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146. Long Term Outcomes of Childhood Externalizing Problems in Extremely Low Birth Weight (ELBW) Survivors
Approximately 10-20% of youth experience mental disorders, and more than half of adults’ mental health problems emerge in childhood or adolescence. While externalizing problems are common in children, their long-term repercussions are not well understood, particularly in atypically developing groups like survivors of preterm birth.
The present study examined associations between externalizing problems in childhood and adult mental and physical health problems in extremely low birth weight survivors (<1000 g; ELBW) and normal birth weight control (>2500 g; NBW) participants.
The parents of ELBW (n = 150) and NBW (NBW; n = 145) participants reported on externalizing problems using the Child Behavior Checklist when children were 8 years old. At 22-26 and 30-35 years of age, ELBW and NBW subjects reported their mental and physical health using the Young Adult Self-Report Questionnaire and Ontario Child Health Study Scales. At age 30-35 they completed the Mini International Neuropsychiatric Interview. Regression analyses were performed, controlling for sex, familial SES at age 8, and age at outcome measurement.
Results indicate that at age 22-26, childhood externalizing problems predicted externalizing problems (b=0.20, p=.001) and chronic physical health conditions (b=.07, p=.015), but only for those who were born at ELBW. At age 30-35, childhood externalizing problems predicted internalizing problems in both birth weight groups (b = 48, p = .015 for ELBWs; b = 43, p = .024 for NBWs), and externalizing problems (b = 0.32, p = .001) in ELBW survivors. Childhood externalizing problems also predicted chronic physical problems at age 30-35 (b=.07, p=.043) for NBWs. Childhood externalizing problems also predicted clinically significant psychiatric disorders at age 30-35 in both birth weight groups (OR = 1.05, 95% CI, .97-1.15 for ELBWs; OR = 1.12, 95% CI, 0.99-1.25 for NBWs).
Findings suggest that childhood externalizing problems persist into adulthood in those exposed to significant perinatal adversity. Early externalizing problems also predicted future internalizing (depression, anxiety) and physical health problems in the third and fourth decades of life in both typically developing children and ELBW survivors.