Roles of perinatal problems on adolescent antisocial behaviors among children born after 33 completed weeks: a prospective investigation

A large body of research has demonstrated that perinatal problems such as low birthweight (LBW) and preterm birth are associated with a wide range of developmental problems throughout childhood – including language and speech problems (Kulkarni, Kalantre, Upadhye, Karande, & Ahuja, 2001; Aram, Hack, Hawkins, Weissman, & Borawski-Clark, 1991), poor cognitive functioning (Hack et al., 1994; Aylward, 2002; Litt, Taylor, Klein, & Hack, 2005), and learning difficulties (Klebanov, Brooks-Gunn, & McCormick, 1994; Kulkarni et al., 2001; Roberts, Bellinger, & McCormick, 2006). Recently, emerging evidence suggests that the risk for developmental problems may not be limited to those who had extremely low (<1000g) or very low (<1500g) birthweight, or those born very early (less than 24 weeks). It has also been suggested that the risk for developmental problems in the context of adverse perinatal conditions needs to be examined using continuous (e.g., birthweight in grams) rather than dichotomized (e.g., LBW vs. normal birthweight) measures, and behavior scales normed on population-based cohorts (Kirkegaard, Obel, Hedegaard, & Henriksen, 2006; Richards, Bellinger, & McCormick, 2001; Sorensen et al., 1997; Breslau, Chilcoat, DelDotto, Andreski, & Brown, 1996; Matte, Bresnahan, Begg, & Susser, 2001). To date, however, no prior study has examined the various long-term implications of perinatal problems in early childhood – including hearing, speech, and language problems, cognitive functioning, and academic performance – on subsequent behavioral problems such as antisocial delinquency. This is especially true for those with milder perinatal problems, whose struggles may only become visible to others as academic demands increase. For this group of children, the trajectory leading to antisocial problems may be highly modifiable. It is also important to examine the nature of behavioral problems and consider possible differences in their meaning in boys and girls. For example, it could be that milder symptoms of noncompliant behavior are equally present in boys and girls, but this same level of early behavior problems might only be a precursor of more serious conduct problems in boys (Robins, 1991; Hinshaw, 1992). In this study, we utilize data from a randomly selected, population-based sample of children born after 33 gestational weeks to simultaneously examine the influence on subsequent antisocial behavior of: a) three perinatal indicators: birthweight, head circumference, and 5-minute Apgar scores; b) a number of neurological abnormalities detected in infancy; c) hearing, speech and language problems at age 3; d) cognitive functioning (IQ) at age 4; e) academic performance at age 7; and f) adolescent anti-social behavior. We hypothesized that perinatal problems would be associated with a higher prevalence of neurological abnormalities in infancy. We also hypothesized that perinatal problems would be indirectly (mediated via neurological abnormalities) associated with impairments in language, hearing and speech, which in turn would be associated with lower IQ. We further hypothesized that this lower IQ would be directly and indirectly (as a result of problems in the preceding stages) associated with poorer academic performance, and this would then be associated with antisocial behavior. These associations were examined simultaneously within a full-information estimation model.