251
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Coppola G, Cassibba R. Mothers' social behaviours in the NICU during newborns' hospitalisation: an observational approach. J Reprod Infant Psychol 2010. [DOI: 10.1080/02646830903298731] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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252
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Psychiatric Disorders in Extremely Preterm Children: Longitudinal Finding at Age 11 Years in the EPICure Study. J Am Acad Child Adolesc Psychiatry 2010. [PMID: 20431465 DOI: 10.1016/j.jaac.2010.02.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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253
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Abstract
Because of increased survival rates, neurodevelopmental issues, chronic medical problems, and sometimes complex family issues involved with prematurity, mental health clinicians commonly assess preterm clients and manage their behavioral and mental health problems. Understanding prematurity survival and neurodevelopmental outcomes is important for contextualizing the mental health problems seen in this high-risk population. This article provides a brief overview of prematurity outcomes in the domains of prematurity relevant to practicing child psychiatrists. Prematurity is also examined as it relates to parental mental health challenges, infant mental health outcomes, high frequency attention problems, and psychiatric disorders. The complex interactions between prematurity and family well-being are also highlighted. Finally, evidence-based treatment modalities involved in prevention and management are explored.
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254
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Abstract
The mother's voice, along with other developmentally appropriate sensory events (ie, touch, light, smells), stimulates maturation of the sensory systems and helps shape normal fetal development. While vast changes in the neonatal intensive care unit have occurred over the last 2 decades, little research has addressed the loss of exposure to maternal voice for the preterm infant. To address this gap, we compared studies that directly investigated effects of exposure to maternal voice on preterm infants. Studies reviewed were conducted between 1972 and 2007. All presented recordings of maternal voice at sound levels above current recommendations, and few of the findings reached statistical significance. Some potentially positive developmental effects were indicated. Future study of the effects of exposure to maternal voice on preterm infants using recommended sound levels is needed.
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255
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Poehlmann J, Schwichtenberg AJM, Shah PE, Shlafer RJ, Hahn E, Maleck S. The development of effortful control in children born preterm. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2010; 39:522-36. [PMID: 20589563 PMCID: PMC2917753 DOI: 10.1080/15374416.2010.486319] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This prospective longitudinal study examined emerging effortful control skills at 24- and 36-months postterm in 172 children born preterm (<36 weeks gestation). Infant (neonatal health risks), family (sociodemographic risks), and maternal risk factors (depressive symptoms, anger expressions during play interactions) were assessed at six time points across 3 years. In addition, children's emerging effortful control skills, cognitive development, and mother-reported behavior and attention problems were assessed at 24 and 36 months. Analyses documented links between effortful control skills, cognitive skills, and concurrent attention problems in children born preterm. The study also found that preterm children's effortful control skills improved over time. In addition, neonatal health risks, family sociodemographic risks, and angry parenting interactions were associated with less optimal effortful control skills.
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Affiliation(s)
- Julie Poehlmann
- Department of Human Development and Family Studies, Waisman Center, University of Wisconsin-Madison, Madison, WI 53705, USA.
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256
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Alvarez L, Cayol V, Magny JF, Morisseau L. L'ombre des traumatismes périnatals sur les premiers liens. PSYCHIATRIE DE L ENFANT 2010. [DOI: 10.3917/psye.532.0609] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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257
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Flykt M, Kanninen K, Sinkkonen J, Punamäki RL. Maternal depression and dyadic interaction: the role of maternal attachment style. INFANT AND CHILD DEVELOPMENT 2010. [DOI: 10.1002/icd.679] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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258
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Spittle AJ, Ferretti C, Anderson PJ, Orton J, Eeles A, Bates L, Boyd RN, Inder TE, Doyle LW. Improving the outcome of infants born at <30 weeks' gestation--a randomized controlled trial of preventative care at home. BMC Pediatr 2009; 9:73. [PMID: 19954550 PMCID: PMC2797495 DOI: 10.1186/1471-2431-9-73] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2009] [Accepted: 12/03/2009] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Early developmental interventions to prevent the high rate of neurodevelopmental problems in very preterm children, including cognitive, motor and behavioral impairments, are urgently needed. These interventions should be multi-faceted and include modules for caregivers given their high rates of mental health problems. METHODS/DESIGN We have designed a randomized controlled trial to assess the effectiveness of a preventative care program delivered at home over the first 12 months of life for infants born very preterm (<30 weeks of gestational age) and their families, compared with standard medical follow-up. The aim of the program, delivered over nine sessions by a team comprising a physiotherapist and psychologist, is to improve infant development (cognitive, motor and language), behavioral regulation, caregiver-child interactions and caregiver mental health at 24 months' corrected age. The infants will be stratified by severity of brain white matter injury (assessed by magnetic resonance imaging) at term equivalent age, and then randomized. At 12 months' corrected age interim outcome measures will include motor development assessed using the Alberta Infant Motor Scale and the Neurological Sensory Motor Developmental Assessment. Caregivers will also complete a questionnaire at this time to obtain information on behavior, parenting, caregiver mental health, and social support. The primary outcomes are at 24 months' corrected age and include cognitive, motor and language development assessed with the Bayley Scales of Infant and Toddler Development (Bayley-III). Secondary outcomes at 24 months include caregiver-child interaction measured using an observational task, and infant behavior, parenting, caregiver mental health and social support measured via standardized parental questionnaires. DISCUSSION This paper presents the background, study design and protocol for a randomized controlled trial in very preterm infants utilizing a preventative care program in the first year after discharge home designed to improve cognitive, motor and behavioral outcomes of very preterm children and caregiver mental health at two-years' corrected age. CLINICAL TRIAL REGISTRATION NUMBER ACTRN12605000492651.
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Affiliation(s)
- Alicia J Spittle
- Physiotherapy, School of Health Sciences, University of Melbourne, 200 Berkley Street, Parkville, Victoria, 3052, Australia
- Victorian Infant Brain Studies, Murdoch Childrens Research Institute, 2ndFloor, Flemington Road, Parkville, Victoria, 3052, Australia
- Neonatal Services, Royal Women's Hospital, 7th Floor, Cnr Grattan Street and Flemington Road, Parkville, Victoria, 3052, Australia
| | - Carmel Ferretti
- Physiotherapy, School of Health Sciences, University of Melbourne, 200 Berkley Street, Parkville, Victoria, 3052, Australia
- Victorian Infant Brain Studies, Murdoch Childrens Research Institute, 2ndFloor, Flemington Road, Parkville, Victoria, 3052, Australia
- Psychology, School of Behavioural Sciences, University of Melbourne, 12th Floor, Redmond Barry Building, Victoria, 3010, Australia
| | - Peter J Anderson
- Physiotherapy, School of Health Sciences, University of Melbourne, 200 Berkley Street, Parkville, Victoria, 3052, Australia
- Victorian Infant Brain Studies, Murdoch Childrens Research Institute, 2ndFloor, Flemington Road, Parkville, Victoria, 3052, Australia
| | - Jane Orton
- Neonatal Services, Royal Women's Hospital, 7th Floor, Cnr Grattan Street and Flemington Road, Parkville, Victoria, 3052, Australia
| | - Abbey Eeles
- Physiotherapy, School of Health Sciences, University of Melbourne, 200 Berkley Street, Parkville, Victoria, 3052, Australia
- Victorian Infant Brain Studies, Murdoch Childrens Research Institute, 2ndFloor, Flemington Road, Parkville, Victoria, 3052, Australia
- Neonatal Services, Royal Women's Hospital, 7th Floor, Cnr Grattan Street and Flemington Road, Parkville, Victoria, 3052, Australia
| | - Lisa Bates
- Physiotherapy, School of Health Sciences, University of Melbourne, 200 Berkley Street, Parkville, Victoria, 3052, Australia
| | - Roslyn N Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, University of Queensland, Level 3, Foundation Building, Royal Children's Hospital, Herston, Queensland, 4006, Australia
| | - Terrie E Inder
- Newborn Medicine, Washington University School of Medicine, 660 S. Euclid Avenue, St. Louis, MO, USA
| | - Lex W Doyle
- Victorian Infant Brain Studies, Murdoch Childrens Research Institute, 2ndFloor, Flemington Road, Parkville, Victoria, 3052, Australia
- Neonatal Services, Royal Women's Hospital, 7th Floor, Cnr Grattan Street and Flemington Road, Parkville, Victoria, 3052, Australia
- Department of Obstetrics and Gynaecology, 7th Floor, Cnr Grattan Street and Flemington Road, Parkville, Victoria, 3052, Australia
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259
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Sophie D, Le Quen V, Bureau V, Ancel PY, Bréart G, Rozé JC. Maternal psychological impact of medical information in the neonatal period after premature birth. Early Hum Dev 2009; 85:791-3. [PMID: 19932945 DOI: 10.1016/j.earlhumdev.2009.10.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2009] [Revised: 10/26/2009] [Accepted: 10/27/2009] [Indexed: 10/20/2022]
Abstract
The mothers of premature infant born 7 years ago were interviewed regarding memory of neonatal hospitalization during a 40-minute phone interview using a questionnaire exploring emotional feeling and satisfaction. The memory of a high emotional feeling was significantly associated with cranial ultrasound abnormalities in neonatal period, but not outcome. Dissatisfaction was reduced by antenatal maternal hospitalization. We speculate that medical information gathered during perinatal hospitalization explains these relationships.
