With the first newsletter of 2013 we would like to present two publications by Mr James Hall and Ms Julia Jäkel, two researchers of the Bavarian Longitudinal Study.

Preterm birth and small for gestational age birth as risk factors for emotional problems between 6 and 13 years of age.

(Source:  Hall J and Wolke D, A comparison of prematurity and small for gestational age as risk factors for age 6–13year emotional problems, Early Human Development. 2012 88(10): 797-804 doi: 10.1016/j.earlhumdev.2012.05.005)

This work examined the occurrence of emotional problems between 6 and 13 years of age in our study group. Of particular interest was the comparison between pretermborn and smallforgestationalage (birth weight below the 10th percentile) children. For ages 6 and 8 years, data from the Child Behavior Checklist were used. This is a behavioural questionnaire on problems such as anxiety, depression, physical complaints, social withdrawal, sleep problems, attention problems, and aggressive behaviour. At age 13, the Strengths and Difficulties Questionnaire was used. This is a questionnaire on behavioural problems and strengths in children and adolescents, covering emotional problems, behavioural problems, hyperactivity, peer problems, and prosocial behaviour.

Results: For the age span 6–13 years, two different patterns of emotional problems over time were identified:

1. 76% of the children showed a consistently low level of problems over the years.

2. The remaining 24% of the children showed a consistently high level of problems over the years.

The pattern of consistently high emotional problems from ages 6 to 13 was found significantly more frequently in pretermborn children. In contrast, no association with smallforgestationalage birth was found. In addition, this group contained more male children and children from families with low socioeconomic status.

Conclusion:

The observed stability of emotional problems between 6 and 13 years once again makes clear that very pretermborn children need particularly early intervention therapies. Further analyses are attempting to identify which environmental factors may be modifiable to explain increased emotional problems in pretermborn children.

Genderspecific effects of preterm birth and smallforgestationalage birth on attention problems at age 6

(Source: Hall, J, J Jaekel, and D Wolke, Gender Distinctive Impacts of Prematurity and Small for Gestational Age (SGA) on Age-6 Attention Problems, Child and Adolescent Mental Health 2012 17 (4): 238–45 doi: 10.1111/j.1475-3588.2012.00649.x)

For this work, pretermborn and smallforgestationalage (birth weight below the 10th percentile) children in our study group were compared at age 6. For this, the data from the Child Behavior Checklist (see above) were used again in addition to data from the Tester’s Rating of Child Behavior. The latter is an observational questionnaire in which the examiner rates, among other things, the child’s adaptability, mood, activity, attention, and persistence.

Results:

Although preterm birth and smallforgestationalage birth are known risk factors for attention problems in childhood, the mechanism of this effect remains unclear. In children born small for gestational age, an attention problem at age 6 correlates with reduced head circumference (brain volume). In contrast, preterm birth at the same age leads to effects due to altered brain function. Attention problems after preterm and/or smallforgestationalage birth occur less often in girls than in boys but are more pronounced when they occur after smallforgestationalage birth.

Conclusion:

Early interventions should aim to improve the postnatal growth of the brain. This could be expected to reduce later attention problems. These investigations again show that gender differences should absolutely be taken into account when analysing preterm and smallforgestationalage children in middle childhood.

The full publications can be read on our website www.bayerische-entwicklungsstudie.de under the menu item “Publications”.

News from the study team:

The research by Dr Jäkel, one of our researchers, is supported by funds from the German Research Foundation since 1 January 2013. This is a great recognition of her work and makes us proud.

Additional funding to better understand learning problems and mathematical abilities after preterm birth, which also includes the BLS study, has been obtained since the beginning of 2013 from the Nuffield Foundation (Director Prof. D. Wolke; http://www.nuffieldfoundation.org/impact-premature-birth-maths-achievement-and-schooling).

Mr James Hall, from the study group in England, is leaving the team. With his publications he was able to complete his assignment. Dr Suna ErygitMadwamuse has taken on a new position for the data analyses of BLS.

