Late-preterm birth by delivery circumstance and its association with parent-reported attention problems in childhood
Published Date:Jun 2012
Source:J Dev Behav Pediatr. 33(5):405-415.
Attention Deficit And Disruptive Behavior Disorders
Attention Deficit Disorder With Hyperactivity
Pregnancy Complications, Cardiovascular
Pubmed Central ID:PMC3369000
Funding:HD34543/HD/NICHD NIH HHS/United States
R01 HD034543/HD/NICHD NIH HHS/United States
R01 MH064769/MH/NIMH NIH HHS/United States
U01 DP000143-01/DP/NCCDPHP CDC HHS/United States
UL1 TR000448/TR/NCATS NIH HHS/United States
Late-preterm birth (LPB: 34–36 weeks) has been associated with an increased risk of attention problems in childhood relative to full-term birth (FTB: ≥ 37 weeks), but little is known about factors contributing to this risk. We investigated the contributions of clinical circumstances surrounding delivery using follow-up data from the Pregnancy Outcomes and Community Health (POUCH) Study.
Women who delivered late-preterm or full-term and completed the sex- and age-referenced Conners’ Parent Rating Scales-Short Form: Revised (CPRS-R:S) were included in the present analysis (N=762: children’s ages: 3–9 years). The CPRS-R:S measures dimensions of behavior linked to attention problems, including: oppositionality, inattention, hyperactivity, and a global attention problem index. Using general linear models, we evaluated whether LPB subtype (medically indicated (MI) or spontaneous) was associated with these dimensions relative to FTB.
After adjustment for parity, socio-demographics, child age, and maternal symptoms of depression and serious mental illness during pregnancy and at the child survey, only MI LPB was associated with higher hyperactivity and global index scores (mean difference from FTB=3.8 [95%CI 0.5,7.0] and 3.1 [95%CI 0.0, 6.2]). These findings were largely driven by children between 6 and 9 years. Removal of women with hypertensive disorders during pregnancy (N=85) or placental findings related to hypertensive conditions (obstruction, decreased maternal spiral artery conversion; N=134) reduced the differences below significance thresholds.
Among LPBs, only MI LPB was associated with higher levels of parent-reported childhood attention problems, suggesting that complications motivating medical intervention during the late-preterm period mark increased risk for such problems. Hypertensive disorders appear to play a role in these associations.
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