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Affiliation(s)
- Denizot Sophie
- INSERM CIC 004; Nantes University Hospital, Department of Neonatalogy, Nantes, France.
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260
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Janssens A, Uvin K, Van Impe H, Laroche SMF, Van Reempts P, Deboutte D. Psychopathology among preterm infants using the Diagnostic Classification Zero to Three. Acta Paediatr 2009; 98:1988-93. [PMID: 19709094 DOI: 10.1111/j.1651-2227.2009.01488.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM To compare the prevalence of psychopathology in infants born preterm with matched full-term infants at the corrected age of 1 year. METHODS Between June 2003 and April 2005, a case-control longitudinal cohort study was conducted at the neonatal unit of the University Hospital of Antwerp, Belgium. We prospectively enrolled 123 live-born infants between 25 and 35 weeks of gestation and/or infants with a birth-weight of <1500 g. Thirty full-term infants were recruited among day care centres in the region. Diagnoses were based on the Diagnostic Classification Zero to Three (DC: 0-3), using the MacArthur Communicative Developmental Inventory Dutch version, Infant-Toddler Sensory Profile, Bayley Scales of Infant Development II, Parent Infant Relationship Global Assessment Scale and Functional Emotional Assessment Scale. RESULTS At the (corrected) age of 12 months, 89 infants were eligible for follow-up and complete data were available for 69 (77%) infants. Fifty-four percentage of the preterm infants fulfilled one or more DC 0-3 diagnoses. Premature infants had significantly more diagnoses than full-term infants on axis I, axis III and axis V of the DC: 0-3. CONCLUSION In this study, the prevalence of psychopathology was significantly higher among preterm infants in comparison with full-term infants. This study did not confirm previous findings of higher rates of relationship disorders among preterm infants.
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Affiliation(s)
- A Janssens
- Collaborative Antwerp Psychiatric Research Institute, University of Antwerp, Antwerp, Belgium.
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261
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Randomized trial of a parenting intervention for very preterm infants: outcome at 2 years. J Pediatr 2009; 155:488-94. [PMID: 19595367 DOI: 10.1016/j.jpeds.2009.04.013] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2009] [Revised: 03/12/2009] [Accepted: 04/08/2009] [Indexed: 11/21/2022]
Abstract
OBJECTIVES To determine the efficacy of a neonatal parenting intervention for improving development in very preterm infants. STUDY DESIGN A cluster-randomized, controlled trial with a cross-over design and washout period was conducted in 6 neonatal centers. Two hundred thirty-three babies <32 weeks' gestation were recruited (intervention = 112; control = 121). Intervention families received weekly Parent Baby Interaction Programme (PBIP) sessions during neonatal intensive care unit admission and up to 6 weeks after discharge. Control families received standard care. All 195 infants remaining in the study at 24 months' corrected age were assessed by psychologists blinded to group allocation. RESULTS There was no significant difference in Mental Development Index (-0.9 points; 95% CI, -5.0, 3.2) or Psychomotor Development Index (2.5; -3.3, 8.4) scores between the intervention and control groups and no significant effect of intervention on Mental Development Index or Psychomotor Development Index scores for subgroups dichotomized by gestational age (<28 weeks/> or =28 weeks), parity (1st/other child) or mother's cohabiting status (supported/unsupported). CONCLUSIONS There was no effect of PBIP on infant development at 2 years' corrected age. Parenting interventions may be better delivered after discharge or targeted for preterm infants with high biological and social risk.
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262
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Feeley N, Zelkowitz P, Cormier C, Charbonneau L, Lacroix A, Papageorgiou A. Posttraumatic stress among mothers of very low birthweight infants at 6 months after discharge from the neonatal intensive care unit. Appl Nurs Res 2009; 24:114-7. [PMID: 20974070 DOI: 10.1016/j.apnr.2009.04.004] [Citation(s) in RCA: 118] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2009] [Accepted: 04/04/2009] [Indexed: 11/18/2022]
Abstract
This correlational study examined how mother's posttraumatic stress disorder (PTSD) symptoms are related to characteristics of the mother and her infant, as well as to mother-infant interaction and infant development, in 21 mothers of very low birthweight infants. Twenty-three percent of mothers scored in the clinical range on a measure of PTSD. How ill the infant was during the NICU hospitalization was related to mothers' PTSD symptoms. Mothers with greater PTSD symptoms were less sensitive and effective at structuring interaction with their infant.
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263
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Kitamura N, Nagahama T, Ishizaki Y, Kinoshita Y, Kaneko K. Effects of interview on mood status of pregnant women with high-risk delivery. Pediatr Int 2009; 51:498-501. [PMID: 19674362 DOI: 10.1111/j.1442-200x.2008.02784.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Expectant mothers at high risk for preterm labor admitted to the Mother and Child Health Centers (MCH) often have psychological problems and mood disturbances. The purpose of the present study was to evaluate the effects of an interview by health professionals on their mood status. METHODS Participants consisted of 52 women admitted to the MCH of Kansai Medical University (KMU) hospital and who had delivered between December 2006 and September 2007. Interview sessions by health professionals consisting of a neonatologist and a clinical psychologist, termed 'KMU baby doctor-team interview', were held once a week. During the interview the neonatologist discussed the physiology of preterm infants and treatment for the possible complications while the clinical psychologist listened to the expectant mothers talk about their anxieties or complaints and responded to their requests as much as possible. To investigate their mood status objectively, the participants were asked to complete the Japanese version of the Profile of Mood States (POMS) before and after the first session. RESULTS On admission, more than 20% of participants ranging from 19 to 42 years of age had mood disturbances in Tension-Anxiety, Depression-Dejection, and Vigor categorized by POMS. The average score for Depression-Dejection, however, significantly improved after the first interview sessions. CONCLUSIONS Mood disturbances were observed in a considerable number of expectant mothers at high risk for preterm labor. Interviews by health professionals consisting of a neonatologist and a clinical psychologist may alter their mood status.
