Photo Credit: Yobro10
The following is a summary of “Adverse Childhood Experiences and Socio-Emotional Outcomes of Children Born Very Preterm,” published in the October 2024 issue of Pediatrics by Bishop et al.
Adverse childhood experiences (ACEs) are associated with various negative outcomes, including socio-emotional challenges, particularly in children born very preterm (VPT).
Researchers conducted a prospective study to examine whether ACEs contribute to socio-emotional problems in children born with VPT.
They recruited 96 infants born VPT (23-30 weeks of gestation) from a level III neonatal ICU and followed them at ages 2 and 5 years. Additionally, 83 full-term (FT, 37-41 weeks of gestation) children were recruited from an obstetric service and the local community. The ACEs were assessed at age 2 using the Child Life Events Scale and at age 5 with the Preschool Age Psychiatric Assessment. Socio-emotional outcomes, including internalizing and externalizing problems as well as Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms, were measured using the Child Behavior Checklist and Conner’s Rating Scale-Revised. Covariates were evaluated for socioeconomic disadvantage, maternal distress, and parent ADHD symptoms at the 2- and/or 5-year follow-up.
The results showed that children born VPT experienced more ACEs (P<0.001), especially medical ACEs (P<0.01), and had worse ADHD and internalizing outcomes (P<0.05) compared to children with FT, ACEs mediated the association between birth group and ADHD outcomes (95% CIs: 0.11–4.08), but no evidence of mediation for internalizing outcomes. Higher parent ADHD symptoms (P<0.001) and maternal distress (P<0.05) were associated with poorer internalizing outcomes.
They concluded that screening for childhood ACEs should be integrated into the follow-up care of families of children born with VPT, highlighting the need to address parental psychosocial functioning to support children’s socio-emotional development.