Consequences of Prematurity on Cortisol Regulation and Adjustment Difficulties: A 9-Year Longitudinal Study

• Published in: Children (Basel) Vol. 9; no. 1; p. 9
• Main Authors: Urfer, Auriana, Turpin, Hélène, Dimitrova, Nevena, Borghini, Ayala, Plessen, Kerstin Jessica, Morisod Harari, Mathilde, Urben, Sébastien
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 24.12.2021; MDPI
• Subjects: Adjustment; Babies; Behavior; Children & youth; child’s behaviors problems; child’s emotional problems; Families & family life; follow-up; Gestational age; Hormones; HPA axis regulation; Influence; Intervention; Longitudinal studies; Mental disorders; Mothers; Newborn babies; Parents & parenting; Pediatrics; Post traumatic stress disorder; Premature birth; prematurity; follow-up; child’s behaviors problems; prematurity; HPA axis regulation; child’s emotional problems
• ISSN: 2227-9067; 2227-9067
• DOI: 10.3390/children9010009

A preterm birth represents a stressful event having potentially negative long-term consequences. Thirty-three children born preterm (<33 weeks gestational age) and eleven full-term children participated in a nine-year longitudinal study. Perinatal Risk Inventory (PERI) was used at birth to assess the perinatal stress. Salivary cortisol, collected four times a day over two consecutive days, was measured with radioimmunoassay technique at six months and nine years to assess the hypothalamic-pituitary-adrenal (HPA) axis. Mothers reported post-traumatic symptoms on a self-report questionnaire 12 months after their child's birth and children's adjustment problems at 9 years of child age on the Child Behavior Checklist. Results showed a significant difference in cortisol regulation at nine years between preterm and full-term children but no differences in adjustment problems. Whereas biological factors (i.e., PERI, cortisol regulation at six months) explained cortisol at nine years, maternal post-traumatic symptoms were predictive of adjustment problems in their child. In conclusion, very preterm birth has some long-term consequences on the HPA-axis regulation at nine years. Although cortisol regulation is mostly influenced by biological factors, the presence of maternal post-traumatic symptoms predicts the manifestation of adjustment problems in both groups. This shows the importance of maternal psychological well-being for child development. Further research is needed to understand the exact consequences of premature birth on cortisol regulation and the implication for the child's development and health.