Am Brubakk

PO-0825 Do Young Adults Born With Very Low Birth Weight Have Poor Emotional, Behavioural And Social Function?

Objective To study emotional and behavioural problems, relations to friends and substance use in young adults born with very low birth weight (VLBW: ≤1500 g) compared to controls. Design/methods A hospital-based follow-up study of 34 VLBW young adults and 35 term-born controls at 23 years of age. Data was collected using the Achenbach System of Empirically Based Assessment – Adult Self-Report (ASR) and the Beck Depression Inventory (BDI). Results The ASR total problems score was 38.6 (21.7) in the VBLW group compared with 29.0 (18.7) in the control group (p = 0.08). The VLBW group had higher scores for anxious/depressed (p = 0.04), attention problems (p = 0.03), aggressive behaviour (p = 0.05), internalising problems (p = 0.02) and critical items (p = 0.02). BDI scores did not differ between the groups. The VLBW group reported lower mean substance use (p = 0.04), mainly due to less use of alcohol. Furthermore, they reported having fewer friends, less closeness to friends, and less time spent with friends compared with controls (p = 0.05). When excluding 11 participants with cerebral palsy and/or low intelligence quotient (<2 SD of mean in the control group), the scores for critical items, anxious/depressed and substance use were essentially the same (p-values: 0.04–0.07). Conclusion The VLBW group reported more emotional problems than controls, and also a higher level of clinically relevant psychiatric symptoms. The findings may indicate that anxiety symptoms and a cautious lifestyle with regard to substance use are characteristics of VLBW individuals in young adulthood.

PS-246 Self-reported Quality Of Life At 19–23 Years And Correlations With Motor Skills In Young Vlbw Adults Without Cerebral Palsy

Objective To study changes in self-reported quality of life (QoL) in very low birth weight (VLBW: ≤1500 g) young adults, and to examine correlations between QoL and motor skills in young adult age. Design/methods A hospital-based follow-up study of 28 VLBW young adults without cerebral palsy and 29 term-born controls. Data was collected by the Short Form 36 Health Survey (SF-36) at 19 and 23 years, and the Grooved Pegboard test (GP), Trail Making Test-5 (TMT-5), Movement Assessment Battery for Children-2 (MABC-2) and High-level Mobility Assessment Tool (HiMAT) at 23 years. Results At 19 years of age, there were no group differences in SF-36 scores, whereas VLBW participants at 23 years had lower physical functioning, role-physical, social functioning and role-emotional scores, and lower physical and mental component scores than controls (p < 0.05). In the VLBW group, the change from 19–23 years was -2.6 (95% CI:-4.5,-0.6) points for the physical, and -3.7 (95% CI:-6.4,-0.9) points for the mental component score (p = 0.01). The physical component score correlated with results on TMT-5, MABC-2 and HiMAT, and the mental component score with TMT-5, after adjustment for intelligence quotient. Corresponding findings were not seen in the control group (change in physical and mental component scores: 0.3;95% CI:-2.0,2.6 and -0.1;95% CI:-3.3,-3.3) (p > 0.8), and no correlations with motor skills were found. Conclusion At 23 years, VLBW participants without cerebral palsy reported poorer QoL than controls, and lower QoL scores were correlated with poorer motor skills. It may be of concern that QoL seems to decrease as the young VLBW adults get older.

O-058 Brain Morphometry In Young Adults Born Small-for-gestational-age At Term

Background/aims Being born small-for-gestational-age (SGA), a proxy for fetal growth restriction (FGR) has been related to poor school performance, lower academic achievement and cognitive problems. The aim of this study was to investigate whether young adults born SGA at term had reduced brain volumes, cortical surface area and/or cortical thickness, and whether brain morphometry measures were related to cognitive functioning. Methods In this population-based follow-up study at age 20, 58 term-born SGA (birthweight < 10 th centile, mean: 2915 g) and 81 non-SGA controls (birthweight >10 th centile, mean: 3707 g) were included. MRI-examinations at 1.5 T were obtained in 47 SGA and 61 control subjects. Image analysis was performed by the FreeSurfer, version 5.1. IQ was assessed by Wechsler Adult Intelligence Scale 3rd edition (WAIS-III). Results Total brain volume was smaller in the SGA than in the control group (-5.6%; p < 0.001). This reduction included most structures, but relative volumes were the same. Cortical surface area was significantly reduced in the SGA group compared with controls in multiple regions across the cerebral cortex, especially in the frontal, parietal and temporal lobes compared with controls (Figure). The reduction in surface area in the SGA group was most pronounced in the anterior cingulate gyri bilaterally. No associations were found between brain measures and IQ measures in either group. Conclusions Young adults born SGA at term have a global reduction in brain volume and regional reductions in cortical surface area. This may have long term consequences for cognitive functioning. Abstract O-058 Figure 1 Group differences in surface area change between SGA young adults and controls. The mapping of cortical surface area reduction in SGA young adults and controls is shown on the reconstructed cortical surface. Cortical areas with statistically significant difference between groups are shown in colour, and the colour scale shows the dynamic range of the statistically significant changes (in p-values), red to yellow reperesents an increasing expansion of the cortex in SGA group to fit the template, thus surface area reduction in these areas compared with controls. All significant clusters survived FDR correction at p < 0.05. No areas with surface area expansion (blue areas) were found in the SGA group compared with controls

