Abstract
Background
Preterm children are at higher risk of developing mental health problems than full-term children. Deterioration of children’s mental health was observed during COVID-19 pandemic restrictive measures. Our study compared emotional and attention-deficit/hyperactivity disorder (ADHD) symptoms during school closure between preterm and full-term children.
Methods
Data from two French birth cohorts—ELFE and EPIPAGE-2—were used. In 2011, infants born ≥22 weeks’ gestation were recruited. Parents completed the Strengths and Difficulties Questionnaire when the children were 9 years old and experiencing school closure. Multivariate multinomial logistic regression models were used.
Results
Subjects included 4164 full-term and 1119 preterm children. In univariate analyses, compared to full-term children: extremely and very preterm children more frequently had abnormal and borderline ADHD scores (odds ratio [OR] 1.86, 95% confidence interval [CI] 1.50–2.30, OR 1.42, 95% CI 1.08–1.85, respectively) and abnormal emotional scores (OR 1.86, 95% CI 1.43–2.40); moderate to late preterm children more often had abnormal ADHD scores (OR 1.33, 95% CI 1.01–1.78). The associations did not remain when previous symptoms at 5 years old were considered.
Conclusions
School closure during lockdown did not appear to increase the risk of mental health problems in preterm compared to full-term children.
Impact statement
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Preterm children are at higher risk of developing mental health problems than full-term children. Deterioration in children’s mental health was observed during COVID-19 pandemic restrictions. However, whether preterm children were a particularly vulnerable subgroup during school closure is unclear.
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In univariate analyses, extremely and very preterm children more often had abnormal and borderline ADHD symptoms and abnormal emotional symptom scores than full-term children. The associations did not remain significantly associated when previous symptoms were considered.
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Preterm compared to full-term children more often suffer from ADHD and emotional symptoms, but school closure during lockdown did not appear to increase this risk.
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Data availability
In regards to data availability, data of the study are protected under the protection of health data regulation set by the French National Commission on Informatics and Liberty (Commission Nationale de l’Informatique et des Libertés, CNIL). The data can be available upon reasonable request after a consultation with the steering com- mittee of the Sapris study. The French law forbids us to provide free access to Sapris data; access could however be given by the steering committee after legal verification of the use of the data.
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Acknowledgements
Agence Nationale de la Recherche (ANR, 0009/SAPRIS/997/NB), Fondation pour la Recherche Médicale, Direction Générale de la Recherche et de l’Innovation, Institut Gustave Roussy, the New-Aquitaine region.
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M.B. concept and design the study, interpreted the data and wrote the manuscript. M.M. did the statistical analysis, interpreted the data and revised the manuscript. F.M., X.T., S.V., S.M.C., B.F., T.S., B.G., L.M., M.N.D., M.A.C., P.Y.A., M.M., A.R., interpreted the data, critiqued the manuscript of important intellectual content and approved the final version of manuscript. C.G. concept and design the study, interpreted the data, and revised the manuscript. The SAPRIS group enrolled participants, collected the data, and revised the manuscript. Authors had access to all the data in the study and participated in the decision to submit.
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M.M. has been funded by the New-Aquitaine region (AMI Flash Recherche et Innovations COVID). The other authors have no competing interests to declare.
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Bailhache, M., Monnier, M., Moulin, F. et al. Emotional and attention-deficit/hyperactivity disorder symptoms of preterm vs. full-term children during COVID-19 pandemic restrictions. Pediatr Res 92, 1749–1756 (2022). https://doi.org/10.1038/s41390-022-02037-4
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DOI: https://doi.org/10.1038/s41390-022-02037-4
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