Tuesday, February 10, 2015

Extremely Low Birth Weight Infants Now in Their 30s: How’s Their Mental Health?


By: Lewis First, MD, MS; Editor-in-Chief

@singingbeagle Flickr

          It is amazing how much we learn from longitudinal follow-ups of our patients. What was once only a follow-up of a few years tracking a cohort (if we were lucky to keep collecting data on them) has evolved into decades of tracking patients since infancy—and preterm infants are a great example. 
This week Van Lishout et al. (doi: 10.1542/peds.2014-3143) report on a prospective longitudinal population-based cohort of extremely low birth weight (ELBW) infants followed for over three decades in Ontario Canada. This cohort was mixed with an equal number of non-ELBW infants in their 30s and were interviewed in regard to their mental health as adults with interviewers unaware of early birth history. 
The results are interesting and reflect that ELBW adults are less likely to have alcohol or substance abuse problems but a greater risk of non-substance related mental health issue including generalized anxiety, and attention-deficit/hyperactivity disorder. Risks increased for both substance and non-substance related psychiatric disorders if antenatal corticosteroids had been administered. 
          While we realize we don’t usually follow our patients into their 30s, the information in this study is useful for educating both parents and adolescent patients to perhaps be better aware of problems that might occur more frequently as they move into adulthood, and at the same time take preventive steps to reduce the occurrence of such problems knowing what this study tells us.  Kudos to the investigators for being able to follow this ELBW cohort for so long and in turn for sharing with us information that can influence how we counsel these patients while they are still in our practice.

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