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Affiliation(s)
- Naoyuki Kitamura
- Department of Pediatrics, Kansai Medical University, Osaka City University, Osaka, Japan.
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264
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Grunau RE, Whitfield MF, Petrie-Thomas J, Synnes AR, Cepeda IL, Keidar A, Rogers M, Mackay M, Hubber-Richard P, Johannesen D. Neonatal pain, parenting stress and interaction, in relation to cognitive and motor development at 8 and 18 months in preterm infants. Pain 2009; 143:138-46. [PMID: 19307058 DOI: 10.1016/j.pain.2009.02.014] [Citation(s) in RCA: 316] [Impact Index Per Article: 21.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2008] [Revised: 01/21/2009] [Accepted: 02/17/2009] [Indexed: 11/16/2022]
Abstract
Procedural pain in the neonatal intensive care unit triggers a cascade of physiological, behavioral and hormonal disruptions which may contribute to altered neurodevelopment in infants born very preterm, who undergo prolonged hospitalization at a time of physiological immaturity and rapid brain development. The aim of this study was to examine relationships between cumulative procedural pain (number of skin-breaking procedures from birth to term, adjusted for early illness severity and overall intravenous morphine exposure), and later cognitive, motor abilities and behavior in very preterm infants at 8 and 18 months corrected chronological age (CCA), and further, to evaluate the extent to which parenting factors modulate these relationships over time. Participants were N=211 infants (n=137 born preterm 32 weeks gestational age [GA] and n=74 full-term controls) followed prospectively since birth. Infants with significant neonatal brain injury (periventricular leucomalacia, grade 3 or 4 intraventricular hemorrhage) and/or major sensori-neural impairments, were excluded. Poorer cognition and motor function were associated with higher number of skin-breaking procedures, independent of early illness severity, overall intravenous morphine, and exposure to postnatal steroids. The number of skin-breaking procedures as a marker of neonatal pain was closely related to days on mechanical ventilation. In general, greater overall exposure to intravenous morphine was associated with poorer motor development at 8 months, but not at 18 months CCA, however, specific protocols for morphine administration were not evaluated. Lower parenting stress modulated effects of neonatal pain, only on cognitive outcome at 18 months.
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Affiliation(s)
- Ruth E Grunau
- Centre for Community Child Health Research, Child and Family Research Institute, Room F605B, 4480 Oak St., Vancouver, BC, Canada V6H 3V4.
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265
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Nottage SL. Parents' Use of Nonmedical Support Services in the Neonatal Intensive Care Unit. ACTA ACUST UNITED AC 2009; 28:257-73. [PMID: 16356897 DOI: 10.1080/01460860500396922] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Parents frequently identify the need for support while their infant is in the Neonatal Intensive Care Unit (NICU), however, they may simultaneously distance themselves from traditional family and friend support. Recognizing this, many NICUs provide additional nonmedical support services such as social workers, chaplains/religious counselors, and support groups. This article, part of a larger research study, suggests an inverse relationship between social support and the use of supportive services. In addition, parents in this study appear to use support services less often than would be anticipated based on their reports of utility. Suggestions are provided to potentially improve desirability/accessibility of these services.
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MESH Headings
- Adaptation, Psychological
- Adult
- Chaplaincy Service, Hospital/statistics & numerical data
- Counseling/statistics & numerical data
- Family/psychology
- Female
- Friends/psychology
- Health Care Surveys
- Health Services Accessibility
- Health Services Needs and Demand
- Hospitals, University
- Humans
- Infant, Newborn
- Intensive Care Units, Neonatal/organization & administration
- Male
- Middle Aged
- Nursing Methodology Research
- Organizational Objectives
- Parents/psychology
- Patient Acceptance of Health Care/psychology
- Patient Acceptance of Health Care/statistics & numerical data
- Psychology, Clinical
- Self-Help Groups/statistics & numerical data
- Social Support
- Social Work Department, Hospital/statistics & numerical data
- Stress, Psychological/etiology
- Stress, Psychological/prevention & control
- Stress, Psychological/psychology
- Surveys and Questionnaires
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Affiliation(s)
- Sage L Nottage
- Oregon Health and Science University, Child Development and Rehabilitation Center, Portland, Oregon, USA.
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266
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Muller-Nix C, Forcada-Guex M. Perinatal assessment of infant, parents, and parent-infant relationship: prematurity as an example. Child Adolesc Psychiatr Clin N Am 2009; 18:545-57. [PMID: 19486837 DOI: 10.1016/j.chc.2009.02.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This article reviews the stresses for parents, infants, and other caregivers during the period surrounding the birth of the premature infant. Principles of assessment of infant discomfort, parental stress, the parent-infant relationship, and the match of the medical caregiving environment to the individual infant's needs are discussed. Relevant tools to aide in these aspects of assessment are reviewed. The role of early assessment as preventive intervention and the indication for subsequent intervention in complicated cases of premature infants and their parents are further discussed. The article offers detailed clinical examples to illustrate these and other points throughout.
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Affiliation(s)
- Carole Muller-Nix
- Department of Child and Adolescent Psychiatry, University Hospital Lausanne, Hôpital Neslté, av. P. Decker 5, Lausanne 1011, Switzerland.
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267
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Hays MA, Millet C. Soutien des parents et des nouveau-nés hospitalisés en néonatologie : intérêt d’un dispositif de groupe. Arch Pediatr 2009; 16:1090-6. [DOI: 10.1016/j.arcped.2009.02.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2008] [Revised: 01/28/2009] [Accepted: 02/18/2009] [Indexed: 10/20/2022]
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268
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Abstract
Premature infants are at increased risk for poor health, feeding difficulties, and impaired mother-infant interaction, leading to developmental delay. Social-environmental risks, such as poverty or minority status, compound these biological risks, placing premature infants in double jeopardy. Guided by an ecological model, the Hospital-Home Transition: Optimizing Prematures' Environment intervention combines the auditory, tactile, visual, and vestibular intervention with participatory guidance provided by a nurse and community advocate to address the impact of multiple risk factors on premature infants' development.
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Affiliation(s)
- Rosemary White-Traut
- Department of Women Children and Family Health Science, the University of Illinois at Chicago, College of Nursing (MC 802), 845 South Damen Avenue, Chicago, IL 60612-7350, USA.
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269
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Korja R, Savonlahti E, Haataja L, Lapinleimu H, Manninen H, Piha J, Lehtonen L. Attachment representations in mothers of preterm infants. Infant Behav Dev 2009; 32:305-11. [DOI: 10.1016/j.infbeh.2009.04.003] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2008] [Revised: 01/28/2009] [Accepted: 04/13/2009] [Indexed: 10/20/2022]
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270
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Holditch-Davis D, Miles MS, Weaver MA, Black B, Beeber L, Thoyre S, Engelke S. Patterns of distress in African-American mothers of preterm infants. J Dev Behav Pediatr 2009; 30:193-205. [PMID: 19412125 PMCID: PMC2755596 DOI: 10.1097/dbp.0b013e3181a7ee53] [Citation(s) in RCA: 114] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To examine inter-relationships among stress due to infant appearance and behavior in the neonatal intensive care unit (NICU), parental role alteration stress in the NICU, depressive symptoms, state anxiety, posttraumatic stress symptoms, and daily hassles exhibited by African-American mothers of preterm infants and to determine whether there were subgroups of mothers based on patterns of psychological distress. METHOD One hundred seventy-seven African-American mothers completed questionnaires on their psychological distress at enrollment during infant hospitalization and 2, 6, 12, 18, and 24 months after term. RESULTS Psychological distress measures were intercorrelated. There were four latent classes of mothers: the low distress class with low scores on all measures; the high NICU-related stress class with high infant appearance and parental role stress and moderate scores on other measures; the high depressive symptoms class with high depressive symptoms and state anxiety and moderately elevated scores on NICU-related stress and posttraumatic stress symptoms; the extreme distress class with the highest means on all measures. Infants in the high stress class were sicker than infants in the other classes. The extreme distress class mothers averaged the lowest educational level. The classes differed on distress measures, worry about the child, and parenting stress through 24 months with the extreme distress class having the highest values. CONCLUSION Although different types of maternal psychological distress were substantially related, there were distinct subgroups of mothers that were identifiable in the NICU. Moreover, these subgroups continued to differ on trajectories of distress and on their perceptions of the infants and parenting through 24 months after term.
