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IJE Advance Access originally published online on May 11, 2009
International Journal of Epidemiology 2009 38(4):944-954; doi:10.1093/ije/dyp204
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Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2009; all rights reserved.
The online version of this article has been published under an open access model. Users are entitled to use, reproduce, disseminate, or display the open access version of this article for non-commercial purposes provided that: the original authorship is properly and fully attributed; the Journal and Oxford University Press are attributed as the original place of publication with the correct citation details given; if an article is subsequently reproduced or disseminated not in its entirety but only in part or as a derivative work this must be clearly indicated. For commercial re-use, please contact journals.permissions@oxfordjournals.org

Low birthweight and subsequent emotional and behavioural outcomes in 12-year-old children in Soweto, South Africa: findings from Birth to Twenty

Farnaz Sabet1, Linda M Richter2, Paul G Ramchandani1,*, Alan Stein1, Maria A Quigley3 and Shane A Norris4

1Section of Child and Adolescent Psychiatry, University of Oxford, Oxford, UK.
2Child Youth Family & Social Development (CYFSD), Human Sciences Research Council, Durban, South Africa.
3National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK.
4Birth to Twenty Research Programme, Department of Paediatrics and Child Health, University of the Witwatersrand, Johannesburg, South Africa.

*Corresponding author. Department of Psychiatry, University of Oxford, Warneford Hospital, Headington, Oxford OX3 7JX, UK. E-mail: paul.ramchandani{at}psych.ox.ac.uk


  Abstract

Background The fetal origins hypothesis suggests that an adverse prenatal environment, indexed by low birthweight (LBW), may increase the risk of developing later disease. Recently the hypothesis has been extended to psychological outcomes, especially depression. The aim of this analysis was to test, for the first time in a developing country setting, the association between LBW and psychological symptoms, in Soweto, South Africa.

Methods A sample of 1029 children was drawn from Birth to Twenty, a longitudinal cohort followed from pregnancy to young adulthood. This sample completed the Youth Self Report at age 12 years, a validated psychological measure of behavioural and emotional adjustment. Scores were compared between LBW (<2500 g) and normal birthweight children using multivariate analysis with adjustment for potential birth and life events confounding factors.

Results No associations were found between LBW and total [adjusted odds ratio (OR) 1.09, 95% confidence interval (CI) 0.69–1.74], internalizing (adjusted OR 0.81, 95% CI 0.52–1.28) or externalizing profiles (adjusted OR 0.81, 95% CI 0.49–1.36). The only difference detected was for the internalizing sub-profile of Somatic Complaints (adjusted OR 2.02, 95% CI 1.21–3.38), which on subgroup analysis was greatest among females.

Conclusions We found no convincing evidence of an association between LBW and emotional and behavioural outcomes in 12-year olds in this sample in urban South Africa. To our knowledge, this is the first published assessment of this association in a developing world context.

Keywords South Africa, birthweight, depression, fetal origins hypothesis, cohort studies

Accepted 1 April 2009


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