Page 64 - Sample Moderate prematurity, socioeconomic status, and neurodevelopment in early childhood

Chapter 7
The main aim of this thesis was to determine the associations between moderate prematurity, SES, and pre-school neurodevelopmental problems, and to consider the underlying neurodevelopmental processes from a life course perspective. This chapter includes an overview of the main findings and a discussion of the findings in the light of the relevant literature. Finally, implications for clinical practice, policy, and research are given.
MAIN FINDINGS
Research question 1 (Chapter 2): Are moderate prematurity and low SES independently associated with developmental delay at pre-school age, or do they have joint effects?
We hypothesized that differences in SES could partially explain the association of moderate prematurity with developmental delay. Findings from multivariate logistic regression analyses showed that this was not the case: moderate prematurity and low SES had separate, multiplicative effects on developmental delay. Prevalence rates for overall developmental delay were 12.5% in MP children with low SES, compared to 2.8% in full-term children with high SES. In particular, the developmental domains fine motor skills, communication, and personal- social skills were affected in MP children. Neither moderate prematurity nor low SES was associated with delay in gross motor skills, and finally, low SES mainly explained the occurrence of problem-solving skills at the age of four years.
Research question 2 (Chapter 3): What is the prevalence of behavioural and emotional problems in four-year-old, moderately preterm-born children, compared to the prevalence in full-term children?
We found that the rates of behavioural and emotional problems were higher in MP children than in full-term children. MP children had poorer mean scores on all CBCL syndrome scales, i.e. emotionally reactive, anxious/depressed, somatic complaints, withdrawn, sleep problems, attention problems, and aggressive behaviour. They were also more likely to have scores in the clinical range, on total problems, externalizing problems, internalizing problems, and somatic complaints. Lastly, prevalence rates of behavioural and emotional problems differed by gender: overall the prevalence rates were higher among preterm-born boys and full-term boys, while being born moderately preterm affected girls more than boys.
114