Journal
PEDIATRICS
Volume 137, Issue 5, Pages -Publisher
AMER ACAD PEDIATRICS
DOI: 10.1542/peds.2015-2255
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Funding
- research foundation of Beatrix Children's Hospital
- Cornelia Foundation for the Handicapped Child
- A. Bulk Preventive Child Health Care Research Fund
- Dutch Brain Foundation
- FrieslandCampina
- Friso Infant Nutrition
- Abbvie
- Pfizer Europe
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BACKGROUND AND OBJECTIVES: Preterm children, compared with term children, are at increased risk of emotional and behavioral problems (EB-problems). Prevalences of EB-problems seem to vary with degree of prematurity and age at assessment. We therefore assessed individual stability of EB-problems in preterm compared with term children first before school entry and again 1 year after school entry, and variation in stability within the preterm group. METHODS: We used data of 401 early preterm (25-31 weeks' gestational age), 653 moderately preterm (32-35 weeks' gestational age), and 389 term children from the Longitudinal Preterm Outcome Project cohort study. We classified EB-problems based on the Child Behavior Checklist at ages 4 and 5; this resulted in 4 categories: consistently normal (2 normal scores), emerging (normal score at age 4 and clinical/subclinical score at age 5), resolving, and persistent EB-problems. RESULTS: All preterm children had higher rates than term children of persistent (7.2% vs 3.6%), emerging (4.3% vs 2.3%), and resolving (7.5% vs 3.6%) EB-problems. Early preterm children had the highest rates of persistent (8.2%) and emerging (5.2%) problems, and moderately preterm children had the highest rates of resolving problems (8.7%). In both preterm and term children, predictive values of normal scores at age 4 for normal scores at age 5 were similar to 96%, and of clinical/subclinical scores at age 4 for clinical/subclinical scores at age 5 were similar to 50%, except for early preterm children (60%). CONCLUSIONS: Compared with term children, all preterm children are at risk for persistent and changing EB-problems at school entry; individual stability, however, is difficult to predict based solely on the factor of preterm-birth.
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