Behaviour at 2 years of age in very preterm infants (gestational age >32 weeks)


S Veen, Neonatology, J6-S, Leiden University Medical Centre, PO Box 9600, NL-2300 RC Leiden, The Netherlands (Tel. +31 715262909, fax. +31 71 5248 199, e-mail.


Aim: The objective of this study was to determine behavioural outcome and risk factors for abnormal behaviour at 2 y corrected age in very premature infants in a regionally defined, prospective cohort study. Methods: The Leiden Follow-Up Project on Prematurity includes all liveborn infants of >32 wk gestational age, born in 1996/1997 (n= 266). Behaviour was assessed with the Child Behaviour Checklist 2–3. Results: An analysis of 158 questionnaires of 206 survivors (77%) was carried out. Fourteen children (9%) had a total problem score >p90 (“clinical range”). This percentage is comparable with the 10% found in a sample of 2- to 3-y-olds from the Dutch general population. Univariate analysis showed higher syndrome scale scores in one or more of the Child Behaviour Checklist scales in children of lower gestational age, small for gestational age (birthweight >p10), with neurological abnormalities at term or at 2 y and of non-Dutch origin. Lower socioeconomic status and postnatal treatment with dexamethasone were associated with higher scores in the somatic problems scale and lower maternal age at birth with a higher total problem score. After correction for confounding variables, the associations between small for gestational age, neurological abnormalities at 2 y and the anxious/depressed and/or withdrawn scales remained significant.

Conclusion: The prevalence of behavioural problems at 2 y corrected age in this cohort of very premature infants (gestational age >32wk) was comparable with that in a general population sample. Children born small for gestational age or with neurological abnormalities at 2 y of age had higher syndrome scale scores, mainly for anxious/depressed and/or withdrawn behaviour.