Objective: To examine behavioral and social-emotional problems in extremely low birth weight (ELBW) children and to assess factors associated with behavioral and social competency outcomes at 30 to 36 months adjusted age.
Study design: A total of 696 ELBW (401 to 1000 g) children from the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network were included. Behavioral and social-emotional problems were assessed using the Brief Infant-Toddler Social and Emotional Assessment administered to parents. Unadjusted comparisons were performed between children with or without behavioral or social-emotional problems. Logistic regression was used to examine factors associated with behavioral outcomes.
Result: Parents reported behavioral problems in 46.8%, deficits in social-emotional competence in 20.4% and having both behavioral and social-emotional competence problems in 15.4% of ELBW children. Characteristics associated with behavioral problems in logistic regression included female gender, lower household income and a Bayley Psychomotor Developmental Index (PDI)<70. Deficits in social competence were associated with Bayley Mental Developmental Index (MDI) and PDI scores<70 and Hispanic or Other races compared with White non-Hispanic.
Conclusion: Half of the (51.9%) ELBW children showed behavioral or social-emotional competence problems at 30 months. Low socioeconomic status and low Bayley MDI and PDI scores were associated with behavioral and socioemotional difficulties.