Babies born prematurely who survive are a wonder to their families.

But according to a new study published in the journal Pediatrics Wednesday by McMaster University's Michael G. DeGroote School of Medicine, the fight to survive is long lasting for some.

The study suggests preemies born with an extremely low birth weight (ELBW) who experience childhood bullying have a greater risk of developing mental health challenges in adulthood compared to children with normal birth weights.

"This is the first study to fully illustrate the profound and long-lasting effects of bullying on the mental health of preterm survivors." - Dr. Ryan Van Lieshout, Sr. Author & Assistant Prof. of Psychiatry and Behavioural Neurosciences, McMastery University

"Being bullied has a significant and lasting impact for those preemies, even into their 30s," said Kimberly Day, lead author of the study and Lawson Postdoctoral Fellow at the Offord Centre for Child Studies at McMaster.

Study results also suggest the more frequently these kids are subjected to bullying, the stronger chance they have to develop problems such as: depression, anxiety, antisocial behavior or attention-deficit/hyperactivity disorder (ADHD) as adults. 

"This is the first study to fully illustrate the profound and long-lasting effects of bullying on the mental health of pre-term survivors," said Dr. Ryan Van Lieshout, senior author of the study and an assistant professor of psychiatry and behavioural neurosciences at McMaster.

Many factors at play

If the bullying continues into the age of 20, the risk is almost double for developing a mental health problem such as anxiety, depression or ADHD. The risk factors could triple into the age of 30 with continued bullying of ELBW kids and the disorders can be more severe; obsessive-compulsive behaviour, social phobias and panic disorder.  

It begs the question, why are ELBW kids at a higher risk for these types of issues?

"Possibly because of poor motor skills, higher levels of anxiety and depression and lower IQ so all these things have been found and they also have fewer resilience factors," said Day.

"This has important implications for parents, teachers, and clinicians who need to be aware of the long-term effects of peer victimization on mental health. They need to watch out for bullying and intervene when possible," said Day.

The study examined extremely low birth weight (ELBW) babies who were 2.2 pounds of less at their birth between 1977 and 1982 in Ontario. These same children were interviewed at age eight, 22 to 26 and again at 29 to 26.  Researchers compared them to normal birth weight children born in the same time span.  

Not a guarantee

Day cautioned against too strong a reaction to the findings.

"This is not a guarantee that those born with a low birth weight who experience bullying will have a psychiatric disorder as an adult."

While they may be at risk, she said not all children born with an ELBW will have a mental disorder whether they've been bullied or not.

"Unfortunately this is the first paper that has shown this so more replication is needed," she explained. 

Interesting to note, she said,  is the increasing amount of cyber bullying. "We focused on physical and verbal bullying and it was retrospectively reported when the participants were 22 to 26 years old. They reported on their experience before the age of 15," said Day. "Bullying that is being experienced now by children is different from the bullying that our participants would have reported on.

There wouldn't have been near as much cyber bullying if any."

According to the study, about a third of children worldwide face this type of victimization behaviour and ELBW kids are most likely to be the victims.  

The study was funded by the Canadian Institutes of Health Research and the American National Institutes of Health.