PO-0005 Cerebellum, Thalamus And Cerebral Cortex In Vlbw Adolescents’ Mental Health

Background Children born preterm present a higher risk of psychiatric disorders during adolescence. Aim To assess whether psychiatric symptoms are associated with changes in cortical thickness and volumes of thalamus and cerebellum in very low birth weight (VLBW) adolescents. Design/methods Fifty VLBW (birth weight ≤1500 g) and 57 term control adolescents were assessed at 14–15 years of age with: Schedule for Affective Disorders and Schizophrenia for School-Age Children, Strengths and Difficulties Questionnaire (SDQ Mother Report), Autism Spectrum Screening Questionnaire (ASSQ), and Children’s Global Assessment Scale (CGAS). Cortical thickness (mm) and volumes of thalamus and cerebellum (ml) were obtained using an automated MRI segmentation technique (Freesurfer). Associations were analysed by linear and ordinal logistic regression, adjusted for age, gender and total intracranial volume, and corrected for multiple comparisons (Benjamini-Hochberg). Results VLBW adolescents had more psychiatric symptoms and diagnoses than controls. On MRI, they had several areas with thinner cortex, including the entorhinal cortex, and areas of thicker cortex, including the insula, compared to controls. Higher SDQ Emotional symptoms scores were associated with thicker insular cortex (Left: B=0.418 (0.192 to 0.644), p = 0.001; Right: B=0.243 (0.061 to 0.426), p = 0.010). Smaller cerebellar WM volumes were associated with higher SDQ Hyperactivity scores (Left: B=-0.638 (-1.101 to -0.176), p = 0.008; Right: B=-0.551 (-0.966 to -0.137), p = 0.010) and lower CGAS scores (Left: B=4.653 (2.182 to 7.123), p < 0.001; Right: B=4.255 (2.073 to 6.437), p < 0.001). Conclusion Our results indicate that psychiatric symptoms in VLBW adolescents may be related to structural brain anomalies in cerebellar white matter and insular cortex.

240 Neuropsychological Profile in Young Adults Born Small-for-Gestational-Age (SGA) at Term

Background and aims Some studies have shown that being born SGA is related to reduced intellectual capacity, learning difficulties and poor school performance. Earlier findings have been diverted, and there are few longitudinal studies that have used a comprehensive neuropsychological test battery. Aim of study was to look at how young adults born SGA perform on a variety of neuropsychological tests, and to see whether they have problems of specific or general origin. Methods Population-based follow-up study at age 19 of 59 term-born SGA (birth weight< 10th centile, mean: 2915g) and 81 controls (birth weight>10th centile, mean: 3707g). One participant in the SGA group had cerebral palsy and was excluded from analysis. A standardized neuropsychological test battery was used to assess several functions: memory, language, attention, executive functions and visual-motor integration. Results The SGA-group performed significantly poorer than controls (p<0.01) on several tests. These were tests assessing memory; (Wechsler memory scale-III: auditive immediate memory and mental control), attention (Trail making test), executive functions (Design fluency) and visual-motor-integration (Motor coordination test). The groups did not differ in visual memory tasks, long term memory, language functions and several other attention/executive tasks. Conclusions Our results suggest that young adults born SGA have specific neuropsychological difficulties, especially problems with auditive learning, eye-hand-coordination, and they are slower at performing and initiating tasks compared to controls. This might further indicate that children born SGA can be in need of special education in school.

238 IQ and Intrauterine Growth Restriction in young Adults Born Small-for-Gestational-Age at Term

Background and aims How cognitive function is affected by being born small for gestational age (SGA) is not clear. This may be related to different definitions of SGA and the lack of discrimination between those born with intrauterine growth restriction (IUGR) and those who are constitutionally small. Our aim was to study the effect of being born SGA with IUGR on later cognitive functioning. Methods Population-based follow-up study at age 19 of 59 term-born SGA (birth weight< 10th centile, mean: 2915g) and 81 controls (birth weight>10th centile, mean: 3707g). WAIS III was used to assess IQ. Foetal weight-deviation was calculated based on repeated ultrasound measurements of biparietal and mid-abdominal diameter at week 25, 33 and 37 of gestation for 29 SGA subjects and 75 controls. Weight-deviations were recorded as positive and negative percentages; zero denoted no deviation from individual expected growth. Mean and standard deviation (sd) for estimated foetal growth in the control group was used to dichotomize the SGA group into normal growth and IUGR (growth deviation of more than -2sd from control mean). Results The total SGA group had significantly lower IQ scores than the control group (p=0.001). In the subgroup with ultrasound measurements, six SGA subjects (21%) were defined as IUGR. In this subgroup, only these six had significantly lower IQ than controls (IQ 87 vs 101, p=0.003) whereas those with normal growth pattern did not differ from controls. Conclusions Young adults born SGA had reduced cognitive outcome. This decrease may be confined to SGA young adults with IUGR.