Psychiatric Disorders in Term-Born Children with Low Birth Weight: A Population-Based Study

Abstract Background: To investigate the risk of psychiatric disorder development in term-born children with marginally low birth weight (MLBW, 2000–2499 g). Methods: This is a nationwide retrospective cohort study, by analysing the data from Taiwan’s National Health Insurance Research Database from 2008 to 2018. The study population includes propensity-score-matched term-born infants with MLBW and those without MLBW (birth weight ³ 2500 g). Cox proportional hazard analysis was used after adjustment for potential demographic and perinatal comorbidity confounders. Incidence rates and hazard ratios (HR) of 11 psychiatric diagnoses were evaluated. Results: A total of 53,276 term-born MLBW infants and 1,323,930 term-born infants without MLBW were included in the study. After propensity score matching for demographic variables and perinatal comorbidities, we determined that the term-born MLBW infants (n = 50,060) were more likely to have specific developmental delays (HR = 1.38, 95% confidence interval (CI) [1.33, 1.43]), attention deficit and hyperactivity disorder (HR = 1.26, 95% CI [1.20, 1.33]), autistic spectrum disorder (HR=1.26, 95% CI [1.14, 1.40]), conduct disorder (HR =1.25, 95% CI [1.03, 1.51]), and emotional disturbance (HR: = 1.13, 95% CI: [1.02, 1.26]) than did the term-born infants without MLBW (n = 50,060). Conclusion:MLBW was significantly associated with the risk of subsequent psychiatric disorder development among term-born infants. The study findings demonstrate that further attention to mental health and neurodevelopment issues may be necessary in term-born children with MLBW. However, possibilities of misclassification in exposures or outcomes, and risks of residual and unmeasured confounding should be concerned when interpreting our data.