Gökşin KARAMAN, Beril TAŞKIN, Beril TAŞKIN

Prematürite ve çocukluk çağı psikiyatrik bozuklukları

Perinatal etkenlerin, çeşitli psikiyatrik bozuklukların gelişiminde rolleri olabileceği uzun süredir düşünülmektedir. Doğum ağırlığı ve gestasyonel yaş azaldıkça psikiyatrik bozuklukların gelişme riskinin arttığı ileri sürülmüştür. Bu gözden geçirmede erken doğum ve/veya düşük doğum ağırlığı ile çocukluk çağı başlangıçlı psikiyatrik bozukluklar arası ndaki ilişkinin incelenmesi amaçlanmıştır. Bu psikiyatrik bozukluklar içinde, başlangıcı çocukluk çağına özgü olup en çok çalışılanlar dikkat eksikliği - hiperaktivite bozukluğu, yaygın gelişimsel bozukluklar ve emosyonel bozukluklardır. Erken doğan ve/veya düşük doğum ağırlığı olan bebeklerde dikkat eksikliği ve hiperaktivite bozukluğunun dikkat eksikliğ inin önde geldiği alt tipinin gelişme riski daha yüksek bulunmuştur. Yaygın gelişimsel bozukluklar ve prematürite ilişkisinin incelendiği çalışmalarda, düşük doğum ağırlığından çok gebelik haftasına göre beklenen ağırlığın altında doğmanın ve erken doğumun daha önemli bir risk faktörü olduğu sonucuna ulaşılmıştır. Emosyonel bozukluklar ile prematürite ilişkisi ele alındığında, bu grupta özellikle anksiyete ve depresyonun sık gözlendiği, ayrıca kız çocukları için artmış bir risk bulunduğu ortaya konmuştur. Sonuç olarak erken ve/veya düşük doğum ağırlığı ile çocukluk çağı başlangıçlı psikiyatrik bozuklukların gelişimi arasında bir ilişki olduğu açıktır. Bu bebeklerde bilişsel ve davranışsal gelişimin yakından gözlenmesi ve olası psikiyatrik bozuklukların erken dönemde saptanması erken müdahale şansını arttıracaktır.

Anahtar Kelimeler:

prematürite, düşük doğum ağırlığı, psikiyatrik bozukluk, dikkat eksikliği ve hiperaktivite bozukluğ u, yaygın gelişimsel bozukluklar, emosyonel bozukluklar

Prematurity and childhood psychiatric disorders

Perinatal factors have long been implicated in the genesis of psychiatric disorders. For many years epidemiologic studies have identified preterm birth and low birth weight as a significant risk factor for psychiatric disorders. This review aims to evaluate the relationship of preterm birth/low birth weight and the childhood psychiatric disorders. The most studied disorders are attention deficit/hyperactivity disorder, pervasive developmental disorders and emotional disorders. In regard to attention deficit/hyperactivity disorder research findings indicate that children with very low birth weight especially have increased risk of attention problems. As for pervasive developmental disorders, preterm birth and being small for gestational age are increased risk factors rather than low birth weight. Regarding emotional disorders preterm birth is a risk factor mainly for anxiety and depression and within this group it can be claimed that female children are at risk more than male children. In conclusion it is obvious that there is a relationship between preterm birth/ low birth weight and childhood-onset psychiatric disorders. Monitoring the cognitive and behavioral development in these infants will allow early detection of possible psychiatric disorders and increase the chances of early intervention.

Keywords:

prematurity, low birth weight, psychiatric disorder, attention deficit/hyperactivity disorder, pervasive developmental disorder and emotional disorder,

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