Behavior Problems in Extremely Premature Babies at School Age
A new study published in the September issue of Pediatrics found an increased frequency of behavioral problems in extremely premature children born at or before 25 weeks gestation. The study was conducted at multiple centers in the UK and Ireland, and looked at behavioral reports from parents and teachers. In total, reports on 200 preemies born at 25 weeks or less, with an average current age of about 6 years, were compared to 148 control children.
Researchers found that 19.4% of the preterm children had pervasive behavior problems, as compared to 3.4% of the control children. Extremely preterm boys were most commonly affected (23.2%), and the difference between preterm boys and girls was greater than the gender difference seen among the controls. Attention problems (33.4%) and hyperactivity (30.6%) were the most common behavioral problems among the extremely preterm children. Problems like poor attention and poor peer relationships could not be explained by problems with cognitive function in the preemie group.
One of the major strengths of this study, is that it used both parent and teacher reports on each child included in the final analysis. Many previous studies have included only parental reports. Researchers suggest that the actual rate of pervasive behavioral problems among micro preemies could be even higher, because a number of the children in the study were lost to follow-up, or didn’t have adequately completed behavioral questionnaires. Unfortunately, more profoundly impacted children are often end up being left out of the final analysis because their parents are too busy with their ongoing care to respond to study questionnaires, or they are unable to attend school.
Of course, more studies are needed, and we don’t have any concrete explanation as to why these pervasive behavioral issues seem to be confined to babies born at this gestational age. While there are many theories, it seems logical that birth at or before 25 weeks disrupts some critical part of brain development related to behavior. Hopefully future research will give us a better understanding of exactly what is going on so future preemie parents can have a clearer picture of what to expect as their children grow.
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September 4th, 2008 at 10:45 am
Having a former 24 weeker (who is now 3) this type of thing worries me. So far, my little guy seems totally normal in his develpoment, though. I have to wonder if this behavioral problem stems from over-stimulation while in the NICU, and after going home. So may preemies have so many different therapies they go to, it seems their brains would always be in “go” mode.
September 4th, 2008 at 12:09 pm
Lisa-
That’s a good point. A lot of preemies probably get more than the average amount of stimulation in the form of “early intervention.” I’m sure that impacts the brain development going on in a baby or toddler as well. I’ve been on hiatus from preemie stuff, mainly because it seems like one bad study after another…
I just checked in on your boys on your blog. I can’t believe our babies are going to be one so soon!!
-Kristie
September 27th, 2008 at 11:38 am
I have a 8 year old daughter (will be 9 at the end of december) and is currently in 2nd grade. She was born at 23 weeks. She is not growing and is the size of a 6 year old. I dont know if this is normal. she has no real significant issues except now we are goign to have her evaluated for ADD. She struggles in school. There are a few other things going on also. If you want to talk my email is jen28@embarqmail.com