ARTICLE PEDIATRICS Volume 137, number 5, May 2016:e20152255 Emotional and Behavioral Problems of Preterm and Full- Term Children at School Entry Jorijn Hornman, BSc, a Andrea F. de Winter, PhD, a Jorien M. Kerstjens, MD, PhD, b Arend F. Bos, MD, PhD, b Sijmen A. Reijneveld, MD, PhD a abstract BACKGROUND AND OBJECTIVES: Preterm children, compared with term children, are at increased risk of emotional and behavioral problems (EB-problems). Prevalences of EB-problems seem to vary with degree of prematurity and age at assessment. We therefore assessed individual stability of EB-problems in preterm compared with term children first before school entry and again 1 year after school entry, and variation in stability within the preterm group. METHODS: We used data of 401 early preterm (25–31 weeks’ gestational age), 653 moderately preterm (32–35 weeks’ gestational age), and 389 term children from the Longitudinal Preterm Outcome Project cohort study. We classified EB-problems based on the Child Behavior Checklist at ages 4 and 5; this resulted in 4 categories: consistently normal (2 normal scores), emerging (normal score at age 4 and clinical/subclinical score at age 5), resolving, and persistent EB-problems. RESULTS: All preterm children had higher rates than term children of persistent (7.2% vs 3.6%), emerging (4.3% vs 2.3%), and resolving (7.5% vs 3.6%) EB-problems. Early preterm children had the highest rates of persistent (8.2%) and emerging (5.2%) problems, and moderately preterm children had the highest rates of resolving problems (8.7%). In both preterm and term children, predictive values of normal scores at age 4 for normal scores at age 5 were ∼96%, and of clinical/subclinical scores at age 4 for clinical/subclinical scores at age 5 were ∼50%, except for early preterm children (60%). CONCLUSIONS: Compared with term children, all preterm children are at risk for persistent and changing EB-problems at school entry; individual stability, however, is difficult to predict based solely on the factor of preterm-birth. Departments of a Health Sciences, University Medical Center Groningen, University of Groningen, Netherlands and b Neonatology, Beatrix Children’s Hospital, University Medical Center Groningen, Netherlands Ms Hornman conceptualized the study, designed and carried out the analysis, interpreted the data, and drafted the initial manuscript; Drs de Winter, Kerstjens, Bos, and Reijneveld conceptualized the study and analysis, interpreted the data, and critically reviewed and revised the manuscript; and all authors approved the final manuscript as submitted. This trial has been registered with the ISRCTN Register (http://isrctn.org) (identifier ISRCTN80622320). DOI: 10.1542/peds.2015-2255 Accepted for publication Feb 2, 2016 Address correspondence to Jorijn Hornman, BSc, Department of Health Sciences, University Medical Center Groningen, University of Groningen HP FA10, PO Box 196, 9700 AD Groningen, Netherlands. E-mail: j.hornman@umcg.nl To cite: Hornman J, de Winter AF, Kerstjens JM, et al. Emotional and Behavioral Problems of Preterm and Full-Term Children at School Entry. Pediatrics. 2016;137(5):e20152255 WHAT’S KNOWN ON THIS SUBJECT: Preterm children are at increased risk of emotional and behavioral problems compared with term children. Prevalences vary with degree of prematurity and assessment age. Unknown is whether stability of these problems at school entry differs between preterm and term children. WHAT THIS STUDY ADDS: Preterm children have higher rates of persistent and changing emotional and behavioral problems at school entry than do term children. Problems in early preterm children are more persistent and in moderately preterm children more resolving. by guest on June 7, 2020 www.aappublications.org/news Downloaded from