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Childhood and adolescent mental health of NICU graduates: an observational study
  1. Andreea Chiorean1,
  2. Calan Savoy1,
  3. Karen Beattie2,
  4. Salhab el Helou3,
  5. Maysoon Silmi3,
  6. Ryan J Van Lieshout1
  1. 1 Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
  2. 2 Division of Rheumatology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
  3. 3 Division of Neonatology, Department of Pediatrics, McMaster University Children's Hospital, Hamilton, Ontario, Canada
  1. Correspondence to Andreea Chiorean, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8S 4L8, Canada; andreea.chiorean{at}


Objective To investigate the mental health of children and adolescents admitted to neonatal intensive/special care units (NICUs) in infancy.

Methods This cross-sectional study used a provincially representative cohort from the 2014 Ontario Child Health Study. Parents provided data on psychiatric disorders using the MINI International Neuropsychiatric Interview for Children and Adolescents in 3141 children aged 4–11 years (NICU n=389; control n=2752) and in 2379 children aged 12–17 years (NICU n=298; control n=2081). Additionally, 2235 adolescents aged 12–17 years completed the interview themselves (NICU n=285; control n=1950). Odds of psychiatric disorder were compared in those admitted and controls.

Results Based on parent reports, NICU graduates aged 4–11 years had increased adjusted ORs (95% CI) of 1.78 (1.39 to 2.28) for any psychiatric disorder, with a marginal prevalence of 32.4% in NICU participants and 27.6% in controls. At this age, NICU graduates also had increased ORs of 1.74 (1.25 to 2.40) for psychiatric comorbidity, 1.48 (1.04 to 2.11) for oppositional defiant disorder, 1.61 (1.19 to 2.19) for attention-deficit hyperactivity disorder, 4.11 (2.33 to 7.25) for separation anxiety disorder and 2.13 (1.37 to 3.31) for specific phobia. At 12–17 years, 40.5% and 30.5% of NICU graduates and 30.6% and 17.9% of controls had any psychiatric disorder as reported by parents and self-report, respectively. Parents and adolescents, respectively, reported increased adjusted ORs (95% CI) of 1.63 (1.18 to 2.26) and 1.55 (1.13 to 2.11) for any disorder, 1.64 (1.06 to 2.54) and 1.74 (1.11 to 2.73) for psychiatric comorbidity, and 1.89 (1.22 to 2.93) and 3.17 (2.03 to 4.95) for oppositional defiant disorder.

Conclusions NICU graduates are at increased risk for psychiatric disorders during childhood and adolescence.

  • child psychiatry
  • adolescent psychiatry
  • intensive care
  • neonatal intensive care

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  • Contributors All authors assisted in the conception of this investigation, manuscript revision and approval. CS analysed the data and AC, RJVL and CS interpreted the data. AC and CS contributed to the first draft.

  • Funding This study was supported by the Canada Research Chairs programme for RJVL, the research operating grant 125941 from the Canadian Institutes of Health Research, Health Services Research Grant 8-42298 from the Ontario Ministry of Health and Long-Term Care (MOHLTC) and funding from MOHLTC, the Ontario Ministry of Children and Youth Services and the Ontario Ministry of Education.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval This study was approved by Hamilton Integrated Research Ethics Board (13-140).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data can be accessed through Statistics Canada Research Data Centres.