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Affiliation(s)
- Diane Holditch-Davis
- Duke University, School of Nursing, 307 Trent Drive, DUMC 3322, Durham, NC 27710, USA.
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271
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Abstract
PURPOSE OF REVIEW Although traditional disciplinary research theory and methods have focused separately on how social and physical environmental factors affect children's health, evolving research underscores important integrated effects. RECENT FINDINGS This review outlines the specific reasons why social determinants should be considered mainstream in children's environmental health research with particular focus on interactive effects between social and physical hazards. These include sensitivity of overlapping physiological systems, via epigenesis, programming, and plasticity to social and physical environmental moderation that may impact health across the life span; ways in which social environmental vulnerabilities moderate the effects of physical environmental factors, providing specific examples related to respiratory health and neurodevelopment; overlapping exposure distribution profiles; and relevance to pediatric health disparities. SUMMARY Because of the covariance across exposures, and evidence that social stress and other environmental toxins (e.g., pollutants, tobacco smoke) may influence common physiological pathways (e.g., oxidative stress, proinflammatory immune pathways, autonomic disruption), understanding the potential synergistic effects promises to more completely inform children's environmental health risk. Although this discussion focuses around the respiratory and neurological systems, these concepts extend more broadly to children's psychological and physical development.
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Affiliation(s)
- Rosalind J Wright
- The Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 181 Longwood Avenue, Boston, MA 02067, USA.
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272
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Conséquences de la grande prématurité dans le domaine visuo-spatial, à l’âge de cinq ans. Arch Pediatr 2009; 16:227-34. [DOI: 10.1016/j.arcped.2008.12.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2008] [Revised: 10/02/2008] [Accepted: 12/10/2008] [Indexed: 11/22/2022]
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273
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Acute posttraumatic stress symptoms among urban mothers with newborns in the neonatal intensive care unit: a preliminary study. J Dev Behav Pediatr 2009; 30:50-6. [PMID: 19194322 DOI: 10.1097/dbp.0b013e318196b0de] [Citation(s) in RCA: 116] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Traumatic stress symptoms from multiple causes are endemic among impoverished women who are also at high risk for delivering infants requiring neonatal intensive care unit (NICU) care, but whether this event itself constitutes a distinct traumatic stress trigger is unknown. Previous research does suggest having an infant in the NICU generates traumatic stress among white middle-class mothers, stress that can impact their infant's behavior and development. This study evaluated the prevalence of acute posttraumatic stress symptoms among low-income mothers of infants admitted to the NICU compared with similar mothers with infants in the well baby nursery (WBN). METHODS A total of 59 NICU and 60 WBN mothers were recruited from the Boston Medical Center. Within the first week after birth, all participants were assessed for postpartum acute posttraumatic stress and depression symptoms and asked about lifetime traumatic events before the birth of their baby. The acute posttraumatic stress symptoms were analyzed as a continuous variable and whether they reached the categorical severity criteria for acute stress disorder. RESULTS NICU mothers show increased symptoms of acute posttraumatic stress and depression. Twenty-three percent of NICU and 3% of WBN reached severity criteria for acute stress disorder. When controlling for relevant covariates, having a newborn in the NICU had a significant association with the number of mothers' acute posttraumatic stress symptoms not fully explained by their symptoms of depression or prior lifetime history of traumatic events. CONCLUSIONS Addressing acute posttraumatic stress symptoms may enhance interventions to help urban families of NICU infants.
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274
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Lindström K, Lindblad F, Hjern A. Psychiatric morbidity in adolescents and young adults born preterm: a Swedish national cohort study. Pediatrics 2009; 123:e47-53. [PMID: 19117846 DOI: 10.1542/peds.2008-1654] [Citation(s) in RCA: 134] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Increasing numbers of infants born preterm survive into adulthood. Previous studies have reported increased levels of neurologic and cognitive disabilities in these children. In this study, we analyzed the effect of having been born preterm on psychiatric morbidity. METHODS A Swedish national cohort of 545628 individuals born in 1973-1979 was followed up in the national registers during 1987-2002. Multivariate Cox analysis of proportional hazards was used to estimate the hazard ratios of hospital admissions for psychiatric disorders and alcohol/illicit drug abuse. RESULTS There was a stepwise increase in psychiatric hospital admissions with an increasing degree of preterm birth. A total of 5.2% of children born at 24 to 28 weeks' gestation and 3.5% born at 29 to 32 weeks' gestation had been hospitalized because of a psychiatric disorder. The hazard ratios for psychiatric disorders were 1.68 in the group of very preterm children (gestational weeks 24-32), 1.21 in the moderately preterm group (gestational weeks 33-36), and 1.08 in the early term group (gestational weeks 37-38) after adjustment for socioeconomic confounders. Moderately preterm and early term birth accounted for 85% of the risk attributed to preterm/early term birth. The effect of preterm birth was greater in households with low socioeconomic status. CONCLUSION Preterm birth carries some risk for psychiatric disorders requiring hospitalization in adolescence and young adulthood (ages 8-29 years). Even if this risk increases with degree of preterm birth, most subjects are moderately preterm, a group in need of more attention in research and secondary prevention.
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Affiliation(s)
- Karolina Lindström
- Department of Clinical Sciences and Education, Karolinska Institutet, Södersjukhuset, Sachs Children's Hospital, Stockholm, Sweden.
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275
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Zelkowitz P, Papageorgiou A, Bardin C, Wang T. Persistent maternal anxiety affects the interaction between mothers and their very low birthweight children at 24 months. Early Hum Dev 2009; 85:51-8. [PMID: 18632229 DOI: 10.1016/j.earlhumdev.2008.06.010] [Citation(s) in RCA: 98] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2008] [Revised: 06/11/2008] [Accepted: 06/12/2008] [Indexed: 11/18/2022]
Abstract
BACKGROUND Parental distress following the birth of a premature infant diminishes the parent's ability to be sensitive to the infant's cues, and this may affect infant developmental outcomes. AIMS The present study examined the effects of maternal anxiety during infant hospitalization in the Neonatal Intensive Care Unit (NICU) on the interactive behavior of mothers with their very low birthweight (VLBW) children in toddlerhood. SUBJECTS A sample of 56 mothers and their VLBW infants were recruited in the NICU. STUDY DESIGN During the infant's NICU stay, mothers completed a self-report measure of trait anxiety. These mothers and their infants were followed when the infants were 24 months corrected age, when mothers and their children were videotaped during free play at home. These videotapes were then coded using the Emotional Availability Scales. RESULTS Maternal anxiety was not found to be related to severity of neonatal illness. Maternal anxiety in the NICU was associated with less sensitivity and less structure in interaction with their toddlers at 24 months corrected age, even controlling for maternal education and child birthweight. Children of mothers with higher anxiety scores in the NICU were less likely to involve their mothers in their play at 24 months corrected age. CONCLUSIONS Maternal anxiety in the NICU predicted adverse interactive behaviors when the children were 24 months corrected age. Early identification of anxious mothers in the NICU is needed in order to initiate preventive intervention to support the mother-infant relationship.
