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THE YOUNG INVESTIGATOR'S PRIZE LECTURE 2013

Presented at the Neonatal Society 2017 Summer Meeting (programme).

Hilary S Wong, Department of Paediatrics, University of Cambridge

Early childhood neuropsychiatric symptoms in children born preterm

Aim: My aim is to understand how early life factors influence lifespan neurodevelopment and
mental health.

Background: Survivors of preterm birth experience neuropsychiatric difficulties, including attention deficit/hyperactivity, autism spectrum disorders (ASD), emotional and social problems. There is limited understanding of the emergence and trajectories of neuropsychiatric symptoms and the factors that influence neuropsychiatric outcomes in the preterm population.

Previous research: I established a cohort of 141 children born at less than 30 weeks’ gestation and explored the characteristics of social-communication skills exhibited by this cohort at age 24-months using the newly developed parent-completed Quantitative Checklist of Autism in Toddlers (Q-CHAT). I found that children born preterm display greater social-communication difficulties and autistic behaviour than the general population in early childhood, even among those considered ‘functionally normal’. The differences were most predominant in the categories of restricted, repetitive, stereotyped behaviour, communication and sensory abnormalities. I also showed poor concordance between Q-CHAT and the Bayley Social-Emotional Scale, demonstrating the difficulties in screening for children ‘at risk’ for ASD.

Current/future research: Genetic inheritance is also a potent early risk factors for behavioural problems. I am leading on a current MRC award that involves analysing genetic markers from 500 preterm infants and their parents in 50 English neonatal units to test the hypothesis that the preterm population is enriched for neuropsychiatric risk variants. Through this study, I aim to develop the infrastructure necessary for a future whole-population cohort study to investigate the inter-relationship between genetic risks, preterm birth and adverse neurodevelopmental and behavioural outcomes.

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