Sibling Comparisons Reveal Consequences of Preterm Births An unprecedented study suggests that only some of the problems previously associated with preterm birth are actually caused by preterm birth itself. The study, published Sept. 25 in JAMA Psychiatry confirms the strong link between preterm birth and the risk of infant and young adult death, autism and ADHD. But ... Research in Brief
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Research in Brief  |   December 01, 2013
Sibling Comparisons Reveal Consequences of Preterm Births
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Special Populations / Autism Spectrum / Attention, Memory & Executive Functions / Research in Brief
Research in Brief   |   December 01, 2013
Sibling Comparisons Reveal Consequences of Preterm Births
The ASHA Leader, December 2013, Vol. 18, 38. doi:10.1044/leader.RIB5.18122013.38
The ASHA Leader, December 2013, Vol. 18, 38. doi:10.1044/leader.RIB5.18122013.38
An unprecedented study suggests that only some of the problems previously associated with preterm birth are actually caused by preterm birth itself. The study, published Sept. 25 in JAMA Psychiatry confirms the strong link between preterm birth and the risk of infant and young adult death, autism and ADHD. But it also suggests that other threats that have been closely tied to the issue—such as severe mental illness, learning problems, suicide and economic woes—may, instead, be more closely related to other conditions in a family.
In what is thought to be the largest population-based study of preterm births to date, Indiana University-Bloomington researchers, led by Brian D’Onofrio, looked at records of 3.3 million children born in Sweden between 1973 and 2008. Using a sibling-comparison approach and considering a broad continuum of premature gestational ages, the study examined the associations between preterm birth and mortality, psychological health, educational outcomes and social functioning.
The results are somewhat consistent with previous studies that compare preterm infants to unrelated non-preterm infants. Unlike those efforts, however, the current study also compared preterm infants to their non-preterm siblings and cousins—an approach that made it possible to control for and hold constant everything those siblings share: mothers and fathers, socioeconomic status, and some genetic factors.
When the researchers looked at infant and young adult mortality, as well as autism and ADHD, the results were the same when comparing siblings as when they compared preterm infants to unrelated non-preterm individuals.
In other areas, however, the results are strikingly different from previous findings. The association between preterm birth and severe mental illness, such as schizophrenia or bipolar disorder, was greatly reduced when comparing siblings. Both siblings had higher chances of severe mental illness than the general population. For suicide, the findings are even more dramatic. Although individuals born preterm are more likely to attempt suicide than unrelated individuals who were not born preterm, no distinction exists between siblings.
“The study confirms the degree to which preterm birth is a major public health concern and strongly supports the need for social services that reduce the incidence of preterm birth,” D’Onofrio said. “Yet, the findings also suggest the need to extend services to all siblings in families with an offspring born preterm. In terms of policy, it means that the entire family, including all of the siblings, is at risk.”
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December 2013
Volume 18, Issue 12