, Newborn
Infant, Very Low Birth Weight - psychology
Male
Maternal, fetal and perinatal monitoring
Medical sciences
Netherlands - epidemiology
Prospective Studies
United States - epidemiology
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Summary:The increased survival chances of extremely low-birthweight (ELBW) infants (weighing ≤1000 g at birth) has led to concern about their behavioural outcome in childhood. In reports from several countries with different assessments at various ages, investigators have noted a higher frequency of behavioural problems in such infants, but cross-cultural comparisons are lacking. Our aim was to compare behavioural problems in ELBW children of similar ages from four countries. We prospectively studied 408 ELBW children aged 8–10 years, whose parents completed the child behaviour checklist. The children came from the Netherlands, Germany, Canada, and USA. The checklist provides a total problem score consisting of eight narrow-band scales. Of these, two (aggressive and delinquent behaviour) give a broad-band externalising score, three (anxious, somatic, and withdrawn behaviour) give a broad-band internalising score, and three (social, thought, and attention problems) indicate difficulties fitting neither broad-band dimension. For each cohort we analysed scores in ELBW children and those in normal-birthweight controls (two cohorts) or national normative controls (two cohorts). Across countries, we assessed deviations of the ELBW children from normative or control groups. ELBW children had higher total problem scores than normative or control children, but this increase was only significant in European countries. Narrow-band scores were raised only for the social, thought, and attention difficulty scales, which were 0·5–1·2 SD higher in ELBW children than in others. Except for the increase in internalising scores recorded for one cohort, ELBW children did not differ from normative or control children on internalising or externalising scales. Despite cultural differences, types of behavioural problems seen in ELBW children were very similar in the four countries. This finding suggests that biological mechanisms contribute to behavioural problems of ELBW children.
ISSN:0140-6736
1474-547X
DOI:10.1016/S0140-6736(00)04818-2