Long-term mental health outcomes of NICU graduates treated for congenital anomalies: A prospective cross-sectional study

PURPOSE: Research examining the long-term mental health needs of NICU graduates treated for non-cardiac congenital anomalies is limited, restricting guidance for clinical practice. This study aimed to characterise mental health outcomes at developmentally important ages and explore risk factors for poor mental health outcomes in these children. METHODS: Emotional and behavioural functioning was examined in 222 children at 5-year-old follow-up and 168 children at 8-year-old follow-up. Participants were treated for non-cardiac congenital anomalies at a large tertiary-level paediatric hospital in Australia. Parent-rated T-scores on the Behaviour Assessment System for Children (BASC) Second or Third Edition were compared to normative data. T-scores were classified according to BASC norms for problem indices: 'normal' (T < 60), 'at-risk' (T = 60-69), and 'clinically significant' (T ≥ 70). 'Elevated' ratings were defined as T ≥ 60. Clinical and sociodemographic risk factors for 'clinically significant' BASC T-scores were examined. RESULTS: Internalising Problems T-scores were significantly elevated at 5-year-old follow-up (p < 0.0004). The proportion of 'clinically significant' ratings was significantly higher than expected across all BASC domains at both 5-year-old and 8-year-old follow-up (p < 0.0004). In unadjusted models, parent-reported neurodevelopmental diagnoses (p = 0.001), small for gestational age (p = 0.005), and genetic diagnoses (p = 0.037) were associated with 'clinically significant' BASC ratings. However, these associations did not remain significant following adjustment for multiple comparisons. CONCLUSION: According to parent-reports, children treated neonatally for non-cardiac congenital anomalies may be at risk of long-term mental health difficulties. These findings highlight the importance of incorporating routine, developmentally timed mental health assessments and follow-up into the standard clinical care of these children.