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Affiliation(s)
- Phyllis Zelkowitz
- Department of Psychiatry, Sir Mortimer B. Davis-Jewish General Hospital and McGill University, Canada.
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276
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Muller Nix C, Forcada-Guex M, Borghini A, Pierrehumbert B, Ansermet F. Prématurité, vécu parental et relations parents/enfant : éléments cliniques et données de recherche. PSYCHIATRIE DE L ENFANT 2009. [DOI: 10.3917/psye.522.0423] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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277
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Fuertes M, Lopes-dos-Santos P, Beeghly M, Tronick E. Infant Coping and Maternal Interactive Behavior Predict Attachment in a Portuguese Sample of Healthy Preterm Infants. EUROPEAN PSYCHOLOGIST 2009. [DOI: 10.1027/1016-9040.14.4.320] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
In this longitudinal study of a Portuguese sample of healthy preterm infants, the aim was to identify specific, independent predictors of infant-mother attachment status from a set of variables including maternal education, maternal representations’ of infant temperament, infant regulatory behavior (coping), and mothers’ interactive behavior in free play. The sample consisted of 48 medically low-risk preterm infants and their mothers who varied in education. When infants were 1 and 3 months (corrected age), mothers described their infants’ temperament using a Portuguese temperament scale (Escala de Temperamento do Bebé). At 3 months (corrected age), infants’ capacity to regulate stress (coping) was evaluated during Tronick’s Face-to-Face Still-Face paradigm (FFSF). At 9 months (corrected age), mothers’ interactive behaviors were evaluated during free play using the Crittenden’s Child-Adult Relationship Experimental Index (CARE-Index). At 12 months (corrected age), infants’ attachment security was assessed during Ainsworth’s strange situation. Sixteen (33.3%) infants were classified as securely attached, 17 (35.4%) as insecure-avoidant, and 15 (31.3%) as insecure-resistant. In bivariate analyses, multiple factors were significantly associated with attachment status. However, in hierarchical regression analyses, only infant coping and maternal responsiveness were significant predictors of attachment status. These findings suggest that both infant characteristics identifiable early in the first year, such as coping, and maternal characteristics such as sensitivity influence the process of attachment formation.
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Affiliation(s)
- Marina Fuertes
- Child Development Unit & Harvard Medical School, Boston, MA, USA
- University of Porto, Porto, Portugal
| | | | - Marjorie Beeghly
- Child Development Unit & Harvard Medical School, Boston, MA, USA
- Wayne State University, Detroit, MI, USA
| | - Ed Tronick
- Child Development Unit & Harvard Medical School, Boston, MA, USA
- Department of Psychology, University of Massachusetts Boston & Fielding Graduate University, Santa Barbara, CA, USA
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278
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Ollivier AM. [Following the high-risk newborn: Why? How? Conducting an early medical-psychosocial consultation during hospitalization]. Arch Pediatr 2008; 16:201-8. [PMID: 19097874 DOI: 10.1016/j.arcped.2008.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2008] [Accepted: 11/14/2008] [Indexed: 11/28/2022]
Abstract
The usual follow-up of high-risk children concentrates on screening for sequelae of perinatal pathology, required by emergency pediatricians and neonatologists to assess their practices. The objective is to manage pathologies by intervening as early as possible. However, is this classical medical model, i.e., the diagnosis of something pathological and a schedule of consultations planned at specific dates, adapted to the needs of high-risk children and their parents? Beyond screening, the child development consultation at the Rozanoff Early Medico-Social Action Center, set up at the A. Trousseau Hospital in 1985, proposes a consultation in which a neuropediatrician, a physical therapist, a pediatric psychiatrist-psychoanalyst, and a social worker closely collaborate. The care begun during neonatal hospitalization concentrates on the needs of the child and parents, with a primary objective of lending support to child-parent interaction. The observation of a child born at 26 GW presenting gaze avoidance concurrent with symptoms of depression in the mother exemplifies the importance of this visit. Why are there still so few of this type of consultation taking into account the medical, psychological, and social risks in a single visit? Why is the attention given to neurologic problems, for which there is currently no cure, so disproportionate to the lack of awareness of the psychological and social risks for which effective prevention and treatment possibilities do exist?
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Affiliation(s)
- A Maurel Ollivier
- Centre d'assistance éducative (CAE) du tout-petit, centre d'action médicosociale précoce (CAMSP), Entraide universitaire, 27, rue du Colonel-Rozanoff, 75012 Paris, France.
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279
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Fuertes M, Faria A, Soares H, Crittenden P. Developmental and evolutionary assumptions in a study about the impact of premature birth and low income on mother–infant interaction. Acta Ethol 2008. [DOI: 10.1007/s10211-008-0051-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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280
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Danerek M, Dykes AK. A theoretical model of parents’ experiences of threat of preterm birth in Sweden. Midwifery 2008; 24:416-24. [DOI: 10.1016/j.midw.2006.07.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2005] [Revised: 07/12/2006] [Accepted: 07/29/2006] [Indexed: 11/15/2022]
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281
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Assessing the feasibility and acceptability of an intervention to reduce anxiety and enhance sensitivity among mothers of very low birth-weight infants. Adv Neonatal Care 2008; 8:276-84. [PMID: 18827517 DOI: 10.1097/01.anc.0000338018.48782.e1] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE A pilot study was conducted to assess the feasibility and acceptability of an intervention program for mothers of very low birth-weight infants in the neonatal intensive care unit (NICU). SUBJECTS Thirty-three mothers of infants born weighing less than 1500 g. DESIGN A single-group, pretest-posttest design was used. METHODS Preintervention mothers completed self-report questionnaires and their interaction with their infant was observed. Mothers then received the intervention program. Mothers were assessed twice postintervention, first when the infant was 1/2 months old and again at 6 months. At the postintervention assessments, mothers completed the same questionnaires and interaction was observed. MAIN OUTCOME MEASURES Mothers completed the State-Trait Anxiety Inventory, the revised Parental Stress Scale: Neonatal Intensive Care Unit, the NICU Parental Beliefs Scale, and the Perinatal PTSD Questionnaire. Interactions between mothers and infants were rated by trained research staff using the Index of Parental Behaviour in the NICU. Postintervention mothers also responded to a questionnaire that assessed their perceptions of the intervention program. RESULTS It was feasible to enroll mothers because 62% of eligible mothers agreed to participate. However, 39% of mothers who enrolled withdrew. Most of the mothers who withdrew did so before even beginning the intervention, and many of these women were mothers of multiples. It was also feasible to provide the intervention because more than 80% of mothers who began the intervention received all 6 teaching sessions. Mothers found both the content and the format of the program to be acceptable. There were nonetheless several challenges in conducting an intervention study with mothers early in the NICU hospitalization. CONCLUSIONS The results of this pilot study are encouraging. It was found to be both feasible and acceptable to provide the intervention program to mothers during the NICU hospitalization. The effectiveness of this program needs to be assessed in a randomized controlled trial.
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282
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Holditch-Davis D, Merrill P, Schwartz T, Scher M. Predictors of wheezing in prematurely born children. J Obstet Gynecol Neonatal Nurs 2008; 37:262-73. [PMID: 18507597 DOI: 10.1111/j.1552-6909.2008.00238.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE To examine the degree to which neonatal illness severity, postneonatal health problems, child characteristics, parenting quality as measured by the HOME Inventory, and maternal characteristics are related to the development of wheezing in prematurely born children over the first 27 months after term. DESIGN Longitudinal predictive study. SETTING Infants were recruited from two neonatal intensive care units, one in southeast and one in Midwest. PARTICIPANTS One hundred thirteen preterm infants who weighed less than 1,500 g or required mechanical ventilation and their mothers. MAIN OUTCOME MEASURES The presence of wheezing was obtained from maternal report at 2, 6, 9, 13, 18, 22, and 27 months. Wheezing was considered to be medically significant if the child was using bronchodilators or pulmonary antiinflammatory medications. RESULTS Sixty-eight percent of the children had wheezing at least one or more ages; 47% of the children were also taking bronchodilators or pulmonary antiinflammatory medications and thus had medically significant wheezing. CONCLUSION Postneonatal health problems and the social environment appear to be more important in developing wheezing in prematurely born children than neonatal medical complications.
