Preemies are 3 times more likely to develop psychiatric problems

Feb 10, 2015 at 5:15 p.m. ET
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A new study published in The Journal of Pediatrics paints a grim picture for premature babies, but it gives doctors a game plan for how to identify and help those with mental illness in the community.

Premature infants already face great odds just to survive, with roughly five deaths in every 1,000 premature births in Canada. In addition, they are prone to having more physiological problems, such as problems with sight, hearing or breathing. This new study has found that they might be more likely to develop mental disorders later in life too.

According to the research, preemies may be three to four and a half times more likely to develop psychiatric problems like anxiety, depression or ADHD. The study also showed that lifesaving steroids given to mothers before they give birth to premature infants puts them at a higher risk for alcohol dependency and an even higher risk of psychiatric problems. Dr. Ryan Van Lieshout, lead author of the study, urges mothers not to decline steroids, though, as they could be life saving.

The research compared 84 individuals born at least 1 kilogram underweight with 90 normal-weight babies. The preemies were more likely to be shy or have attention problems in their teens and more likely to have anxiety issues in their 20s. There are other possible contributing factors at play, like how they were raised, but Van Lieshout thinks the results speak largely to the vast amount of stress an underweight baby's brain and body go through.

Van Lieshout hopes the information will better help doctors to detect and treat mental disorders in this population. Knowing that there might be a higher likelihood of developing certain disorders gives both parents and health care professionals the opportunity to try to prevent problems or to diagnose and treat them more quickly if they do arise.

Mothers can take a proactive stance to prevent premature births; however, in many cases, it is unavoidable. But that doesn't mean parents are powerless to helping their children, nor does it mean their child is guaranteed to have mental issues in the future. Dr. Courtney Manser, a family doctor in Ontario, suggests taking a proactive approach from the start with any concerns you might have about your preemie. "Be aware of your premature baby's health concerns before you leave the hospital so that you can stay on top of them from the start," she says.

Discuss weight, feeding regimens, proper temperature and appropriate vaccines with your doctor to be sure your premature infant is as healthy as possible and doesn't have to overcome even further challenges. "Be especially careful when your preemie gets sick in the first year of their life, as they are more prone to lung infections. Staying on top of their health and assuring they get treated early will help prevent more serious health concerns," Manser says.

Of course, you won't likely know if your child will develop any mental health complications for several years, if not decades, but being cognizant of any possible indications that something may be wrong can make a big difference. "Assure that you are in tune with their special needs, if they have any, from the start so that your child can get the support they need early on — at school and at home," Manser says.

"If you notice a change in your child's or teen's behaviour, such as acting out more, dropping grades or avoidance of regular activities that they used to enjoy, speak with your child about how they are feeling first," Manser says. Much like adults, children may have bad days or go through stages where their behaviour may seem erratic, and that doesn't necessarily mean anything is wrong.

That's why it's so important to be aware of the signs and communicate with your child starting at a young age so that it's easier to communicate with them in the teen years, when they are less likely to want to talk with you. "Encourage an open dialogue so that your child feels comfortable coming to you with their feelings. If you are at all concerned about their mental health, don't wait. Speak with your health care professional right away," Manser says.

Preemature infants can face many challenges, many of which can span their lifetime, but in many cases, there are no residual issues at all. "Prematurity does not guarantee that your baby will have long-term health concerns. In fact, many children thrive despite having a difficult start to life. Staying informed and in close contact with your pediatrician early on can help pave a healthier road ahead for your child," Manser says.

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