We examined the effects of prematurity ( 37 weeks of gestation) and low birthweight ( 2500？g) on mental health outcomes among US children aged 2–17 years. The 2011-2012 National Survey of Children’s Health ( = 95,677) was used to estimate prevalence of parent-reported mental health problems in children. Prevalence of mental disorders was 22.9% among children born prematurely, 28.7% among very-low-birth-weight ( 1500？g) children, and 18.9% among moderately low-birth-weight (1500–2499？g) children, compared with 15.5% in the general child population. Compared to those born full term, children born prematurely had 61% higher adjusted odds of serious emotional/behavioral problems, 33% higher odds of depression, and 58% higher odds of anxiety. Children born prematurely had 2.3 times higher odds of autism/ASD, 2.9 times higher odds of development delay, and 2.7 times higher odds of intellectual disability than term children. Very-low-birth-weight children had 3.2 times higher odds of autism/ASD, 1.7 times higher odds of ADD/ADHD, 5.4 times higher odds of development delay, and 4.4 times higher odds of intellectual disability than normal-birth-weight children. Social factors were significant predictors of mental disorders in both premature/low-birth-weight and term/normal-birth-weight children. Neurodevelopmental conditions accounted for the relationship between prematurity and depression/anxiety/conduct problems. Prematurity and low birthweight are significant risk factors for mental health problems among children. 1. Introduction Perinatal factors such as preterm birth and low birthweight (LBW) have significant impacts on the health and well-being of children and adolescents, which have been shown to persist well into adulthood and, indeed, throughout the life course [1–4]. Prematurity/LBW has long been the second leading cause of infant death in the United States after congenital malformations [5]. While US infant mortality rates due to prematurity and LBW (<2500 grams) have declined markedly over time, preterm (<37 weeks of gestation) infants are still 15 times more likely to die before their birthday than those born at term [5, 6]. Nearly two-thirds of all infant deaths in the USA occur among infants who are born preterm [5]. Nearly a quarter of all infants born with very low birthweight (<1500 grams) die during the first year of life [5]. The infant mortality rates for very-low-birth-weight (<1500 grams) and moderately low-birth-weight (1500–2499 grams) infants are, respectively, 105 and 6 times higher than the rate for normal-birth-weight infants [5, 6].
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