Comparing the Prevalence of Psychiatric Disorders in Cohorts of Children Born Extremely Preterm in 1995 and 2006: The EPICure Studies

Objective

This study aimed to identify the prevalence of psychiatric disorders in two population-based cohorts of children born extremely preterm (EP) 11 years apart to ascertain if psychiatric outcomes have changed over time following improved survival of EP children.

Method

In the EPICure2 study, 200 children born EP (22-26 weeks’ gestation) in England in 2006 were assessed at 11 years of age alongside 143 term-born children. Children were assessed using the Developmental and Wellbeing Assessment (DAWBA). DSM-IV diagnoses were assigned by clinical psychiatrists for 145 EP and 98 term-born children. Outcomes were compared between a sub-sample of children from the EPICure2 cohort (2006, n=76) and the earlier born EPICure (1995, n=161) cohort born at 22-25 weeks’ gestation in England.

Results

EP children in EPICure2 were significantly more likely than term-born children to have any psychiatric disorder (39.3% vs. 3.1%, adjusted odds ratio [OR] 15.1; 95% confidence interval [CI] 4.4, 51.1), emotional disorders (14.6% vs. 2.0%, OR 7.3; 1.6, 32.7), conduct disorders (6.3% vs. 0.0%, P=0.01), attention-deficit/hyperactivity disorder (ADHD, 21.9% vs. 2.6%, OR 7.2; 1.5, 33.6) and autism spectrum disorder (ASD, 18.9% vs. 0.0%, P<0.001). There was no significant difference in the rates of any psychiatric disorder between EP children in the EPICure2 and EPICure cohorts.

Conclusion

EP children remain at increased risk of psychiatric disorders at 11 years of age compared with term-born peers. Increased survival has not translated into improved psychiatric outcomes. Healthcare professionals need to be aware of this ongoing risk when caring for children born preterm.