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283
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Latva R, Korja R, Salmelin RK, Lehtonen L, Tamminen T. How is maternal recollection of the birth experience related to the behavioral and emotional outcome of preterm infants? Early Hum Dev 2008; 84:587-94. [PMID: 18403139 DOI: 10.1016/j.earlhumdev.2008.02.002] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2007] [Revised: 02/21/2008] [Accepted: 02/21/2008] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To investigate how mother's recollections of birth experiences and first contact with the newborn relate to the child's behavioral and emotional problems at five to six years of age. METHODS The study included 28 mothers of preterm (birth weight < or =2500 g) and 39 mothers of full-term children, born in Tampere University Hospital in 1998. When the children were five to six years old, maternal recollections of the birth experiences were assessed using the Clinical Interview for Parents of High-Risk Infants (CLIP) and children's behavioral and emotional problems were assessed using the Child Behavior Checklist (CBCL). RESULTS Mothers of the preterm children still had more negative recollections of the labor (p < 0.001) and first contact with the newborn (p < 0.001) than mothers of the full-term children. These recollections related to the child's behavioral and emotional symptoms when the child was five to six years old in the preterm group but not in the full-term group. CONCLUSION The impact of mother's birth experience seems to have long-lasting effects on the preterm child. This finding emphasizes the importance of early physical mother-infant contact and supporting the mothers of preterm infants, especially if they articulate negative or traumatic experiences related to the birth of their child.
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Affiliation(s)
- Reija Latva
- Department of Child Psychiatry, Tampere University Hospital and University of Tampere, Finland.
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284
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Moyer-Mileur LJ, Ball SD, Brunstetter VL, Chan GM. Maternal-administered physical activity enhances bone mineral acquisition in premature very low birth weight infants. J Perinatol 2008; 28:432-7. [PMID: 18337741 DOI: 10.1038/jp.2008.17] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To determine if physical activity delivered by an infant's mother would be as effective in promoting bone mineral acquisition in preterm very low birth weight (VLBW) infants as the same intervention administered by a trained therapist. PATIENTS AND METHODS Preterm VLBW infants were randomized to receive daily physical activity administered by the infant's mother (MOM, n=11) or a trained therapist (OT, n=11), or control (n=11). Physical activity consisted of range of motion movements against passive resistance to all extremities for 5 to 10 min daily. All infants were fed mother's milk with fortification to 24 kcal oz(-1). Dual energy x-ray of the forearm bone area (BA, cm(2)), mineral content (BMC, g), and density (BMD, g/cm(2)) and measurement of bone formation (bone-specific alkaline phosphatase, BAP) and resorption (urine pyridinium crosslinks of collagen, Pyd) were obtained at study entry and at 2.0 kg of body weight. RESULT Forearm BA and BMC gains were greater in MOM and OT infants compared to the control infants despite similar postnatal growth rate and nutrient intake. Serum BAP levels decreased in controls but remained unchanged in MOM and OT infants. Urine Pyd levels were similar at baseline to 2.0 kg for all groups. These findings suggest greater bone growth and mineral acquisition in MOM and OT infants than control infants. CONCLUSION This study demonstrates that a physical activity program administered by the infant's own mother is as equally effective as therapist-administered physical activity in promoting greater bone growth and mineral acquisition in preterm VLBW infants.
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Affiliation(s)
- L J Moyer-Mileur
- Division of Neonatology, Department of Pediatrics, University of Utah, Salt Lake City, UT 84132, USA.
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285
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Korja R, Savonlahti E, Ahlqvist-Björkroth S, Stolt S, Haataja L, Lapinleimu H, Piha J, Lehtonen L. Maternal depression is associated with mother-infant interaction in preterm infants. Acta Paediatr 2008; 97:724-30. [PMID: 18373715 DOI: 10.1111/j.1651-2227.2008.00733.x] [Citation(s) in RCA: 101] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM The purpose of this study was to assess the prevalence and the background factors of maternal depressive symptoms and their relation to the quality of mother-infant interaction in a group of preterm infants and their mothers. METHODS The signs of maternal depression were evaluated in 125 mothers of very preterm infants (birth weight < or = 1500 g or < 32 gestational weeks) at 6 months of infant's corrected age using Edinburgh Postnatal Depression Scale (EPDS). The association between maternal depressive symptoms and the quality of mother-infant interaction as assessed by the parent child early relational assessment method (PCERA) method was studied at 6 and 12 months of corrected age in 32 preterm infants who were their mothers' firstborn infants and singletons. RESULTS The prevalence of depression assessed by EPDS in mothers of very preterm infants was 12.6%. Most interestingly, the number of postnatal signs of depression associated negatively with the quality of the maternal interaction behaviour with their preterm infants. CONCLUSIONS This study suggests that maternal depression may be a risk factor in the development of the mother-infant relationship between preterm infants and their mothers. Therefore, it would be important to identify signs of depression in mothers of preterm infants to offer early support.
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Affiliation(s)
- Riikka Korja
- Department of Child Psychiatry, Turku University Hospital, Turku, Finland.
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286
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Korja R, Maunu J, Kirjavainen J, Savonlahti E, Haataja L, Lapinleimu H, Manninen H, Piha J, Lehtonen L. Mother-infant interaction is influenced by the amount of holding in preterm infants. Early Hum Dev 2008; 84:257-67. [PMID: 17707118 DOI: 10.1016/j.earlhumdev.2007.06.006] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2007] [Revised: 06/05/2007] [Accepted: 06/29/2007] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate associations between infant crying, holding and mother-infant interaction. METHODS The study groups included 30 firstborn Finnish preterm infants (<1501 g or <32 weeks), and their 36 full-term controls. Caregiver's holding and infant's crying behavior was assessed using Baby Day Diary at 5 months of corrected age. The quality of mother-infant interaction was assessed using PC-ERA at 6 and 12 months of corrected age. RESULTS The results showed that longer duration of holding in home environment was associated with better quality of mother-infant interaction at 6 and 12 months of corrected age in preterm infants. Preterm infants cried more often and were held more than full-term infants. The frequency of crying was associated with the duration of holding in preterm infants. Mother-infant interaction was comparable between the groups of preterm and full-term infants. CONCLUSIONS Our results underline the importance of caregiver's physical closeness for the quality of the mother-infant interaction in preterm infants. Prematurity itself does not necessary affect the quality of mother-infants interaction in a non-risk population.
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Affiliation(s)
- Riikka Korja
- Department of Psychology, University of Turku, Turku, Finland.
