Self-Reported Mental Health Problems Among Adults Born Preterm: A Meta-analysis

Pyhälä, Riikka; Wolford, Elina; Kautiainen, Hannu; Andersson, Sture; Bartmann, Peter; Baumann, Nicole; Brubakk, Ann-Mari; Evensen, Kari Anne I.; Hovi, Petteri; Kajantie, Eero; Lahti, Marius; Van Lieshout, Ryan J.; Saigal, Saroj; Schmidt, Louis A.; Indredavik, Marit S.; Wolke, Dieter; Räikkönen, Katri

doi:10.1542/peds.2016-2690

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Review Article| April 01 2017

Self-Reported Mental Health Problems Among Adults Born Preterm: A Meta-analysis

Riikka Pyhälä, PhD;

Riikka Pyhälä, PhD

aDepartment of Psychology and Logopedics, and

bFolkhälsan Research Centre, Helsinki, Finland;

Address correspondence to Riikka Pyhälä, PhD, Department of Psychology and Logopedics, Siltavuorenpenger 1A, 00014 University of Helsinki, Finland. E-mail: [email protected]

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Elina Wolford, MA;

Elina Wolford, MA

aDepartment of Psychology and Logopedics, and

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Hannu Kautiainen, BA;

Hannu Kautiainen, BA

cDepartment of General Practice, University of Helsinki, Helsinki, Finland;

dUnit of Primary Health Care, Helsinki University Central Hospital, Helsinki, Finland;

eUnit of Primary Health Care, Kuopio University Hospital, Kuopio, Finland;

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Sture Andersson, MD;

Sture Andersson, MD

fChildren’s Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland;

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Peter Bartmann, MD;

Peter Bartmann, MD

gDepartment of Neonatology, University Hospital Bonn, Bonn, Germany;

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Nicole Baumann, BSc;

Nicole Baumann, BSc

hDepartment of Psychology, University of Warwick, Coventry, United Kingdom;

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Ann-Mari Brubakk, MD;

Ann-Mari Brubakk, MD

iDepartment of Laboratory Medicine, Children’s and Women’s Health,

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Kari Anne I. Evensen, PT;

Kari Anne I. Evensen, PT

iDepartment of Laboratory Medicine, Children’s and Women’s Health,

jDepartment of Public Health and General Practice, and

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Petteri Hovi, MD;

Petteri Hovi, MD

fChildren’s Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland;

kNational Institute for Health and Welfare, Helsinki, Finland;

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Eero Kajantie, MD;

Eero Kajantie, MD

fChildren’s Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland;

kNational Institute for Health and Welfare, Helsinki, Finland;

lNational Institute for Health and Welfare, Oulu, Finland;

mPEDEGO Research Unit, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland;

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Marius Lahti, PhD;

Marius Lahti, PhD

aDepartment of Psychology and Logopedics, and

nUniversity/British Heart Foundation Centre for Cardiovascular Science, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom;

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Ryan J. Van Lieshout, MD;

Ryan J. Van Lieshout, MD

oDepartment of Psychiatry and Behavioral Neurosciences,

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Saroj Saigal, MD;

Saroj Saigal, MD

pDepartment of Pediatrics, and

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Louis A. Schmidt, PhD;

Louis A. Schmidt, PhD

kNational Institute for Health and Welfare, Helsinki, Finland;

qDepartment of Psychology, Neuroscience & Behavior, McMaster University, Hamilton, Ontario, Canada;

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Marit S. Indredavik, MD;

Marit S. Indredavik, MD

rRegional Centre for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology, Trondheim, Norway;

sDepartment of Child and Adolescent Psychiatry, St. Olav’s Hospital, Trondheim University Hospital, Norway; and

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Dieter Wolke, PhD;

Dieter Wolke, PhD

gDepartment of Neonatology, University Hospital Bonn, Bonn, Germany;

tWarwick Medical School, University of Warwick, Coventry, United Kingdom

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Katri Räikkönen, PhD

aDepartment of Psychology and Logopedics, and

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Address correspondence to Riikka Pyhälä, PhD, Department of Psychology and Logopedics, Siltavuorenpenger 1A, 00014 University of Helsinki, Finland. E-mail: [email protected]

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose.

Pediatrics (2017) 139 (4): e20162690.

https://doi.org/10.1542/peds.2016-2690

CONTEXT:

Preterm birth increases the risk for mental disorders in adulthood, yet findings on self-reported or subclinical mental health problems are mixed.

OBJECTIVE:

To study self-reported mental health problems among adults born preterm at very low birth weight (VLBW; ≤1500 g) compared with term controls in an individual participant data meta-analysis.

DATA SOURCES:

Adults Born Preterm International Collaboration.

STUDY SELECTION:

Studies that compared self-reported mental health problems using the Achenbach Young Adult Self Report or Adult Self Report between adults born preterm at VLBW (n = 747) and at term (n = 1512).

DATA EXTRACTION:

We obtained individual participant data from 6 study cohorts and compared preterm and control groups by mixed random coefficient linear and Tobit regression.

RESULTS:

Adults born preterm reported more internalizing (pooled β = .06; 95% confidence interval .01 to .11) and avoidant personality problems (.11; .05 to .17), and less externalizing (–.10; –.15 to –.06), rule breaking (–.10; –.15 to –.05), intrusive behavior (–.14; –.19 to –.09), and antisocial personality problems (–.09; –.14 to –.04) than controls. Group differences did not systematically vary by sex, intrauterine growth pattern, neurosensory impairments, or study cohort.

LIMITATIONS:

Exclusively self-reported data are not confirmed by alternative data sources.

CONCLUSIONS:

Self-reports of adults born preterm at VLBW reveal a heightened risk for internalizing problems and socially avoidant personality traits together with a lowered risk for externalizing problem types. Our findings support the view that preterm birth constitutes an early vulnerability factor with long-term consequences on the individual into adulthood.

2017

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Self-Reported Mental Health Problems Among Adults Born Preterm: A Meta-analysis

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