Psychiatric symptoms and disorders in adolescents with low birthweight

Objective   To evaluate the prevalence of psychiatric symptoms and disorders associated with low birthweight.
Design/study groups   A population-based follow-up study of 56 very low birthweight (VLBW: birthweight ≤1500 g), 60 term small for gestational age (SGA: birthweight <10th centile), and 83 term control (birthweight ≥10th centile) children at 14 years of age.
Outcome measures   Schedule for affective disorders and schizophrenia for school-aged children, attention deficit/hyperactivity disorder (ADHD) rating scale IV, autism spectrum screening questionnaire, and children's global assessment scale.
Results   VLBW adolescents had a higher prevalence of psychiatric symptoms (46%) than controls (13%) odds ratio (OR) 5.7, 95% confidence interval (CI) 2.5–13.0] and, more psychiatric disorders (25%) than controls (7%) (OR 4.3, 95% CI 1.5–12.0), especially anxiety disorders. Although 25% of the VLBW adolescents had attention problems, ADHD was diagnosed in only 7%. Four VLBW adolescents had symptoms of Asperger's disorder, and the VLBW group had a higher sum score than controls on the autism spectrum screening questionnaire. Although more SGA adolescents had psychiatric symptoms than controls (23% vs. 13%), the difference was not statistically significant. Results remained essentially the same when adolescents with low estimated intelligence quotient were excluded, and persisted after possible psychosocial confounders had been controlled for.
Conclusion   VLBW, but not SGA adolescents, have a high risk of developing psychiatric symptoms and disorders by the age of 14, especially attention deficit, anxiety symptoms and relational problems.