Dataset Information

Mental Disorders Among Mothers of Children Born Preterm: A Population-Based Cohort Study in Canada.

ABSTRACT:

Background

Our aim was to examine the association between preterm delivery and incident maternal mental disorders using a population-based cohort of mothers in Canada.

Methods

Retrospective matched cohort study using Manitoba Centre for Health Policy (MCHP) administrative data in Manitoba. Mothers who delivered preterm babies (<37 weeks gestational age) between 1998 and 2013 were matched 1:5 to mothers of term babies using socio-demographic variables. Primary outcome was any incident mental disorder within 5 years of delivery defined as any of (a) mood and anxiety disorders, (b) psychotic disorders, (c) substance use disorders, and (d) suicide or suicide attempts. Multivariable Poisson regression model was used to estimate the 5-year adjusted incidence rate ratios (IRRs).

Results

Mothers of preterm children (N = 5,361) had similar incidence rates of any mental disorder (17.4% vs. 16.6%, IRR = 0.99, 95% CI, 0.91 to 1.07) compared to mothers of term children (N = 24,932). Mothers of term children had a higher rate of any mental disorder in the first year while mothers of preterm children had higher rates from 2 to 5 years. Being the mother of a child born <28 week (IRR = 1.5, 95% CI, 1.14 to 2.04), but not 28-33 weeks (IRR = 1.03, 95% CI, 0.86 to 1.19) or 34-36 weeks (IRR = 0.96, 95% CI, 0.88 to 1.05), was associated with any mental disorder.

Interpretation

Mothers of preterm and term children had similar rates of incident mental disorders within 5-years post-delivery. Extreme prematurity was a risk factor for any mental disorder. Targeted screening and support of this latter group may be beneficial.

SUBMITTER: Louis D

PROVIDER: S-EPMC10192828 | biostudies-literature | 2023 May

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Mental Disorders Among Mothers of Children Born Preterm: A Population-Based Cohort Study in Canada.

Louis Deepak D Akil Hammam H Bolton James M JM Bacchini Fabiana F Netzel Karen K Oberoi Sapna S Pylypjuk Christy C Flaten Lisa L Cheung Kristene K Lix Lisa M LM Ruth Chelsea C Garland Allan A

Canadian journal of psychiatry. Revue canadienne de psychiatrie 20221122 5

<h4>Background</h4>Our aim was to examine the association between preterm delivery and incident maternal mental disorders using a population-based cohort of mothers in Canada.<h4>Methods</h4>Retrospective matched cohort study using Manitoba Centre for Health Policy (MCHP) administrative data in Manitoba. Mothers who delivered preterm babies (<37 weeks gestational age) between 1998 and 2013 were matched 1:5 to mothers of term babies using socio-demographic variables. Primary outcome was any incid ...[more]

