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. 2022 Dec;92(6):1749-1756.
doi: 10.1038/s41390-022-02037-4. Epub 2022 Mar 30.

Emotional and attention-deficit/hyperactivity disorder symptoms of preterm vs. full-term children during COVID-19 pandemic restrictions

Marion Bailhache  1   2   3 , Maeva Monnier  4   5 , Flore Moulin  4   5 , Xavier Thierry  6 , Stéphanie Vandentorren  7 , Sylvana M Côté  8 , Bruno Falissard  9 , Thierry Simeon  10 , Bertrand Geay  10 , Laetitia Marchand  11 , Marie N Dufourg  10 , Marie A Charles  10   11 , Pierre Y Ancel  11 , Maria Melchior  12 , Alexandra Rouquette  9   13 , Cédric Galera  4   5   14 ; SAPRIS study group
Collaborators, Affiliations

Emotional and attention-deficit/hyperactivity disorder symptoms of preterm vs. full-term children during COVID-19 pandemic restrictions

Marion Bailhache et al. Pediatr Res. 2022 Dec.

Abstract

Background: Preterm children are at higher risk of developing mental health problems than full-term children. Deterioration of children's mental health was observed during COVID-19 pandemic restrictive measures. Our study compared emotional and attention-deficit/hyperactivity disorder (ADHD) symptoms during school closure between preterm and full-term children.

Methods: Data from two French birth cohorts-ELFE and EPIPAGE-2-were used. In 2011, infants born ≥22 weeks' gestation were recruited. Parents completed the Strengths and Difficulties Questionnaire when the children were 9 years old and experiencing school closure. Multivariate multinomial logistic regression models were used.

Results: Subjects included 4164 full-term and 1119 preterm children. In univariate analyses, compared to full-term children: extremely and very preterm children more frequently had abnormal and borderline ADHD scores (odds ratio [OR] 1.86, 95% confidence interval [CI] 1.50-2.30, OR 1.42, 95% CI 1.08-1.85, respectively) and abnormal emotional scores (OR 1.86, 95% CI 1.43-2.40); moderate to late preterm children more often had abnormal ADHD scores (OR 1.33, 95% CI 1.01-1.78). The associations did not remain when previous symptoms at 5 years old were considered.

Conclusions: School closure during lockdown did not appear to increase the risk of mental health problems in preterm compared to full-term children.

Impact statement: Preterm children are at higher risk of developing mental health problems than full-term children. Deterioration in children's mental health was observed during COVID-19 pandemic restrictions. However, whether preterm children were a particularly vulnerable subgroup during school closure is unclear. In univariate analyses, extremely and very preterm children more often had abnormal and borderline ADHD symptoms and abnormal emotional symptom scores than full-term children. The associations did not remain significantly associated when previous symptoms were considered. Preterm compared to full-term children more often suffer from ADHD and emotional symptoms, but school closure during lockdown did not appear to increase this risk.

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Conflict of interest statement

M.M. has been funded by the New-Aquitaine region (AMI Flash Recherche et Innovations COVID). The other authors have no competing interests to declare.

Figures

Fig. 1
Fig. 1
Cohort selection flow diagram.
See this image and copyright information in PMC

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