Study examines preterm births

When infants are born before their due date, they are more likely to have psychological disorders than babies who spent a full nine months in the womb.

But IU researchers have found many correlations between these disorders and preterm birth are weaker than what’s commonly believed.

A study revealed that while disorders such as ADHD and autism are directly related to preterm birth, this is not the case for other disorders.

Mental illnesses like schizophrenia and bipolar disorder have been found to be more influenced by environment and other external factors than by early birth.

“There are many factors that influence whether a child who was born premature will later develop problems,” lead researcher Dr. Brian D’Onofrio said. “This includes medical, social, psychological, economic and educational resources.”

The study compared siblings in families where one of the children was born preterm.

D’Onofrio said the comparison revealed contributors that siblings share, suggesting psychological problems stemmed from problems in the family.

“One of our key findings identifies that all siblings in a family where one child was born preterm are at risk for some of the psychological, educational and economic problems that have been correlated with preterm birth,” he said. “The assumption that preterm birth causes all of these outcomes suggests the patient’s siblings do not need services.

“Our research, however, indicates that the entire family needs wraparound services to help prevent later problems.”

According to the Centers for Disease Control, preterm births affect up to half a million babies a year in the United States, which amounts to one out of every nine births.

The trend costs the U.S. health care system more than $26 billion each year.

It could begin to cost more when families seek the proper treatment they once thought they didn’t need.

The CDC says preterm birth often happens because women are unaware of the risks of everyday habits.

Quitting smoking and drinking during pregnancy can eliminate a large portion of the preterm population.

But Dr. D’Onofrio said it’s not always that easy. There are other factors to consider, and they can be much more complex.

“Preterm birth is a complex trait, meaning it is influenced by multiple genetic and environmental factors,” he said. “There are many risks for preterm birth, including poverty, poor prenatal care and infections, to name just a few.”

IU psychology professor Irene Vlachos-Weber said the research could give important insight into how the brain is affected by early birth.

“In ADHD the executive functioning is affected, which lies in the frontal cortex of the brain, which is the last part to develop,” she said. “Preterms are missing out on important development in-utero.”

She said the study could change how preterms are treated in the future.

“It could give us important information about prevention and what biological treatments need to be administered,” she said. “It would be helpful to learn what behaviors need to be strengthened in these individuals.”

Subjects born between 23 and 27 weeks were found to have a three times greater risk for autism and a two times greater risk for developing ADHD.

Although these findings were somewhat suspected, the research came with a surprise.

Early gestation was associated with a 50 percent decrease in risk of substance abuse and a 30 percent decrease in risk of criminality.

D’Onofrio said he’s not sure why.

“Those findings were unexpected, although a lot of the past research on preterm birth with these outcomes has been mixed,” he said. “Perhaps the consequences of preterm birth influence family dynamics so that the children are less likely to engage in such behaviors. Future research is needed to further understand this phenomenon.”

Follow reporter Ashley Jenkins on Twitter @ashmorganj.