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Child and family factors associated with positive outcomes among youth born extremely preterm

Pediatric Research volume 94, pages 172–177 (2023)Cite this article

Abstract

Background

To analyze the relationship of child behavioral and communication disorders, and adverse family events, to later-in-life child health and cognitive function among youth born extremely preterm.

Methods

The study participants were 694 children enrolled in the Extremely Low Gestational Age Newborn Study. At ages 2 and 10, we assessed internalizing and externalizing behaviors, and at age 10, we assessed adverse life events within the family. Associations were evaluated between these child and family factors and positive child health at age 10 years, and global health and cognitive function at age 15 years.

Results

Lower T-scores for internalizing or externalizing behaviors at age 2 were associated with more positive health at age 10. The absence of internalizing behaviors at age 10 was associated with better global child health and better cognitive function at age 15. The absence of communication deficits at age 10 was associated with better cognitive function at age 15. The absence of parent job loss was associated with better global child health at age 15.

Conclusion

Among individuals born extremely preterm, child health and cognitive outcomes might be improved by timely interventions to address child behavioral symptoms and the impact of adverse life events in the family.

Impact

  • The absence of child behavioral and communication disorders, and adverse family events, were associated with more positive health, higher global health, and better cognitive function among youth born extremely preterm.

  • Interventions to address behavioral disorders in early childhood, and to reduce the impact of adverse life events on the family, might promote improved health and developmental outcomes for adolescents born extremely preterm.

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Data availability

ELGAN Study data through 10 years of follow-up are available from Archived Clinical Research Datasets by completing the NINDS Data Request Form. ELGAN Study after age 10 is expected to be available in 2022 from the NIH-sponsored Environmental Influences on Child Health Outcomes (ECHO) study. Those interested in data from the ECHO Study are encouraged to contact the coordinating center for that study: https://www.nih.gov/research-training/environmental-influences-child-health-outcomes-echo-program.

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Acknowledgements

The authors would like to acknowledge the contributions of the ELGAN subjects and the ELGAN subjects’ families.

Funding

Some of the first author’s time was supported by a Hillman Scholars Nursing Innovation Scholarship, the Arthur C. Maimon Doctoral Student Research Award and Linda Waring Matthews Research Fund. This study was also supported by grants from the National Institute of Neurological Disorders and Stroke (U01NS040069 to Alan Leviton; (R01NS040069 to K.K.C.K.), the National Institute of Child Health and Human Development (R01HD092374 to T.M.O. and R.C.F., R03HD101413 to H.P.S.), the National Institute of Nursing Research (R01NR019245 to H.P.S.), and the Office of the NIH Director (UG3OD023348 to T.M.O.), The content is solely the responsibility of the authors and does not necessarily represent the official views of any of the funders.

Author information

Authors and Affiliations

  1. School of Nursing, University of North Carolina, Chapel Hill, NC, USA

    Crisma Emmanuel, Kathy A. Knafl & Eric A. Hodges

  2. Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Joe X. Yi & Rebecca C. Fry

  3. School of Medicine, Boston University, Boston, MA, USA

    Robert M. Joseph & Karl K. C. Kuban

  4. School of Nursing, Duke University, Durham, NC, USA

    Sharron L. Docherty

  5. School of Medicine, University of North Carolina, Chapel Hill, NC, USA

    Rebecca C. Fry & T. Michael O’Shea

  6. Nursing, University of Miami, Coral Gables, USA

    Hudson P. Santos Jr.

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Contributions

All authors have agreed on the final version and meet at least one of the following criteria [recommended by the ICMJE (http://www.icmje.org/ethical_1author.html)]: substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; and drafting the article or revising it critically for important intellectual content.

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Correspondence to Crisma Emmanuel.

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Emmanuel, C., Yi, J.X., Joseph, R.M. et al. Child and family factors associated with positive outcomes among youth born extremely preterm. Pediatr Res 94, 172–177 (2023). https://doi.org/10.1038/s41390-022-02424-x

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