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

Larsen, Jennifer; Holland, Josephine; Kochhar, Puja; Wolke, Dieter; Draper, Elizabeth S.; Marlow, Neil; Johnson, Samantha

Abstract

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.
Conclusions: 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.

• Journal Article Type: Article
• Acceptance Date: Feb 25, 2024
• Online Publication Date: Mar 25, 2024
• Publication Date: 2024-03
• Deposit Date: Mar 22, 2024
• Publicly Available Date: Mar 26, 2025
• Journal: Journal of the American Academy of Child and Adolescent Psychiatry
• Print ISSN: 0890-8567
• Electronic ISSN: 1527-5418
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1016/j.jaacop.2024.02.005
• Keywords: Infant; Extremely Premature; Mental Disorders; Psychiatric Diagnosis; Developmental and Wellbeing Assessment (DAWBA)
• Public URL: https://nottingham-repository.worktribe.com/output/32752254
• Additional Information: This article is maintained by: Elsevier; Article Title: Comparing the Prevalence of Psychiatric Disorders in Cohorts of Children Born Extremely Preterm in 1995 and 2006: The EPICure Studies; Journal Title: JAACAP Open; CrossRef DOI link to publisher maintained version: https://doi.org/10.1016/j.jaacop.2024.02.005; Content Type: article; Copyright: © 2024 The Authors. Published by Elsevier Inc. on behalf of American Academy of Child & Adolescent Psychiatry.