How Does Being Born Extremely Early Affect Mental Health in Young Adulthood?

What you need to know

• Adults born extremely preterm or with extremely low birthweight had similar mental health outcomes at age 25 compared to those born at full term.
• Rates of ADHD decreased from late adolescence to young adulthood in both groups.
• Anxiety and depression became more common from ages 18 to 25 for all participants, regardless of birth status.

Background

Babies born extremely early (before 28 weeks of pregnancy) or at an extremely low birthweight (less than 1000 grams or about 2.2 pounds) face many health challenges. In the past, studies have shown these babies may be at higher risk for mental health issues as they grow up. However, neonatal care has improved dramatically since the 1990s, allowing more of these vulnerable infants to survive. This study aimed to see how young adults born extremely preterm or with extremely low birthweight in the early 1990s are doing in terms of their mental health compared to those born at full term.

The Study

Researchers followed two groups of people born in Australia in 1991-1992:

1. 297 survivors born extremely preterm or with extremely low birthweight
2. 260 people born at normal birthweight (over 2500 grams or about 5.5 pounds)

They assessed the mental health of these individuals at ages 18 and 25 using questionnaires and clinical interviews. The study looked at several mental health conditions:

• Attention-deficit/hyperactivity disorder (ADHD)
• Anxiety disorders
• Mood disorders (like depression)
• Substance use disorders

Key Findings

Similar Mental Health Outcomes at Age 25

Surprisingly, the study found that at age 25, there were very few differences in mental health between those born extremely preterm/low birthweight and those born at full term. The rates of mental health conditions were similar between the two groups:

• ADHD: 7% vs. 5%
• Anxiety disorders: 32% vs. 27%
• Mood disorders: 38% vs. 35%
• Substance use disorders: 12% vs. 14%

These results are encouraging, suggesting that being born extremely early or at a very low weight does not necessarily lead to worse mental health outcomes in young adulthood.

Changes from Late Adolescence to Young Adulthood

The study also looked at how mental health changed for both groups between ages 18 and 25. Some interesting patterns emerged:

1. ADHD rates decreased for everyone Both groups saw a decline in ADHD diagnoses as they moved from late adolescence to young adulthood. This matches what we know about ADHD often improving with age.

2. Anxiety and depression became more common For all participants, regardless of birth status, generalized anxiety disorder and major depressive episodes became more frequent between ages 18 and 25. This increase in mood and anxiety issues is common during the transition to adulthood.

3. Substance use disorders remained low Rates of substance use disorders were relatively low in both groups and didn’t change much over time.

What This Means

These findings are quite positive for individuals born extremely preterm or at extremely low birthweight. Despite their challenging start in life, by young adulthood, their mental health outcomes were very similar to those born at full term. This suggests that improvements in neonatal care since the 1990s may be having long-term benefits for these vulnerable infants.

However, it’s important to note that mental health challenges were relatively common for all young adults in the study, regardless of their birth status. About one-third of participants in both groups experienced anxiety or mood disorders. This highlights the need for mental health support and resources for all young adults during this important transition period.

Limitations and Future Research

While this study provides valuable insights, there are some limitations to consider:

1. Some participants were lost to follow-up over time, which could potentially bias the results.
2. The study relied on self-reported symptoms, which may not always match clinical diagnoses.
3. The research was conducted in Australia, so the results may not apply equally to other countries with different healthcare systems.

Future studies could explore:

• Why some individuals born extremely preterm/low birthweight have better mental health outcomes than others
• The long-term effects of specific neonatal care practices on mental health
• How family and social support influence mental health outcomes for those born extremely preterm

Conclusions

• Young adults born extremely preterm or with extremely low birthweight had similar mental health outcomes to those born at full term.
• Mental health patterns from late adolescence to young adulthood were comparable between the two groups.
• While these results are encouraging, mental health support remains important for all young adults as they transition to adulthood.