In Episode 7 of the DIAL Podcast, Rachel Robinson from the University of Helsinki discusses her research looking at whether pre-term babies are more likely to be pessimists or optimists and the implications for how they get on as young adults. The research is part of the NORFACE-funded PremLife Project looking at adaptation and life outcomes of preterm and low birth weight children across the lifespan.
Rachel Robinson was discussing research presented at the DIAL Mid-Term Conference in June 2019.
Christine Garrington 0:00
Welcome to DIAL, a podcast where we tune into evidence on inequality over the lifecourse. In today’s episode, we’re discussing optimism and pessimism in preterm babies, and the implications for their long-term health. Our guest is Rachel Robinson from the University of Helsinki who is part of the DIAL funded project Life Course Dynamics after Preterm Birth -Protective Factors for Social and Educational Transitions, Health and Prosperity.
Rachel Robinson 0:25
Research does show that the more optimistic a person is and the less pessimistic they are the better health outcomes they have, whether that’s physical, psychological and social. We have been looking at this, specifically in relation to preterms. A term pregnancy is from the beginning of the 37th week to the end of the 41st week. And so, the most simple way, preterm birth is anything before the 37th week of gestation, of course there’s varying degrees of prematurity, with medical technology we have babies surviving much earlier than we did in the past, and the chances of survival have increased so much. In the 1960s 1000 gram infant, which are predominantly very low birth weight infants or preterm would have had a 95% chance of death, where in by the year 2000 that same 1000 gram infant would have a 5% chance of death. So with our great advances in medical technology over the years, we have children surviving who weren’t surviving before, and we are now at a point that those children are reaching adulthood. So we see adult life outcomes, which we could never previously see before.
Christine Garrington 1:43
Now you looked at people born preterm in the UK and in Finland. Where did your information come from?
Rachel Robinson 1:48
Our work is part of the Premlife project, and it’s a collaboration of several cohorts from around Europe. We use specifically three cohorts, the ALSPAC cohort, the Avon Longitudinal Study of Parents and Children looking at children born in the 90s from the UK. And then we had two clinical cohorts from Finland, one, which is the Arvo Ylppö longitudinal study where the children were born in the late 80s and then the Helsinki Study of Very Low Birth Weight Children, which were born in the 70s to early 80s. And all of these cohorts had information, starting from the mother’s pregnancy, and then extending into early adulthood. So we have quite a few factors and characteristics that we can use to explore.
Christine Garrington 2:36
Now the great thing about these data sets, they are also very large right? And they have a lot of information.
Rachel Robinson 2:43
Yeah, yeah, I mean, for instance the ALSPAC study originally followed over 15,000 children, of course we have less in our analysis just because they didn’t all have the outcome that we were looking to study, but the issue in many preterm birth studies is that there’s such a limited number of preterm children and each birth cohort that you don’t have enough statistical power to really differentiate the effects. And so by combining these cohorts, we have the power to actually see those differences and more nuanced differences, especially over the different gestational ages.
Christine Garrington 3:21
So how did you work out from the information given in those studies, whether people were pessimists or optimists and how optimistic or pessimistic they were compared with their peers? For example.
Rachel Robinson 3:31
So, all of the studies had participants in early adulthood, so around early 20s, take the life orientation test, which looks at some scale of optimism and pessimism and they self-rate whether questions such as, if something bad will happen to me than it will, or you know I always expect good things to happen to me. Questions sort of along those lines, and then they get a score for those.
Christine Garrington 4:00
So Rachel what did you find when you looked at the links between being born preterm and how optimistic someone was?
Rachel Robinson 4:05
So, with optimism, we found great news. Which is that preterm children do not differ in their level of optimism with term born children, which is great and it actually quite aligns well with literature that preterm children rate their quality of life at a similar level as term born children, as well as their life satisfaction, things like that. So, so it makes quite a lot of sense and it’s great news that they don’t see themselves differently.
