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PEDIATRICS Vol. 111 No. 5 May 2003, pp. 969-975

Psychopathology and Social Competencies of Adolescents Who Were Extremely Low Birth Weight

Saroj Saigal, MD, FRCP(C)*, Janet Pinelli, RNC, MScN, DNS*,{ddagger}, Lorraine Hoult, BA*, M. Marie Kim, MD, FRCP(C)* and Michael Boyle, PhD§

* Department of Pediatrics
{ddagger} School of Nursing
§ Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada

--> Background. We have previously shown that infants who were extremely low birth weight (ELBW) are particularly vulnerable to problems related to inattention and hyperactivity at school age. It is not known whether these problems persist to adolescence.

Objective. To explore and compare the levels of psychopathology in a regional cohort of ELBW infants and sociodemographically matched term controls as reported by teens and their parents.

Design/Methods. Cross-sectional cohort study/geographically defined region.

Participants. Teens: ELBW 141/169 (83%) and control 122/145 (84%), aged 12 to 16 years. Parents: ELBW 143/169 (85%) and control 123/145 (85%). Both cohorts and their parents completed the Ontario Child Health Study-Revised questionnaire with 6 behavioral subsca1es: conduct disorder, oppositional defiant disorder, attention-deficit/hyperactivity disorder (ADHD), overanxious, separation anxiety, and depression.

Results. By teen self-report, there were no significant differences between ELBW and control teens on any of the 6 subscale scores. However, parents of ELBW teens reported significantly higher scores than parents of control for depression and ADHD based on 2-way analysis of variance (group x gender). Comparison within teen/parent dyads showed that both cohorts of teens reported significantly higher scores than their parents. Multivariable analyses on behavioral subscale scores demonstrated a number of variables that were significant predictors by parent report: group (ELBW vs control), gender, family function, developmental quotient, maternal mood, and socioeconomic status; no predictors were significant by teen report. There were no statistically significant interaction effects for any of the models. These models explained a greater percent of the variance in behavioral scores for parents than for teens (12.5%–22.0% vs 3.4%–8.2%). Results were similar when teens with neurosensory impairment were excluded.

Conclusions. This study is unique in the inclusion of both parent and teen self-report of behaviors. Significant differences were apparent only by parent report for ADHD and depression among ELBW teens. Significant predictors of behavioral scores for parents include group, gender, family function, developmental quotient, maternal mood, and socioeconomic status.

Key Words: extremely low birth weight • attention deficit hyperactivity disorder • psychopathology • social competence • prematurity • controls

Abbreviations: ELBW, extremely low birth weight • VLBW, very low birth weight • ADHD, attention-deficit/hyperactivity disorder • SES, socioeconomic status • SD, standard deviation • DQ, developmental quotient • OCHS-R, Ontario Child Health Study-Revised • DSM-III-R, Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised • SES, socioeconomic status • NSI, neurosensory impairment • ODD, oppositional defiant disorder


Received for publication Mar 21, 2002; Accepted Oct 8, 2002.




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