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287
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Erickson SJ, Lowe JR. The role of maternal responsiveness in predicting infant affect during the still face paradigm with infants born very low birth weight. Infant Ment Health J 2008. [DOI: 10.1002/imhj.20172] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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288
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Zusammenhänge zwischen dem Wohlbefinden der Mutter und der Herzfrequenzvariabilität von Frühgeborenen. Prax Kinderpsychol Kinderpsychiatr 2007; 56:852-69. [DOI: 10.13109/prkk.2007.56.10.852] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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289
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Tu MT, Grunau RE, Petrie-Thomas J, Haley DW, Weinberg J, Whitfield MF. Maternal stress and behavior modulate relationships between neonatal stress, attention, and basal cortisol at 8 months in preterm infants. Dev Psychobiol 2007; 49:150-64. [PMID: 17299787 PMCID: PMC1851900 DOI: 10.1002/dev.20204] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
There is evidence that the developmental trajectory of cortisol secretion in preterm infants is altered, with elevated basal cortisol levels observed postnatally through at least 18 months corrected age (CA). This alteration is possibly due to neonatal pain-related stress. High cortisol levels might contribute to greater risk of impaired neurodevelopment. Since maternal factors are important for the regulation of infant stress responses, we investigated relationships between infant (neonatal pain-related stress, attention, cortisol) and maternal (stress, interactive behaviors) factors at age 8 months CA. We found that interactive maternal behaviors buffered the relationship between high neonatal pain-related stress exposure and poorer focused attention in mothers who self-reported low concurrent stress. Furthermore, in preterm infants exposed to high concurrent maternal stress and overwhelming interactive maternal behaviors, higher basal cortisol levels were associated with poor focused attention. Overall, these findings suggest that maternal factors can influence the cognitive resilience at 8 months of preterm infants exposed to early life stress.
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Affiliation(s)
- Mai Thanh Tu
- Centre for Community Child Health Research Child and Family Research Institute Children's and Women's Health Centre of British Columbia, L408-4480 Oak Street Vancouver, V6H 3V4 Canada
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290
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Suter SE, Huggenberger HJ, Schächinger H. Cold pressor stress reduces left cradling preference in nulliparous human females. Stress 2007; 10:45-51. [PMID: 17454966 DOI: 10.1080/10253890601141259] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
The left cradling preference refers to the finding that women hold their infants more frequently on the left side of their own bodies. Several observational studies showed reduced left cradling during stressful circumstances, such as mother-infant separation, or domestic violence. However, until now no experimental study was conducted to investigate the immediate impact of stress on cradling behaviour. Half of the 64 female subjects participating were randomly assigned to a stressful bilateral cold pressor test. The remaining subjects performed a non-stressful control procedure. Before and after this intervention, cradling behaviour was assessed using a baby-like doll. Subjects showed a left cradling preference prior to the intervention. The cold pressor test increased blood pressure and heart rate significantly. A repeated ANOVA revealed an interaction of intervention (cold pressor vs. control) X assessment period (pre- vs. post-intervention), indicating that cold pressor stress reduces left cradling behaviour in female volunteers. Our data indicate that stress influences cradling preference. This may be of relevance for caregiver-infant interactions.
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Affiliation(s)
- Susanne E Suter
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Basel, Missionsstrasse 60/62, CH-4055 Basel, Switzerland
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291
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Jackson K, Ternestedt BM, Magnuson A, Schollin J. Parental stress and toddler behaviour at age 18 months after pre-term birth. Acta Paediatr 2007; 96:227-32. [PMID: 17429910 DOI: 10.1111/j.1651-2227.2007.00015.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM To describe the parent's judgement of their own stress and the child's behaviour at 18 months after pre-term birth and if there are any correlations between these assessments, the morbidity in the neonatal period, the gestational age at birth and the occurrence of twin/triplet births. METHOD Twenty-one mothers and 19 fathers of pre-term infants answered two questionnaires, The Swedish Parenthood Stress Questionnaire (SPSQ) and The Toddler Behaviour Questionnaire (TBQ). RESULTS Mothers scored somewhat higher than fathers concerning parental stress. Parents with twins/triplets and of children born in gestational week 25-30 felt more stress, though the differences were not statistically significant. High-risk diagnoses did not correlate to any of the dimensions. The parents judged the behaviour of the children similar except that parents of children born in gestational week 25-30 scored significantly higher for intensity/activity (p = 0.002). The correlation between parental stress and judgement of their children's behaviour did not show any significant association except for the dimension regularity in TBQ (p = 0.016). CONCLUSIONS The mothers' and fathers' assessments of their own stress and of the children's behaviour were similar. Parents of very pre-term children felt more stress and judged the children somewhat delayed in their social behaviours, probably due to their low gestational age.
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Affiliation(s)
- Karin Jackson
- Department of Health Science, Orebro University, Orebro, Sweden.
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294
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Zelkowitz P, Bardin C, Papageorgiou A. Anxiety affects the relationship between parents and their very low birth weight infants. Infant Ment Health J 2007. [PMID: 28640465 DOI: 10.1002/imhj.20137] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | - Claudette Bardin
- Sir Mortimer B. Davis-Jewish General Hospital and McGill University
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295
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Holditch-Davis D, Schwartz T, Black B, Scher M. Correlates of mother–premature infant interactions. Res Nurs Health 2007; 30:333-46. [PMID: 17514707 DOI: 10.1002/nur.20190] [Citation(s) in RCA: 92] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study's purpose was to examine whether child characteristics, child illness severity, maternal characteristics, maternal psychological well-being, and paternal support influenced interactions between 108 premature infants and their mothers. Mothers with singletons or more infant illness stress showed more positive involvement. Mothers with less infant illness stress, less education, or less participation in caregiving by fathers showed more negative control. First-time mothers and mothers of singletons provided more developmental stimulation. Children of younger and White mothers showed more social behaviors. Less maternal education and shorter period of mechanical ventilation were associated with greater developmental maturity. Greater maternal worry was related to more child irritability. These findings are consistent with the developmental science view that the mother-premature relationship is a complex, reciprocal process.
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296
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Riordan DV, Selvaraj S, Stark C, Gilbert JSE. Perinatal circumstances and risk of offspring suicide. Birth cohort study. Br J Psychiatry 2006; 189:502-7. [PMID: 17139033 DOI: 10.1192/bjp.bp.105.015974] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND A higher risk of suicide has been associated with low birth weight in one study, but not yet replicated. Higher birth order has been associated with self-harm, but not with suicide. AIMS To examine the relationship between perinatal circumstances and subsequent young adult suicide in Scotland. METHOD Using linked data from the Scottish Morbidity Record and Scottish death records, a birth cohort of 1061830 people was followed-up for a mean of 25.1 years. Data were analysed using Cox regression. RESULTS Higher maternal parity, younger maternal age (<25 years), non-professional parental occupations and low birth weight (<2500 g) were independently associated with higher suicide risk of offspring as young adults. There was no independent association with gestational age. CONCLUSIONS Our findings provide support for the influence of maternal circumstance and foetal experience on subsequent mental health.
