RT Journal
A1 Whitaker AH, Feldman JF, Lorenz JM, et al
T1 NEonatal head ultrasound abnormalities in preterm infants and adolescent psychiatric disorders
JF Archives of General Psychiatry
JO Archives of General Psychiatry
YR 2011
FD July 1
VO 68
IS 7
SP 742
OP 752
DO 10.1001/archgenpsychiatry.2011.62
UL http://dx.doi.org/10.1001/archgenpsychiatry.2011.62
AB Context 
                  Infants born prematurely are at risk for a perinatal encephalopathy characterized by white and gray matter injuries that affect subsequent cortical development and neural connectivity and potentially increase risk for later psychiatric disorder.Objective 
                  To determine the relation of perinatal brain injury, as detected by neonatal head ultrasound, to psychiatric disorders in adolescents who were born prematurely.Design 
                  Prospective cohort.Setting 
                  Community.Participants 
                  Adolescent survivors of a population-based low-birth-weight (<2000 g; 96% preterm; born 1984-1987) cohort (n = 1105) screened as neonates with serial head ultrasounds. Neonatal head ultrasound abnormalities were categorized as either (1) germinal matrix and/or intraventricular hemorrhage or (2) parenchymal lesions and/or ventricular enlargement. Of 862 eligible survivors, 628 (72.9%) were assessed at age 16 years. The sample consisted of 458 nondisabled survivors assessed in person.Main Outcome Measure 
                  Adolescent current and lifetime psychiatric disorders assessed with parent report on the Diagnostic Interview Schedule for Children–IV.Results 
                  Compared with no abnormality, germinal matrix/intraventricular hemorrhage increased risk for current major depressive disorder (odds ratio, 2.7; 95% confidence interval, 1.0-6.8) and obsessive-compulsive disorder (9.5; 3.0-30.1). Parenchymal lesions/ventricular enlargement increased risk for current attention-deficit/hyperactivity disorder–inattentive type (odds ratio, 7.6; 95% confidence interval, 2.0-26.5), tic disorders (8.4; 2.4-29.6), and obsessive-compulsive disorder (7.6; 1.39-42.0). Parenchymal lesions/ventricular enlargement were not related to lifetime attention-deficit/hyperactivity disorder–inattentive type, but all other relations were similar for lifetime disorders. Control for other early risk factors did not alter these relations. Most of these relations persisted with control for concurrent cognitive or motor problems.Conclusion 
                  In preterm infants, 2 distinct types of perinatal brain injury detectable with neonatal head ultrasound selectively increase risk in adolescence for psychiatric disorders in which dysfunction of subcortical-cortical circuits has been implicated.