Psychological and psychophysiological functioning of young adults born preterm: The Helsinki Study of Very Low Birth Weight Adults
Year: 2012
Type: dissertation
Study design: Observational Study
Abstract: Improvements in neonatal intensive care during the last few decades have led to a remarkable improvement in the survival rates of preterm infants born with very low birth weight (< 1500 g; VLBW). However, VLBW may have a cost for the physical, psychosocial and cognitive development of the survivors. Nevertheless, there has been little research into the long-term consequences of VLBW that last till or emerge in adulthood. In addition, there have been relatively few studies on whether the adult outcomes of VLBW depend on sex or fetal growth. Within the Helsinki Study of Very Low Birth Weight Adults, we studied whether young adults with VLBW differ from term-born adults in psychological and psychophysiological functioning as well as in recollections of parenting, and whether potential group differences are modified by sex or intrauterine growth. The original cohort comprised 335 VLBW infants born between 1978 and 1985, treated at the Children s Hospital of Helsinki University Central Hospital, and discharged alive. A total of 373 infants born at term at the same birth hospitals were identified to form a control group. At the first follow-up visit in young adulthood (mean age 22.5 years), 166 VLBW (42.8% men) and 172 term-born control adults (40.1% men) participated. Of the VLBW participants, 33.1% were born small for gestational age (SGA; birth weight for gestational age < -2 SD), which was used as a crude indicator of poorer intrauterine growth. In conjunction with the first visit, the participants filled in questionnaires on personality, romantic attachment and the parenting behavior of their parents. In addition, blood pressure reactivity to psychosocial stress was measured in a subsample of 44 VLBW and 37 control adults. At the second follow-up visit, three years later (mean age 25.0 years), 113 VLBW (44.2% men; 37.2% SGA) and 105 control adults (42.9% men) participated, and their academic achievement was self-reported and neurocognitive abilities were tested. In addition, the parents of the participants filled in questionnaires on their own parenting behaviors. In comparison to the term-born adults, the VLBW adults scored lower in all the neurocognitive tests, and they had more often received remedial education, although they did not differ in years of education or in their grade point averages (Study I). The VLBW adults also showed a higher diastolic blood pressure reactivity to psychosocial stress (Study II). Sex and being born SGA modified the results concerning personality, romantic attachment and parenting. In the personality assessment, all the VLBW adults reported less fun seeking indicating less spontaneous eagerness for new, potentially rewarding actions, but only the VLBW-SGA women reported more behavioral inhibition than the term-born women (Study III). In relation to their romantic attachment style, the VLBW adults, with the exception of the VLBW-SGA women, reported less anxiety than the controls, indicating less concerns over being rejected by their partner. In contrast, the VLBW-SGA women reported increased attachment-related avoidance behavior (Study IV). In relation to parenting, the VLBW women reported that their mothers had been more protective and authoritarian than did women in the term-born group, but there were no group differences in parental care. The parents of the VLBW adults reported more supportive parenting than the parents of the term-born adults (Study V). In conclusion, we found that the VLBW adults differed from those born at term in all the areas of functioning included in the thesis. Of the VLBW adults, more alterations were found in women and in those with poor intrauterine growth. Overall, according to the results in young adulthood, VLBW may be related to vulnerabilities such as lower neurocognitive abilities and increased blood pressure reactivity; however, it may also give rise to potentially protective factors, such as higher parental involvement. Knowledge of the different vulnerabilities and protective factors could be utilized in planning interventions and optimal measures of support among preterm children and their families.
Source: Työväentutkimus Vuosikirja
Author: Riikka Pyhälä
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W1519587922