145 - Extremely Preterm Adolescents: Behavioral Outcomes In Multiple Versus Singleton Births

Sunday, April 30, 2023

3:30 PM – 6:00 PM ET

Poster Number: 145
Publication Number: 145.362

Laura N. Reniker, University of North Carolina at Chapel Hill School of Medicine, Nashville, NC, United States; Ali Oran, University of North Carolina, Gillings School of Global Public Health, Chapel Hill, NC, United States; Jean A. Frazier, University of Massachusetts Chan Medical School, Worcester, MA, United States; DAVID M. COCHRAN, UMass Chan Medical School, WORCESTER, MA, United States; Rebecca Fry, UNC-Chapel Hill, Chapel Hill, NC, United States; Steven L. Pastyrnak, Michigan State University College of Human Medicine, Ada, MI, United States; Sohye Kim, University of Massachusetts Chan Medical School, Worcester, MA, United States; Michael O'Shea, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, United States

Presenting Author(s)

Laura N. Reniker, MD

Assistant Professor
University of North Carolina at Chapel Hill School of Medicine
Nashville, North Carolina, United States

Background:

Multifetal pregnancies account for approximately 3% of births in the United States; in contrast, in a large cohort of individuals born extremely preterm, about one-third were born to a multifetal pregnancy. Few studies of behavioral problems of adolescents born extremely preterm have compared outcomes of offspring of singleton (S) versus multifetal (M) pregnancies.

Objective:

To compare behavioral outcomes at 15 years of age of offspring of S versus M pregnancies.

Design/Methods: Study participants were enrolled at birth, 2002-2004, at one of 14 U.S. hospitals. Plurality was determined by a review of maternal medical records during the perinatal period. Of the 1,196 participants alive at 15 years of age, 642 (54%) were evaluated with the Mini-International Neuropsychiatric Interview for Children and Adolescents (MINI-KID) and the Achenbach Youth Self-Report and Child Behavior Checklist (CBCL). Two hundred thirty-seven participants were born to multifetal pregnancies and 405 to singleton pregnancies. Categorical outcomes were compared using chi squared tests and continuous measures were compared using 2-sample t-tests.

Results: Offspring of M pregnancies were more often born to mothers who were White race (80% vs 59%), over 21 years of age (96% vs 83%), married (78% vs 57%), and college graduates (55% vs 33%). Neonatal factors and the proportion of mothers with a history of psychiatric illness were similar for offspring of S versus M pregnancies. Rates of anxiety (S: 24%; M: 22%) and depression (S: 18%; M: 16%) were similar for offspring of S and M pregnancies. Also similar were self-reported T-scores for anxiety symptoms, presented as median (interquartile range in square brackets): (S:51 [50, 57]; M:51 [50, 56]); attention problems (S: 54 [50, 60]; M:51 [50, 54]); aggressive symptoms (S: 50 [50, 52]; M: 50 [50, 51]); and the CBCL behavioral dysregulation profile: (S: 158 [151, 173]; M: 153 [150, 163]). Similar findings were obtained from parent-reported anxiety symptoms and the CBCL behavioral dysregulation profile.

Conclusion(s):

In a large multi-center cohort of adolescents born extremely preterm, individuals born after multifetal pregnancies had behavioral outcomes similar to those born after singleton pregnancies.