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Mental health outcomes at age 11 of very low birth weight infants in Ireland

  • F. McNicholas (a1) (a2) (a3) (a4), E. Healy (a5), M. White (a6) (a7), M. Sheridan-Pereira (a2) (a6) (a8), N. O’Connor (a1), S. Coakley (a1) and B. Dooley (a9)...



To compare mental health (MH) outcomes of and service use by children born under 1500 g in Ireland with a matched control group.


Using a retrospective cohort design, semi-structured and standardised MH assessments were conducted with parents, teachers and youth.


A total of 64 of 127 surviving children from a very low birth weight (VLBW) cohort from a National Maternity Hospital participated at a mean age of 11.6 years (s.d. 1.0), along with 51 matched controls. More VLBW children received clinical or borderline scores when rated by parents [χ2 (1, n=114)=7.3, p=0.007] or youths [χ2 (1, n=114)=4.83, p=0.028], but not by teachers [χ2 (1, n=114)=1.243, p=0.463]. There was no increase in the use of MH services. A main effect of birth weight remained on the parent Strengths and Difficulties Questionnaire [F (1, 88)=5.07, p<0.05) after controlling for intelligence quotient (IQ) and socio-economic status (SES), but only on hyperactivity in males. SES, rather than IQ or birth weight, predicted identification of problems by teachers [F (1, 82)=6.99, p=0.01).


Teachers miss MH difficulties and are influenced more by SES than by IQ or birth weight. This has implications for MH service access. Initial perinatal investment needs to be matched with ongoing surveillance and psychoeducation to ensure that disorders are recognised early and offered appropriate interventions.


Corresponding author

*Address for correspondence: Professor F. McNicholas, Lucena Clinic Services, 59 Orwell Road, Rathgar, Dublin 6, Ireland. (Email:


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Action, AO (2002). Practice parameter for the use of stimulant medications in the treatment of children, adolescents, and adults. Journal of the American Academy of Child and Adolescent Psychiatry 41 (Suppl. 2): 26s49s.
Burnett, A, Davey, CG, Wood, SJ, Wilson-Ching, M, Molloy, C, Cheong, JLY, Anderson, PJ (2014). Extremely preterm birth and adolescent mental health in a geographical cohort born in the 1990s. Psychological Medicine 44, 15331544.
Conrad, AL, Richman, L, Lindgren, S, Nopoulos, P (2010). Biological and environmental predictors of behavioral sequelae in children born preterm. Pediatrics 125, e83e89.
Crump, C, Winkleby, MA, Sundquist, K, Sundquist, J (2010). Preterm birth and psychiatric medication prescription in young adulthood: a Swedish national cohort study. International Journal of Epidemiology 39, 15221530.
Elgen, SK, Leversen, KT, Grundt, JH, Hurum, J, Sundby, AB, Elgen, IB, Markestad, T (2012). Mental health at 5 years among children born extremely preterm: a national population-based study. European Child & Adolescent Psychiatry 21, 583589.
Elgen, I, Sommerfelt, K, Markestad, T (2002). Population based, controlled study of behavioural problems and psychiatric disorders in low birthweight children at 11 years of age. Archives of Disease in Childhood. Fetal and Neonatal Edition 87, F128F132.
European Foundation for the Care of Newborn Infants (2011). European Foundation for the Care of Newborn Infants: EU bench marketing report (, Accessed 9 July 2014.
Goodman, R, Ford, T, Richards, H, Gatward, R, Meltzer, H (2000). The Development and Well-Being Assessment: description and initial validation of an integrated assessment of child and adolescent psychopathology. Journal of Child Psychology and Psychiatry, and Allied Disciplines 41, 645655.
Goodman, A, Goodman, R (2009). Strengths and difficulties questionnaire as a dimensional measure of child mental health. Journal of the American Academy of Child and Adolescent Psychiatry 48, 400403.
Gross, SJ, Mettelman, BB, Dye, TD, Slagle, TA (2001). Impact of family structure and stability on academic outcome in preterm children at 10 years of age. The Journal of Pediatrics 138, 169175.
Hack, M, Taylor, H, Schlichter, M, Andreias, L, Drotar, D, Klein, N (2009). Behavioral outcomes of extremely low birth weight children at age 8 years. Journal of Developmental and Behavioral Pediatrics 30, 122130.
Halmoy, A, Klungsoyr, K, Skjaerven, R, Haavik, J (2012). Pre- and perinatal risk factors in adults with attention-deficit/hyperactivity disorder. Biological Psychiatry 71, 474481.
Health Research & Information Division (2012). The Economic & Social Research Institute (ESRI) Perinatal Statistics Report 2011 ( Accessed 27 February 2013.
Hille, ETM, den Ouden, AL, Bauer, L, van den Oudenrijn, C, Brand, R, Verloove-Vanhorick, SP (1994). School performance at nine years of age in very premature and very low birth weight infants: perinatal risk factors and predictors at five years of age. The Journal of Pediatrics 125, 426434.
Johnson, S, Hollis, C, Kochhar, P, Hennessy, E, Wolke, D, Marlow, N (2010a). Psychiatric disorders in extremely preterm children: longitudinal finding at age 11 years in the EPICure study. Journal of the American Academy of Child and Adolescent Psychiatry 49, 453.e1463.e1.
Johnson, S, Hollis, C, Kochhar, P, Hennessy, E, Wolke, D, Marlow, N (2010b). Autism spectrum disorders in extremely preterm children. The Journal of Pediatrics 156, 525531.
Johnson, S, Hollis, C, Marlow, N, Simms, V, Wolke, D (2010c). Screening for childhood mental health disorders using the Strengths and Difficulties Questionnaire: the validity of multi-informant reports. Developmental Medicine and Child Neurology 56, 453459.
Johnson, S, Marlow, N (2014). Growing up after extremely preterm birth: lifespan mental health outcomes. Seminars in Fetal and Neonatal Medicine 19, 97104, WB Saunders.
Kramer, MS, Séguin, L, Lydon, J, Goulet, L (2000). Socio-economic disparities in pregnancy outcome: why do the poor fare so poorly? Paediatric and Perinatal Epidemiology 14, 194210.
Kuntsi, J, Eley, TC, Taylor, A, Hughes, C, Asherson, P, Caspi, A, Moffitt, TE (2004). Co-occurrence of ADHD and low IQ has genetic origins. American Journal of Medical Genetics 124B, 4147.
Laucht, M, Esser, G, Baving, L, Gerhold, M, Hoesch, I, Ihle, W, Schmidt, MH (2000). Behavioral sequelae of perinatal insults and early family adversity at 8 years of age. Journal of the American Academy of Child and Adolescent Psychiatry 39, 12291237.
Lindstrom, K, Lindblad, F, Hjern, A (2009). Psychiatric morbidity in adolescents and young adults born preterm: a Swedish national cohort study. Pediatrics 123, e47e53.
Loe, I, Lee, E, Luna, B, Feldman, H (2011). Behavior problems of 9–16 year old preterm children: biological, sociodemographic, and intellectual contributions. Early Human Development 87, 247252.
Marlow, N (2004). Neurocognitive outcome after very preterm birth. Archives of Disease in Childhood 89, F224F228.
McCormick, MC, Brooks-Gunn, J, Workman-Daniels, K, Turner, J, Peckham, GJ (1992). The health and developmental status of very low-birth-weight children at school age. JAMA 267, 22042208.
McNicholas, F, Healy, E, White, M, Sherdian-Pereira, M, O’Connor, N, Coakley, S, Dooley, B (2014). Medical, cognitive and academic outcomes of very low birth weight infants at age 10–14 years in Ireland. Irish Journal of Medical Science (1971-), 183, 525532.
Miech, RA, Caspi, A, Moffitt, TE, Entner Wright, BR, Silva, PA (1999). Low socioeconomic status and mental disorders: a longitudinal study of selection and causation during young adulthood. American Journal of Sociology 104, 10961131.
Rickards, AL, Kelly, EA, Doyle, LW, Callanan, C (2001). Cognition, academic progress, behavior and self-concept at 14 years of very low birth weight children. Journal of Developmental and Behavioral Pediatrics 22, 1118.
Rickards, AL, Kitchen, WH, Doyle, LW, Ford, GW, Kelly, EA, Callanan, C (1993). Cognition, school performance, and behavior in very low birth weight and normal birth weight children at 8 years of age: a longitudinal study. Journal of Developmental & Behavioral Pediatrics 14, 363368.
Rose, D, Pevalin, DJ, O’Reilly, K (2005). The National Statistics Socio-economic Classification: origins, development and use. Basingstoke: Palgrave Macmillan.
Saigal, S, Stoskopf, B, Streiner, DL, Boyle, M, Pinelli, J, Paneth, N, Goddeeris, J (2006). Transition of extremely low-birth weight infants from adolescence to young adulthood: comparison with normal birth-weight controls. JAMA 295, 667675.
Scahill, L, Schwab-Stone, M, Meirkangas, KR, Leckman, JF, Zhang, H, Kasi, S (1999). Psychosocial and clinical correlates of ADHD in a community sample of school-age children. Journal of the American Academy of Child and Adolescent Psychiatry 38, 976984.
Simonoff, E, Pickles, A, Charman, T, Chandler, S, Loucas, T, Baird, G (2008). ADHD symptoms in children with mild intellectual disability. Journal of the American Academy of Child and Adolescent Psychiatry 46, 591600.
Szatmari, P, Saigal, S, Rosenbaum, P, Campbell, D (1993). Psychopathology and adaptive functioning among extremely low-birth-weight children at 8 years of age. Development and Psychopathology 5, 345357.
Wechsler, D (2004). WISC-IV UK: Administration and Scoring Manual. Harcourt Assessment: London.
Whitaker, AH, Feldman, JF, Lorenz, JM, McNicholas, F, Fisher, PW, Shen, S, Pinto-Martin, J, Shaffer, D, Paneth, N (2011). Neonatal head ultrasound abnormalities in preterm infants and adolescent psychiatric disorders. Archives of General Psychiatry 68, 742752.
Whitaker, AH, Van Rossem, R, Feldman, JF, Schonfeld, IS, Pinto-Martin, JA, Tore, C, Shaffer, D, Paneth, N (1997). Psychiatric outcomes in low-birth-weight children at age 6 years: relation to neonatal cranial ultrasound abnormalities. Archives of General Psychiatry 54, 847856.
World Health Organization (WHO) (2012). ‘Born too soon’: global action report for preterm birth. MoD, PMNCH, Save the Children, WHO, New York.


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Mental health outcomes at age 11 of very low birth weight infants in Ireland

  • F. McNicholas (a1) (a2) (a3) (a4), E. Healy (a5), M. White (a6) (a7), M. Sheridan-Pereira (a2) (a6) (a8), N. O’Connor (a1), S. Coakley (a1) and B. Dooley (a9)...


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