Babies born prematurely are more likely to be bullied as children, and those who are bullied are at a significantly increased risk of developing mental health problems as adults, according to research published in Pediatrics.

“Being bullied has a significant and lasting impact for preemies, even into their 30s,” said Kimberly Day, PhD, Lawson Postdoctoral Fellow at the Offord Centre for Child Studies at McMaster University, Hamilton, Canada, in a statement. “This has important implications for parents, teachers, and clinicians who need to be aware of the long-term effects of peer victimization on mental health. They need to watch out for bullying and intervene when possible.”

To investigate lasting effects into adulthood of those who were born premature and who were bullied as children, Dr Day and colleagues followed 179 extremely low birth weight (ELBW) babies (2.2 pounds or less) born between 1977-1982 in Ontario. They recruited a matched control group of normal birth weight (NBW) children at age 8, and interviewed both the ELBW and NBW participants at ages 8, 22 to 26, and 29 to 36.

“Children born at very low (<1500 g) or extremely low birth weight (ELBW; <1000 g) appear to be at particularly high risk for experiencing peer victimization,” the authors wrote. “This finding may be a result of these children possessing elevated levels of characteristics that put them at risk for peer victimization, including poor motor abilities, more anxiety and depression, and lower IQ. They may also have fewer resilience factors that buffer the effects of peer victimization, including better academic performance and social skills.”

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Specifically, the researchers found that for every 1-point increase in the peer victimization score, ELBW survivors had increased odds of current depressive (odds ratio [OR] = 1.67, 95% confidence interval [CI], 1.23–2.28), anxiety (OR = 1.36, 95% CI, 1.05–1.76), avoidant (OR = 1.39, 95% CI, 1.08–1.79), antisocial (OR = 1.92, 95% CI, 1.06–2.87), and attention-deficit/hyperactivity (OR = 1.39, 95% CI, 1.06–1.83) problems at age 22 to 26 years.

At age 29 to 36 years, the peer victimization score predicted an increased odds of current panic disorder (OR = 1.69, 95% CI, 1.01–2.83) and obsessive-compulsive disorder (OR = 3.56, 95% CI, 1.25–10.09). For NBW participants, peer victimization predicted increased odds of antisocial problems at age 22 to 26 years.

“This is the first study to fully illustrate the profound and long-lasting effects of bullying on the mental health of preterm survivors,” said Ryan Van Lieshout, MD, PhD, assistant professor of psychiatry and behavioural neurosciences at McMaster in a statement. “Their risk for anxiety disorders is especially high, particularly among those who are exposed to bullying on a regular basis.”

The researchers emphasize that their results demonstrate important implications for parents, caregivers, educators, and physicians in understanding the lasting effects of bullying on those who were born premature, and that they should be aware of these risks and intervene in peer victimization whenever possible.

Reference

Day KL, et al. Long-term Psychiatric Impact of Peer Victimization in Adults Born at Extremely Low Birth Weight. Pediatrics. 2016; doi:10.1542/peds.2015-3383.