Mental Health Outcomes in US Children and Adolescents Born Prematurely or with Low Birthweight

Abstract

We examined the effects of prematurity (<37 weeks of gestation) and low birthweight (<2500 g) on mental health outcomes among US children aged 2-17 years. The 2011-2012 National Survey of Children's Health (N = 95,677) was used to estimate prevalence of parent-reported mental health problems in children. Prevalence of mental disorders was 22.9% among children born prematurely, 28.7% among very-low-birth-weight (<1500 g) children, and 18.9% among moderately low-birth-weight (1500-2499 g) children, compared with 15.5% in the general child population. Compared to those born full term, children born prematurely had 61% higher adjusted odds of serious emotional/behavioral problems, 33% higher odds of depression, and 58% higher odds of anxiety. Children born prematurely had 2.3 times higher odds of autism/ASD, 2.9 times higher odds of development delay, and 2.7 times higher odds of intellectual disability than term children. Very-low-birth-weight children had 3.2 times higher odds of autism/ASD, 1.7 times higher odds of ADD/ADHD, 5.4 times higher odds of development delay, and 4.4 times higher odds of intellectual disability than normal-birth-weight children. Social factors were significant predictors of mental disorders in both premature/low-birth-weight and term/normal-birth-weight children. Neurodevelopmental conditions accounted for the relationship between prematurity and depression/anxiety/conduct problems. Prematurity and low birthweight are significant risk factors for mental health problems among children.

Figure 1

Prevalence (%) and adjusted odds of mental disorders (one or more of the eight conditions) among US children aged 3–17 years by prematurity and low birthweight. Notes. Differences in prevalence and odds between preterm and birthweight categories were all statistically significant at P < 0.001. Odds ratios were adjusted for child's age, sex, race/ethnicity, household composition, race/ethnicity, household composition, place of residence, household poverty, and education levels. Term birth and normal birthweight were the respective reference categories for the prematurity and birthweight variables. Source. The 2011-2012 National Survey of Children's Health (N = 80,649).