Self-Reported Mental Health Problems Among Adults Born Preterm: A Meta-analysis

Author:

Pyhälä Riikka12,Wolford Elina1,Kautiainen Hannu345,Andersson Sture6,Bartmann Peter7,Baumann Nicole8,Brubakk Ann-Mari9,Evensen Kari Anne I.910,Hovi Petteri611,Kajantie Eero6111213,Lahti Marius114,Van Lieshout Ryan J.15,Saigal Saroj16,Schmidt Louis A.1117,Indredavik Marit S.1819,Wolke Dieter720,Räikkönen Katri1

Affiliation:

1. Department of Psychology and Logopedics, and

2. Folkhälsan Research Centre, Helsinki, Finland;

3. Department of General Practice, University of Helsinki, Helsinki, Finland;

4. Unit of Primary Health Care, Helsinki University Central Hospital, Helsinki, Finland;

5. Unit of Primary Health Care, Kuopio University Hospital, Kuopio, Finland;

6. Children’s Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland;

7. Department of Neonatology, University Hospital Bonn, Bonn, Germany;

8. Department of Psychology, University of Warwick, Coventry, United Kingdom;

9. Department of Laboratory Medicine, Children’s and Women’s Health,

10. Department of Public Health and General Practice, and

11. National Institute for Health and Welfare, Helsinki, Finland;

12. National Institute for Health and Welfare, Oulu, Finland;

13. PEDEGO Research Unit, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland;

14. University/British Heart Foundation Centre for Cardiovascular Science, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom;

15. Department of Psychiatry and Behavioral Neurosciences,

16. Department of Pediatrics, and

17. Department of Psychology, Neuroscience & Behavior, McMaster University, Hamilton, Ontario, Canada;

18. Regional Centre for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology, Trondheim, Norway;

19. Department of Child and Adolescent Psychiatry, St. Olav’s Hospital, Trondheim University Hospital, Norway; and

20. Warwick Medical School, University of Warwick, Coventry, United Kingdom

Abstract

CONTEXT: Preterm birth increases the risk for mental disorders in adulthood, yet findings on self-reported or subclinical mental health problems are mixed. OBJECTIVE: To study self-reported mental health problems among adults born preterm at very low birth weight (VLBW; ≤1500 g) compared with term controls in an individual participant data meta-analysis. DATA SOURCES: Adults Born Preterm International Collaboration. STUDY SELECTION: Studies that compared self-reported mental health problems using the Achenbach Young Adult Self Report or Adult Self Report between adults born preterm at VLBW (n = 747) and at term (n = 1512). DATA EXTRACTION: We obtained individual participant data from 6 study cohorts and compared preterm and control groups by mixed random coefficient linear and Tobit regression. RESULTS: Adults born preterm reported more internalizing (pooled β = .06; 95% confidence interval .01 to .11) and avoidant personality problems (.11; .05 to .17), and less externalizing (–.10; –.15 to –.06), rule breaking (–.10; –.15 to –.05), intrusive behavior (–.14; –.19 to –.09), and antisocial personality problems (–.09; –.14 to –.04) than controls. Group differences did not systematically vary by sex, intrauterine growth pattern, neurosensory impairments, or study cohort. LIMITATIONS: Exclusively self-reported data are not confirmed by alternative data sources. CONCLUSIONS: Self-reports of adults born preterm at VLBW reveal a heightened risk for internalizing problems and socially avoidant personality traits together with a lowered risk for externalizing problem types. Our findings support the view that preterm birth constitutes an early vulnerability factor with long-term consequences on the individual into adulthood.

Publisher

American Academy of Pediatrics (AAP)

Subject

Pediatrics, Perinatology and Child Health

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