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. 2018 Nov;59(11):1192-1200.
doi: 10.1111/jcpp.12909. Epub 2018 Apr 18.

Trajectories of psychopathology in extremely low birth weight survivors from early adolescence to adulthood: a 20-year longitudinal study

Ryan J Van Lieshout  1 , Mark A Ferro  2 , Louis A Schmidt  3 , Michael H Boyle  1 , Saroj Saigal  4 , Katherine M Morrison  4 , Karen J Mathewson  3
Affiliations

Trajectories of psychopathology in extremely low birth weight survivors from early adolescence to adulthood: a 20-year longitudinal study

Ryan J Van Lieshout et al. J Child Psychol Psychiatry. 2018 Nov.

Abstract

Background: Individuals born extremely preterm are exposed to significant perinatal stresses that are associated with an increased risk of psychopathology. However, a paucity of longitudinal studies has prevented the empirical examination of long-term, dynamic effects of perinatal adversity on mental health. Here, internalizing and externalizing problems from adolescence through adulthood were compared in individuals born at extremely low birth weight (ELBW; <1,000 g) and normal birth weight (NBW; >2,500 g).

Methods: Internalizing and externalizing data were collected over 20 years in three waves, during adolescence, young adulthood, and adulthood. Growth models were used to compare longitudinal trajectories in a geographically based sample of 151 ELBW survivors and 137 NBW control participants born between 1977 and 1982 matched for age, sex, and socioeconomic status at age 8.

Results: After adjusting for sex, socioeconomic and immigrant status, and family functioning, ELBW survivors failed to show the normative, age-related decline in internalizing problems over time relative to their NBW peers (β = .21; p < .01). Both groups exhibited small declines in externalizing problems over the same period. Self-esteem (but not physical health, IQ, or maternal mood) partially mediated the association between ELBW status and internalizing problems.

Conclusions: Extremely low birth weight survivors experienced a blunting of the expected improvement in depression and anxiety from adolescence to adulthood. These findings suggest that altered physiological regulatory systems supporting emotional and cognitive processing may contribute to the maintenance of internalizing problems in this population.

Keywords: Extremely low birth weight; adolescent; adult; internalizing disorder; longitudinal studies.

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Conflict of interest statement

Conflict of interest statement: No conflicts declared.

Figures

Figure 1
Figure 1
Change trajectories for A) internalizing and B) externalizing problems between adolescence and adulthood in ELBW survivors and NBW controls. Note: Mean age differed between consecutive assessments by 9 years in each case (adolescent to young adult, young adult to adult).
Figure 1
Figure 1
Change trajectories for A) internalizing and B) externalizing problems between adolescence and adulthood in ELBW survivors and NBW controls. Note: Mean age differed between consecutive assessments by 9 years in each case (adolescent to young adult, young adult to adult).
Figure 2
Figure 2
Mediation of associations between birth weight status and internalizing by self-esteem, maternal depressed mood, physical health, and intellectual functioning.
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Comment in

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