Decreased exposure to bullying and family problems during childhood and adolescence could help reduce adult mental illness in extremely low birth weight preemies, according to a new study from McMaster University.

Furthermore, mental health support for extremely low birth weight survivors who are born at 2.2 pounds or less, and their parents could also prove beneficial.

The study, published October 3 in The Journal of Child Psychology and Psychiatry, looked at the impact of mental health risk factors on extremely low birth weight preemies during childhood and adolescence.

“In terms of major stresses in childhood and adolescence, preterm survivors appear to be impacted more than those born at normal birth weight,” said Ryan J. Van Lieshout, assistant professor of psychiatry and behavioural neurosciences at McMaster University and the Albert Einstein/Irving Zucker Chair in Neuroscience.

“If we can find meaningful interventions for extremely low birth weight survivors and their parents, we can improve the lives of preterm survivors and prevent the development of depression and anxiety in adulthood.”

The study utilized the McMaster Extremely Low Birth Weight (ELBW) Cohort, which includes a group of 179 extremely low birth weight survivors and 145 normal birth weight controls born between 1977 and 1982, which has 40 years’ worth of data.

The study showed that although these preemies were not necessarily exposed to a larger number of risk factors compared to their normal birth weight counterparts, these stresses appeared to have a greater impact on their mental health as adults.

Besides bullying by peers and a small circle of friends, researchers looked at a number of other risk factors, like maternal anxiety or depression and family dysfunction.

“We believe it may be helpful to monitor and provide support for the mental health of mothers of preemies, in particular, as for the purposes of this study, they were the primary caregiver,” said Van Lieshout.

“There can also be family strain associated with raising a preemie and all the related medical care, which can lead to dysfunction. Support for the family in a variety of forms might also be beneficial.”

The paper builds on previous research that identified that extremely low birth weight survivors have an increased risk of mental illness in adulthood.

“We are concerned that being born really small and being exposed to all the stresses associated with preterm birth can lead to an amplification of normal stresses that predispose people to develop depression and anxiety later in life,” said Van Lieshout.

He recommended future research focus on the timing and type of supports for risk factors that would create better mental health outcomes in preemies.

The study was supported by grants from the Canadian Institutes of Health Research and the U.S. National Institute of Child Health and Human Development.

Additional authors on the study came from the departments of psychiatry and behavioural neurosciences; pediatrics, and psychology, neuroscience and behaviour at McMaster.