Anxiety in adolescents born preterm or with very low birthweight: a meta-analysis of case–control studies


Mr Mikael J Sømhovd, Department of Psychology, University of Copenhagen, Øster Farimagsgade 2a, 1353 Copenhagen K, Denmark. E-mail:


Aim  To determine if adolescents who are born very preterm (<32wks; of gestation) and/or with very low birthweight (VLBW; <1500g) have a higher risk of experiencing clinically significant anxiety problems.

Method  We used a systematic review and meta-analysis. We searched the databases ISI Web of Knowledge, PubMed, PsycNET, Educational Resources Information Center (ERIC), Latin American and Caribbean Literature on the Health Sciences (LILACS), and Virtual Health Library (VHL) with equivalent search expressions (from the databases’ inception to June 2011). Also, we screened reference lists of identified articles. We selected case–control studies of adolescents 11 to 20 years old who were very preterm/VLBW and had a matched reference group born at term with normal birthweight that reported a validated anxiety outcome measure. For data extraction, two authors independently reviewed titles, abstracts, and full articles identified through the searches. Subsequently two authors independently extracted data.

Results  We included six studies with 1519 adolescents (787 very preterm/VLBW, 732 comparisons). The general risk of developing clinically significant anxiety problems was nearly doubled (p<0.05) in the very preterm/VLBW population (OR 2.27, 95% confidence interval 1.15–4.47). The overall prevalences were 9.9% in the very preterm/VLBW group and 5.5% in the comparison group.

Interpretation  Those born very preterm/VLBW have an increased risk of developing clinically significant anxiety problems in adolescence.