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The prenatal environment can exert important effects on mental health. While much research has linked low birth weight to psychopathology, the intrauterine environment associated with high birth weight (macrosomia; > 4000 g) is also sub-optimal and may increase risk. Given the increasing prevalence of macrosomic births, understanding the mental health outcomes of infants born macrosomic can help refine theories of etiology, predict disorder, and target preventive interventions. Using data from the 2014 Ontario Child Health Study (OCHS), we examined the risk for psychiatric disorders in adolescents born macrosomic. Youth (N = 2151) aged 12–17 years completed the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID). Rates of common mental disorders assessed by the MINI-KID were compared between those born at normal birth weight (NBW; 2500–4000 g, n = 1817) and adolescents born macrosomic (> 4000 g, n = 334). These associations were then adjusted for participant age, sex, socioeconomic status (SES) of the family, parental mental health, and gestational diabetes mellitus. After adjustment for covariates, adolescents born macrosomic had higher odds of conduct disorder (CD; OR = 3.19, 95% CI: 1.37–7.43), oppositional defiant disorder (ODD; OR = 1.79, 95% CI: 1.11–2.91), and ADHD (OR = 1.77, 95% CI: 1.21–2.80). Moderation analyses revealed that males born macrosomic were more likely to have psychiatric problems than their female peers. Socioeconomic disadvantage also amplified the risk posed by macrosomia for ODD, ADHD, major depressive disorder, and generalized anxiety disorder. In this study, macrosomia was associated with an increased risk of clinically significant externalizing problems in adolescence, most notably among boys and those facing socioeconomic disadvantage. [ABSTRACT FROM AUTHOR]

Objective Extremely low birth weight (ELBW; <1000 g) survivors are exposed to significant perinatal adversity. In many cases, mothers of these infants receive antenatal corticosteroids (ACS), which reduce offspring neonatal mortality but may have lasting neuropsychiatric effects. However, the long-term neurophysiological effects of being born at ELBW and exposed to ACS are unknown. Methods We compared resting frontal electroencephalogram (EEG) alpha asymmetry in ELBW survivors ( n  = 51), some of whom were exposed to antenatal corticosteroids (ELBW-S; n  = 23) versus non-exposed (ELBW-NS; n  = 28), and normal birth weight controls (NBW; n  = 66) in adulthood (m age  = 32.3 years). Results ELBW survivors exhibited greater relative right frontal EEG alpha (11.5 to 13.5 Hz) asymmetry at rest relative to NBW controls. A linear relation was observed between increased exposure to perinatal adversity (NBW vs. ELBW-NS vs. ELBW-S) and greater relative right frontal asymmetry. Relative right frontal asymmetry was also linked to contemporaneous psychopathology in all individuals. Conclusion In the fourth decade of life, exposure to perinatal adversity was associated with patterns of frontal brain activity that reflect risk for psychopathology. Exposure to additional physiological stresses such as antenatal corticosteroids may amplify these effects. Significance The mental health of ELBW survivors, particularly those exposed to antenatal corticosteroids, should be monitored into adulthood. [ABSTRACT FROM AUTHOR]

Background: Preterm birth is associated with an increased risk of depression and anxiety, but it is not known if this is due to greater exposure to risk, or if perinatal adversity amplifies the impact of traditional risk factors. This study sought to determine if exposure to perinatal adversity modifies associations between traditional risk and resilience factors and depression and anxiety in adulthood. Methods: A sample of 142 extremely low‐birth‐weight (ELBW < 1,000 g) survivors and 133 sociodemographically matched normal birth weight (NBW) control participants was followed longitudinally to 22–26 years of age. Separate postnatal risk and resilience scales were created using eight risk and seven resilience factors, respectively. Depression and anxiety were assessed using the internalizing scale of the Young Adult Self‐Report (YASR). This scale was also dichotomized at the 90th percentile to define clinically significant psychopathology. Results: While the average number of risk exposures did not differ between groups, ELBW survivors were more susceptible to risk than NBW control participants. For the ELBW group, each additional risk factor resulted in a 2‐point increase in internalizing scores, and two and a half times the odds of clinically significant internalizing symptoms (OR = 2.47, 95% CI = 1.63, 3.76). The protective effect of resiliency factors was also blunted among ELBW survivors. Conclusions: Extremely low‐birth‐weight survivors may be more sensitive to traditional risk factors for psychopathology and less protected by resiliency factors. Intervention strategies aimed at preventing or reducing exposure to traditional childhood risk factors for psychopathology may reduce the burden of mental illness in adult survivors of prematurity. [ABSTRACT FROM AUTHOR]