Abstract
INTRODUCTION: The COVID-19 pandemic has caused a global mental health crisis, especially for those individuals who are vulnerable to stress and anxiety due to pre-existing mental health problems. This study aimed to understand the emotional impact of the COVID-19 lockdown on children who were born very preterm (VPT, <32 weeks' gestation), as they are vulnerable to mental health difficulties and are at increased risk of developing psychiatric problems during childhood compared to their full-term-born counterparts. METHODS: The parents of 32 VPT children (mean age = 8.7) and 29 term-born controls (mean age = 8.8), who had previously taken part in a study of brain development and psychopathology following VPT birth, completed an online modified version of the Coronavirus Health and Impact Survey (CRISIS). The emotional impact of the COVID-19 lockdown on the child and the parent, measured by the CRISIS, was studied in relation to pre-existing mental health, assessed with the parent-rated Strengths and Difficulties Questionnaire (SDQ), evaluated before the CRISIS completion (mean time gap 15 months). Linear regression model comparisons were conducted to study the effects of COVID-19-related stressors on children's and parents' behavior, relationships and mental health. RESULTS: There were no significant group differences in pre-existing SDQ internalizing/externalizing symptoms, child's emotions or parent's emotions during the COVID-19 lockdown. However, higher pre-existing internalizing symptoms in VPT children were associated with greater lockdown-related emotional problems and worries (simple slope = 1.95, p < 0.001), whereas this was not observed in term-born children. CONCLUSION: Our results suggest that VPT children with pre-existing internalizing problems may be more vulnerable to the negative impact of certain societal and familial stressors, such as social restrictions during the national COVID-19 lockdown periods. Further rigorous studies are therefore needed to assess the severity of increased risks for this particularly vulnerable group in the context of potentially stressful life changes and adjustments.