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Anxiety and depressive disorders in children born preterm: a meta-analysis


Fitzallen, GC and Sagar, Y and Taylor, HG and Bora, S, Anxiety and depressive disorders in children born preterm: a meta-analysis, Journal of developmental and behavioral pediatrics : JDBP, 42, (2) pp. 154-162. ISSN 1536-7312 (2021) [Refereed Article]

Copyright Statement

2021 Wolters Kluwer Health, Inc

DOI: doi:10.1097/DBP.0000000000000898


Objective:Preterm birth is associated with a high prevalence of psychiatric disorders including internalizing problems. However, there is a lack of consensus on the risk for depression and on specific diagnostic profiles. This meta-analysis investigates the independent pooled odds of Diagnostic and Statistical Manual of Mental Disorders Fourth Edition anxiety and depressive disorders in children between 3 and 19 years of age born preterm compared with their term-born peers.

Methods:PubMed/MEDLINE, PsycINFO, and Cumulative Index to Nursing and Allied Health Literature electronic databases were searched (last updated in September 2019) using population ("child"), exposure ("preterm birth"), and outcome ("anxiety") terms for English peer-reviewed publications. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed with the risk of bias assessed using the Newcastle-Ottawa Quality Assessment Scale. Pooled odds ratio (OR) with 95% confidence intervals (CIs) was estimated using fixed-effects models.

Results:Eleven independent studies met the inclusion criteria. The pooled sample comprised 1294 preterm and 1274 term-born children with anxiety outcomes and 777 preterm and 784 term-born children with depressive outcomes between 3 and 19 years of age. Children born preterm had significantly greater odds for anxiety (OR: 2.17; 95% CI, 1.43-3.29), generalized anxiety (OR: 2.20; 95% CI, 1.26-3.84), and specific phobia (OR: 1.93; 95% CI, 1.05-3.52) relative to their term-born peers. There were no significant between-group differences for reported depressive disorders.

Conclusion: Preterm birth is associated with a higher prevalence of anxiety, but not depressive disorders, from 3 to 19 years of age, suggesting distinct etiological pathways in this high-risk population. The findings support variation in the rates of specific anxiety diagnoses, indicating the need to extend neurodevelopmental surveillance to encompass a holistic emotional screening approach.

Item Details

Item Type:Refereed Article
Keywords:Preterm birth, Anxiety, Depression, Child, Meta-analysis
Research Division:Psychology
Research Group:Clinical and health psychology
Research Field:Clinical psychology
Objective Division:Health
Objective Group:Specific population health (excl. Indigenous health)
Objective Field:Neonatal and child health
UTAS Author:Fitzallen, GC (Dr Grace Fitzallen)
ID Code:153502
Year Published:2021
Web of Science® Times Cited:6
Deposited By:Psychology
Deposited On:2022-09-21
Last Modified:2022-11-29

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