Christine Garrington 4:34
And what about the pessimism?
Rachel Robinson 4:36
Pessimism is a bit of a different story. Unfortunately, which is that they do differ in their level of pessimism preterms do have a higher level on their pessimism score, but it’s not that simple that it’s just preterm makes you more pessimistic. Once we adjusted for other factors, you see that the differences actually go away, and that it’s really important to consider maybe other factors that are more concentrated in a preterm population than actually just whether someone is preterm or not.
Christine Garrington 5:11
And that brings me quite nicely into the next question because, of course, you know, some children born preterm might have something like a brain impairment, for example, that might affect their personality I am guessing. Did this have any bearing at all on your findings? Is that one of those things.
Rachel Robinson 5:26
Actually neurosensory impairments, do not have any effect on our findings. When we perform certain sensitivity analysis, which neurosensory impairments include cerebral palsy, hearing, vision, and developmental disability. So, for that group, it didn’t actually change the results, but there are factors that do change the result. We see, for instance, that there’s a significant impact from your gender, for one, females tend to be more pessimistic than males, but then also there is whether your mother smoked during pregnancy or not, as well as your parental education which we use as a proxy for socio economic status in childhood. And also then an adult BMI, all play a role, and it’s important to note that three of those things are all modifiable characteristics.
Christine Garrington 6:22
So what does that actually tell you then?
Rachel Robinson 6:24
It tells us that it’s not so much about being preterm, but that more about your level of pessimism is explained by these other factors, and that these other factors for instance maternal smoking is highly predictive of a preterm birth. So you have that much more concentrated in preterm populations, and what it tells us as it affirms literature that smoking has harmful long term effects in pregnancy on the offspring later in life. In regards to the parental education, it tells us that society and government policies which continue to lift up the overall education level of families will improve their societal circumstances and their long term outcomes and also as far as adult BMI goes, continuing to encourage healthy lifestyle behaviours will play a role in people’s personalities.
Christine Garrington 7:19
Are there any other key takeaways that you’d like to mention?
Rachel Robinson 7:21
I think it’s just quite important that one we recognise that the level of optimism is is equal and that in itself is a very good thing because our research group is looking at what are the factors that allow certain preterm children to prosper. Because there is strong evidence that preterm children have worse outcomes in cognitive impairments, and depression, ADHD, autism spectrum disorder, academic achievement and physical health factors, higher blood pressure, there’s so many factors that we see later in life which are negatively affected, and it’s really refreshing to see that there is, in certain ways, no difference. So that’s quite good and, but then, many of the factors that we see, explain the difference between preterms and terms are something that are modifiable.
Christine Garrington 8:16
Yeah, so there are small changes potentially that could make big, long term differences for these for these for these babies. So early work, obviously, showing some really important findings, really interesting findings where things go from here in the project? And what more are you hoping to be able to do?
Rachel Robinson 8:36
Our project will continue to pursue other outcomes there we’ll be looking at how we can find ways to encourage societal government and family policies to really support pre terms now, and in future, and improve their lives and so that’s that’s the general direction that our work will continue to go and there are many universities and institutions around Europe collaborating to bring their data on preterm birth together and really join forces to find what makes life better. And also I was preterm myself that it has its own level of importance to me and also I think it’s a topic that impacts a lot of people because people think that when you’re a small child, or the small infant, then you catch up, that they don’t suffer as much as far as social, academic, relational, all of these outcomes that we see now being different, as a preterm child I had no idea that I was at higher risk for for these things later in life. So, at least to me, it’s fascinating.
Christine Garrington 9:46
Optimism and Pessimism and Preterm is research presented at the DIAL Conference 2019 by Rachel Robinson. You can find out more about the NORFACE funded DIAL projects at www.dynamicsofinequality.org. Thanks for listening to this episode of our podcast, which is presented and produced by Chris Garrington and edited by Elina Kilpi-Jakonen.