Childhood Precursors of Social Relationships, Health and Wealth in Preterm Born Adults

• In Event: The Relevance of Typical and At-Risk Development for Adult Outcomes

Abstract

Evidence suggests that preterm born adults are at risk for problems across multiple real-life outcomes, including social relationships, health, and wealth that may affect long-term well-being and life success. However, it is not known whether childhood factors, such as disability, mental health, academic achievement and social function predict these adult outcomes.

A prospective longitudinal cohort of individuals born very preterm (VP; <32 weeks gestation) or with very low birth weight (VLBW; <1500g birth weight) VP/VLBW N:260) and term controls (full term; N:229) were studied at birth, 6 times between 5 months and 13 years and at age 26 years. Adult outcomes were assessed with multiple measures including a Life Course interview at 26 years and direct measures of IQ (Wechsler Scales), questionnaires and standard mental health interviews for diagnoses. The adult measures were combined into overall indices of partner relationships (8 items; e.g. never had a romantic relationship), peer relationships (14 items; e.g. troubles making or keeping friends); parent relationships (6 items; stressful conflicts with parents); health (19 items; current DSM-IV mood and anxiety disorder) and wealth (10 items; fails to pay debts or meet financial responsibilities). All adult measures were standardised according to the fullterm controls. Childhood assessments included neurosensory disabilities (e.g. IQ<70, blind, deaf or cerebral palsy), academic achievement (6 measures), mental health (four measures), and parent-child (three measures) and peer relationships (eight measures).

Compared to term born controls, adults born preterm had worse partner and peer relationships, more health problems, and lower wealth compared to full term controls (see Figure 1; zero line indicates the fullterm controls). In contrast, no differences of VP/VLBW in their relationship to their parents were found.
Childhood academic achievement and parent-child relationships predicted multiple outcomes in adulthood (Figure 2). In contrast, prematurity (VP/VLBW) and childhood peer relationships were additional unique contributors to poor partner relationships in adulthood. Disability in childhood neither predicted social relationships or wealth in adulthood uniquely but contributed to health status in adulthood. Academic achievement and parent-child relationships in childhood where the most consistent and strongest childhood factors associated with health, wealth and social relationships in adulthood.

VP/VLBW show good relationships to parents in adulthood despite their early care incubators and separation from parents. High academic achievement and sensitive parent-child relationships are associated with adult health, wealth and social relationships, regardless of preterm or disability status. The findings emphasise the importance of fostering good parent-child relationships and educational achievement for all children in childhood whether born preterm or full term.

Authors

• Dieter F H Wolke, University of Warwick
  Presenting Author

• Nicole Baumann, University of Leicester

• Peter Bartmann, University of Bonn