PMID: 36412096

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Project description:ImportanceChildren born preterm may experience learning challenges at school. However, there is a paucity of data on the school readiness of these children as they prepare to begin grade 1.ObjectiveTo examine the association between prematurity and school readiness in a population-based cohort of children.Design, setting, and participantsThis cohort study was conducted in the province of Manitoba, Canada, and involved 2 cohorts of children in kindergarten at the time of data collection. The population-based cohort included children born between January 1, 2000, and December 31, 2011, whose school readiness was assessed in kindergarten using the Early Development Instrument (EDI) data. The sibling cohort comprised children born preterm and their closest-in-age siblings born full term. Data were analyzed between March 12 and September 28, 2021.ExposuresPreterm birth, defined as gestational age (GA) less than 37 weeks.Main outcomes and measuresThe primary outcome was vulnerability in the EDI, defined as a score below the tenth percentile of the Canadian population norms for any 1 or more of the 5 EDI domains (physical health and well-being, social competence, emotional maturity, language and cognitive development, and communication skills and general knowledge). Logistic regression models were used to identify the factors associated with vulnerability in the EDI. P values were adjusted for multiplicity using the Simes false discovery method.ResultsOf 86 829 eligible children, 63 277 were included, of whom 4352 were preterm (mean [SD] GA, 34 [2] weeks; 2315 boys [53%]) and 58 925 were full term (mean [SD] GA, 39 (1) weeks; 29 885 boys [51%]). Overall, 35% of children (1536 of 4352) born preterm were vulnerable in the EDI compared with 28% of children (16 449 of 58 925) born full term (adjusted odds ratio [AOR], 1.32; 95% CI, 1.23-1.41; P < .001]). Compared with children born full term, those born preterm had a higher percentage of vulnerability in each of the 5 EDI domains. In the population-based cohort, prematurity (34-36 weeks' GA: AOR, 1.23 [95% CI, 1.14-1.33]; <34 weeks' GA: AOR, 1.72 [95% CI, 1.48-1.99]), male sex (AOR, 2.24; 95% CI, 2.16-2.33), small for gestational age (AOR, 1.31; 95% CI, 1.23-1.40), and various maternal medical and sociodemographic factors were associated with EDI vulnerability. In the sibling cohort, EDI outcomes were similar for both children born preterm and their siblings born full term except for the communication skills and general knowledge domain (AOR, 1.39; 95% CI, 1.07-1.80) and Multiple Challenge Index (AOR, 1.43; 95% CI, 1.06-1.92), whereas male sex (AOR, 2.19; 95% CI, 1.62-2.96) and maternal age at delivery (AOR, 1.53; 95% CI, 1.38-1.70) were associated with EDI vulnerability.Conclusions and relevanceResults of this study suggest that, in a population-based cohort, children born preterm had a lower school-readiness rate than children born full term, but this difference was not observed in the sibling cohort. Child and maternal factors were associated with lack of school readiness among this population-based cohort.

Project description:BackgroundExposure to illicit substances during pregnancy may have long-term impacts on children's neurodevelopment. This study explores subsequent risks for intellectual disability, autistic disorders, and attention deficit and hyperactivity disorders in children born to mothers exposed to illicit substances before or during pregnancy.MethodsWe identified women with illicit drug use by linking the police records from the "Substance Abuse Control Databases" and Taiwan Birth Registration and Birth Notification records from 2004 to 2014. Children whose mothers that had exposed to illicit substances during pregnancy identified from the police records were the "substance-exposed cohort." A 1:1 ratio exact-matched comparison cohort based on child's gender, child's birth year, mother's birth year, and child's first use of the health insurance card, as well as a "propensity score (PS)-matched" comparison cohort of children born by substance-unexposed mothers, was established. Multivariate Cox regression analyses with competing risk models were performed.ResultsHigher incidences of intellectual disability (adjusted hazard ratio (aHR) = 2.41, 95% confidence interval (CI): 1.15-5.03) and attention deficit and hyperactivity disorder (ADHD) (aHR = 2.35, 95% CI: 1.63-3.28) were found in children prenatally exposed to illicit substances during pregnancy compared to exact-matched non-exposed cohorts. Adjusted risks of ADHD were significantly higher in mothers exposed to substances during pregnancy (aHR = 1.77 (1.42-2.21)) and before pregnancy (aHR = 1.43 (1.14-1.80)) compared to PS-matched unexposed cohorts after adjusting for covariates.ConclusionsThis is one of the first studies using large population-based data linked to criminal records to reveal increased risks of intellectual disability and ADHD in children with prenatal exposure to illicit substances compared to matched unexposed controls. Our results also highlight the importance of preventive measures and interventions for the well-being of both the mother and the child.

Dataset Information

Mental Disorders Among Mothers of Children Born Preterm: A Population-Based Cohort Study in Canada.

Background

Methods

Results

Interpretation

Publications

Mental Disorders Among Mothers of Children Born Preterm: A Population-Based Cohort Study in Canada.

Similar Datasets

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