There have also been changes in Bonn. As of 1 March, Ms van Rossum’s position ended. She successfully completed her recruitment work for the study. Mr Koch will continue to maintain contact with the study participants. Ms Claudia Grünzinger has been supporting Ms Busch with the parent interviews since December 2012.

In Augsburg, the team of psychologists has shrunk to only Ms Diana Kurze. She will carry out the last, still outstanding assessments.

The two MRI teams in Munich and Bonn are being supported by the doctoral students Josef Bäuml and Thomas Runkel.

Now we would like to make a request on our own behalf:

Of the roughly 700 participants in this study, we were able to reestablish contact with over 90% after 13 years without assessments. About 490 participants have already taken part in the psychological interview and 200 in the MRI assessment. In addition, we have already conducted telephone interviews with 260 parents.

Together with you we hope for a successful completion of the assessments in the second half of 2013. To avoid losing track of any participant, we kindly ask you to inform us of any changes in name or address.

We would like to speak with you personally about whether and how participation in the study may be possible for you. Our goal is to establish contact with all participants and their parents. We ask all those who have not yet decided to take part in the fourth assessment cycle of the Bavarian Longitudinal Study to contact the study office in Bonn.

Please get in touch with the study office in Bonn even if active participation is not possible for you this time!!

And, how was it…?

We asked some participants and parents how they experienced the assessments they did as part of the study. Here we would like to present the feedback, which shows how straightforward the examination procedures are. We hope this may motivate some of you to participate.

"Hello dear BLSteam,

I had my MRI appointment in Bonn on Sunday. Everything was great, and I just wanted to say “thank you”. The accommodation in the youth hostel was nice and cosy, Bonn is really worth a trip, and I found the examination day very interesting. I hope you can ‘do something’ with the data you gained from me :).

I also wanted to thank you because the contact with you, whether by phone or email, was always helpful and friendly. Please keep it that way, yes? 🙂

If there are results from the MRI examinations, can I find and read them on your homepage later in 2013, or will participants even be informed personally about what came out of it?

I have sent off the documents for the travel cost reimbursement for the MRI appointment in Bonn last weekend today. Could you please confirm receipt again?

thank you.

Kind regards from Berlin,"

"Dear Team,

I do not regret a single minute I spent with you.

I was completely satisfied.

I am also very grateful for the MRI, because an incidental diagnosis was detected for me. Thankfully that has developed positively.

Everyone was super friendly and the atmosphere was relaxed.

Many thanks for everything!

Kind regards"

"Dear Ms van Rossum,

the study was really interesting. I had a chat with my interviewer at lunch – unfortunately I cannot remember the name – about what kind of results might be derived.

And it was quite interesting for me personally as well. Some of the questions were quite personal and got me thinking from time to time. So if it takes place again… I enjoyed it.

Gladly again 🙂

Kind regards from the Inn Valley"

"Good day Ms van Rossum,

the interview was already about 1.5 years ago, but I remember the atmosphere in that old building in Augsburg, and also my interviewer, early 30s, as very relaxed, certainly humorous as well. The tests were manageable within the given time frame. Unfortunately, the food at the hospital was hardly edible. The explanations were appropriate for the context. The appointment in Munich for the MRI in March last year was in the service of science. Unfortunately, due to an error on my part, I had to stay in the machine for 1 hour. The only disadvantage for me was headaches afterwards. The study is on a good path; I must confess that as an adult I preferred participating compared to earlier as a child. My parents used to have to lure me to Munich with McDonald’s."

"Greetings, Ms van Rossum,

back then I took part in the developmental study with my daughter with great interest.  Therefore I am still very interested, and if the opportunity to participate arises… gladly!!

Please tell Dr Busch that she can call me.

It would be good if we could arrange a fixed appointment because I work fulltime.

Many thanks and greetings to Bonn"

Warm greetings from the Bonn study office on behalf of the entire BLS team

Prof. Dr. Dr. Peter Bartmann      Dr. Barbara Busch

Dipl.Soz. Arb. Christian Koch     Dipl. Psych. Claudia Grünzinger

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