Behavioural and emotional outcome of very low birth weight infants--literature review.

OBJECTIVE: To examine whether low birth weight (LBW) children are at greater risk for behavioural and emotional problems than normal birth weight children.
METHODS: Electronic databases (PubMed, Google) were searched. Key search terms (LBW, emotional behavioural outcome) were used to identify possible studies. Selection of studies was limited to those including detailed assessment of behavioural and/or emotional outcome of very low birth weight or very preterm infants with normal term infants as controls, published from the year 2000 to date. A total of 20 studies were identified for inclusion in our review.
RESULTS: Overall studies showed a significant increase in behavioural problems in particular poor attention span, withdrawn behaviour and poorer adaptive functioning. Rates of a clinically significant neurobehavioural impairment in cases ranged from 25% to 55% with controls displaying a relatively constant rate of around 7%. Attention problems without hyperactivity (ADD) were more common than 'classical attention deficit/hyperactivity disorder' in LBW children. Only 4% of the LBW children had previously been referred to a consultant psychiatric suggesting that at present these problems are being under-recognised.
CONCLUSION: VLBW or very preterm infants are at significant risk of behavioural and emotional problems. The risk is further increased when cognitive or motor difficulties are present or when social circumstances are poor.