Emotional and attention-deficit/hyperactivity disorder symptoms of preterm vs. full-term children during COVID-19 pandemic restrictions

Background: Preterm children are at higher risk of developing mental health problems than full-term children. Deterioration of children’s mental health was observed during COVID-19 pandemic restrictive measures. Our study compared emotional and attention-deficit/hyperactivity disorder (ADHD) symptoms during school closure between preterm and full-term children. Methods: Data from two French birth cohorts—ELFE and EPIPAGE-2—were used. In 2011, infants born ≥22 weeks’ gestation were recruited. Parents completed the Strengths and Difficulties Questionnaire when the children were 9 years old and experiencing school closure. Multivariate multinomial logistic regression models were used. Results: Subjects included 4164 full-term and 1119 preterm children. In univariate analyses, compared to full-term children: extremely and very preterm children more frequently had abnormal and borderline ADHD scores (odds ratio [OR] 1.86, 95% confidence interval [CI] 1.50–2.30, OR 1.42, 95% CI 1.08–1.85, respectively) and abnormal emotional scores (OR 1.86, 95% CI 1.43–2.40); moderate to late preterm children more often had abnormal ADHD scores (OR 1.33, 95% CI 1.01–1.78). The associations did not remain when previous symptoms at 5 years old were considered. Conclusions: School closure during lockdown did not appear to increase the risk of mental health problems in preterm compared to full-term children. Impact statement: Preterm children are at higher risk of developing mental health problems than full-term children. Deterioration in children’s mental health was observed during COVID-19 pandemic restrictions. However, whether preterm children were a particularly vulnerable subgroup during school closure is unclear.In univariate analyses, extremely and very preterm children more often had abnormal and borderline ADHD symptoms and abnormal emotional symptom scores than full-term children. The associations did not remain significantly associated when previous symptoms were considered.Preterm compared to full-term children more often suffer from ADHD and emotional symptoms, but school closure during lockdown did not appear to increase this risk.