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The most recent version of this article was published on 1 November 2006

Arch. Dis. Child. Fetal Neonatal Ed.. Published Online First: 28 July 2006. doi:10.1136/adc.2006.093674
Copyright © 2006 BMJ Publishing Group Ltd & Royal College of Paediatrics and Child Health

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Original articles

Behavioural and emotional problems in very preterm and very low birth weight infants at age 5 years

Sijmen A. Reijneveld 1*, Martin J. de Kleine 2, Anneloes L. van Baar 3, Louis A.A. Kollée 4, Christianne M. Verhaak 4, Frank C. Verhulst 5 and S. Pauline Verloove-Vanhorick 6

1 University Medical Center Groningen, University of Groningen, Dept of Health Sciences, Netherlands
2 Maxima Medical Centre, Dept of Neonatology, Netherlands
3 Tilburg University, Paediatric Psychology, Netherlands
4 University Medical Center Nijmegen, Radboud University, Department of Paediatrics, Netherlands
5 Erasmus University Rotterdam, Academic Hospital Rotterdam-Sophia, Dept of Child and Adol. Psychiatry, Netherlands
6 TNO (Netherlands Organization of Applied Scientific Research) Quality of Life, Dept of Child Health, Netherlands

* To whom correspondence should be addressed. E-mail: s.a.reijneveld{at}med.umcg.nl.

Accepted 20 July 2006


*   Abstract

Objective: Children born very preterm (VP, < 32 weeks) or with very low birth weight (VLBW, <1500 grms) are at risk for behavioural and emotional problems during school age and adolescence. At school entrance these problems may hamper school functioning, but evidence on their occurrence at this age in VP/VLBW children is lacking. The aim of this study is to provide such information, and to examine the association of behavioural and emotional problems with other developmental problems assessed by paediatricians.

Design, setting and participants: We compared a cohort of 431 VP and/or VLBW children aged 5 years (response 76.1%) with two large national samples of children in the same age (n=6,007, response 86.9%).

Outcome measures: Behavioural and emotional problems measured by the Child Behavior Checklist (CBCL), and paediatrician assessment of other developmental domains among VP/VLBW children.

Results: The prevalence rate of a clinical CBCL Total Problems score was higher among VP/VLBW than among children of the same age from the general population (13.2 vs. 8.7%, odds ratio: 1.60 (95%-confidence interval 1.18 to 2.17)). Mean differences were largest for social and attention problems. Moreover, they were larger in children with paediatrician diagnosed developmental problems at 5 years, and somewhat larger in case of severe perinatal problems.

Conclusion: VP/VBW children are more likely at school entrance to have behavioural and emotional problems that are detrimental for school functioning. Targeted and timely help is needed to support them and their parents in surpassing these problems and to enable a successful societal career.


Keywords: follow-up studies, infant, premature, infant, very low birth weight, mental disorders


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