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297
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Forcada-Guex M, Pierrehumbert B, Borghini A, Moessinger A, Muller-Nix C. Early dyadic patterns of mother-infant interactions and outcomes of prematurity at 18 months. Pediatrics 2006; 118:e107-14. [PMID: 16818525 DOI: 10.1542/peds.2005-1145] [Citation(s) in RCA: 274] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE With the increased survival of very preterm infants, there is a growing concern for their developmental and socioemotional outcomes. The quality of the early mother-infant relationship has been noted as 1 of the factors that may exacerbate or soften the potentially adverse impact of preterm birth, particularly concerning the infant's later competencies and development. The first purpose of the study was to identify at 6 months of corrected age whether there were specific dyadic mother-infant patterns of interaction in preterm as compared with term mother-infant dyads. The second purpose was to examine the potential impact of these dyadic patterns on the infant's behavioral and developmental outcomes at 18 months of corrected age. METHODS During a 12-month period (January-December 1998), all preterm infants who were <34 weeks of gestational age and hospitalized at the NICU of the Lausanne University Hospital were considered for inclusion in this longitudinal prospective follow-up study. Control healthy term infants were recruited during the same period from the maternity ward of our hospital. Mother-infant dyads with preterm infants (n = 47) and term infants (n = 25) were assessed at 6 months of corrected age during a mother-infant play interaction and coded according to the Care Index. This instrument evaluates the mother's interactional behavior according to 3 scales (sensitivity, control, and unresponsiveness) and the child's interactional behavior according to 4 scales (cooperation, compliance, difficult, and passivity). At 18 months, behavioral outcomes of the children were assessed on the basis of a semistructured interview of the mother, the Symptom Check List. The Symptom Check List explores 4 groups of behavioral symptoms: sleeping problems, eating problems, psychosomatic symptoms, and behavioral and emotional disorders. At the same age, developmental outcomes were evaluated using the Griffiths Developmental Scales. Five areas were evaluated: locomotor, personal-social, hearing and speech, eye-hand coordination, and performance. RESULTS Among the possible dyadic patterns of interaction, 2 patterns emerge recurrently in mother-infant preterm dyads: a "cooperative pattern" with a sensitive mother and a cooperative-responsive infant (28%) and a "controlling pattern" with a controlling mother and a compulsive-compliant infant (28%). The remaining 44% form a heterogeneous group that gathers all of the other preterm dyads and is composed of 1 sensitive mother-passive infant; 10 controlling mothers with a cooperative, difficult, or passive infant; and 10 unresponsive mothers with a cooperative, difficult, or passive infant. Among the term control subjects, 68% of the dyads are categorized as cooperative pattern dyads, 12% as controlling pattern dyads, and the 20% remaining as heterogeneous dyads. At 18 months, preterm infants of cooperative pattern dyads have similar outcomes as the term control infants. Preterm infants of controlling pattern dyads have significantly fewer positive outcomes as compared with preterm infants of cooperative pattern dyads, as well as compared with term control infants. They display significantly more behavioral symptoms than term infants, including more eating problems than term infants as well as infants from cooperative preterm dyads. Infants of the controlling preterm dyads do not differ significantly for the total development quotient but have worse personal-social development than term infants and worse hearing-speech development than infants from cooperative preterm dyads. The preterm infants of the heterogeneous group have outcomes that can be considered as intermediate with no significant differences compared with preterm infants from the cooperative pattern or the controlling pattern dyads. CONCLUSION Among mother-preterm infant dyads, we identified 2 specific patterns of interaction that could play either a protective (cooperative pattern) or a risk-precipitating (controlling pattern) role on developmental and behavioral outcome, independent of perinatal risk factors and of the family's socioeconomic background. The controlling pattern is much more prevalent among preterm than term dyads and is related to a less favorable infant outcome. However, the cooperative pattern still represents almost 30% of the preterm dyads, with infants' outcome comparable to the ones of term infants. These results point out the impact of the quality of mother-infant relationship on the infant's outcome. The most important clinical implication should be to support a healthy parent-infant relationship already in the NICU but also in the first months of the infant's life. Early individualized family-based interventions during neonatal hospitalization and transition to home have been shown to reduce maternal stress and depression and increase maternal self-esteem and to improve positive early parent-preterm infant interactions.
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Affiliation(s)
- Margarita Forcada-Guex
- Division of Neonatology, Department of Pediatrics, University Hospital Lausanne, Switzerland.
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298
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Yang J, Han H, Cao J, Li L, Xu L. Prenatal stress modifies hippocampal synaptic plasticity and spatial learning in young rat offspring. Hippocampus 2006; 16:431-6. [PMID: 16598704 DOI: 10.1002/hipo.20181] [Citation(s) in RCA: 117] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Clinical studies demonstrate that prenatal stress causes cognitive deficits and increases vulnerability to affective disorders in children and adolescents. The underlying mechanisms are not yet fully understood. Here, we reported that prenatal stress (10 unpredictable, 1 s, 0.8 mA foot shocks per day during gestational days 13-19) impaired long-term potentiation (LTP) but facilitated long-term depression (LTD) in hippocampal CA1 region in slices of the prenatal stressed offspring (5 weeks old). Cross-fostering neonate offspring by the prenatal stressed or control mothers did not change the effects of prenatal stress on the hippocampal LTP and LTD. Furthermore, prenatal stress enhanced the effects of acute stress on the hippocampal LTP and LTD and impaired spatial learning and memory in the Morris water maze in the young rat offspring. Therefore, prenatal stress alters synaptic plasticity and enhances the effects of acute stress on synaptic plasticity in the hippocampus, which may be the mechanism for the impaired spatial learning and memory in young rat offspring.
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Affiliation(s)
- Jianli Yang
- Mental Health Institute, The 2nd Xiangya Hospital of Central South University, Changsha 410011, Hunan, People's Republic of China
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299
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Punamäki RL, Repokari L, Vilska S, Poikkeus P, Tiitinen A, Sinkkonen J, Tulppala M. Maternal mental health and medical predictors of infant developmental and health problems from pregnancy to one year: does former infertility matter? Infant Behav Dev 2006; 29:230-42. [PMID: 17138278 DOI: 10.1016/j.infbeh.2005.12.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2005] [Revised: 11/14/2005] [Accepted: 12/27/2005] [Indexed: 11/15/2022]
Abstract
BACKGROUND Transition to parenthood involves considerable psychological, social and physiological changes. We examined how prenatal and perinatal mental health and medical conditions predict infant's developmental and health status at 12 months, and whether former infertility and assisted reproduction treatment (ART) affect the predictor model. METHODS The participants were 520 mothers who filled in questionnaires at the second trimester of pregnancy (T1), and when the child was 2 months (T2) and 12 months old (T3). Depressive and anxiety symptoms indicate reduced levels of mental health, and medical factors involve problems in pregnancy (e.g., high blood pressure and bleeding) and birth complications (pain and loss of blood). Neonatal health refers to, e.g., birth-weight and neurological status. At 12 months mothers reported infants' verbal and motor development and general health status. RESULTS First, it was shown that generally maternal prenatal anxiety and medical problems in pregnancy together predicted infant's developmental problems at 12 months through poor neonatal health, and medical problems alone also through increased level of birth complications. Second, the predictor models differed according to the history of infertility. In the ART group prenatal depression and anxiety and medical problems together predicted infant's developmental problems through maternal post-partum depression, and medical problems also through birth complications, whereas in the spontaneous conception group psychological and medical paths were separated and did not carry on developmental and health problems into 12 months. CONCLUSIONS Maternal health care should consider both psychological and medical risk paths across the whole transition to parenthood, and be aware of specific mediating paths in the risk groups.
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300
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Borghini A, Pierrehumbert B, Miljkovitch R, Muller-Nix C, Forcada-Guex M, Ansermet F. Mother's attachment representations of their premature infant at 6 and 18 months after birth. Infant Ment Health J 2006. [PMID: 28640398 DOI: 10.1002/imhj.20103] [Citation(s) in RCA: 98] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The effects of premature birth on attachment have generally been examined from the infant's perspective. There is a lack of data concerning parental attachment representations toward a premature child. Because of the psychological stress engendered in parents confronted with a premature birth, we hypothesized that their attachment representations would be altered during the first months after the hospital discharge. Fifty families with a premature infant (25-33 gestation weeks) and a control group of 30 families with a full-term infant participated to the study. Perinatal risks were evaluated during hospitalization. To assess mothers' representations of their infant, the Working Model of the Child Interview (WMCI, Zeanah & Benoit, 1995 & Benoit, Zeanah, Parker, Nicholson, & Coolbear, 1997) were administered when their children were 6 and 18 months old. The severity of the perinatal risks was found to have an impact on the mothers' attachment representations. At six months, only 20% of the mothers of a prematurely born infant (30% at 18 months) had secure attachment representations, vs. 53% for the control group (57% at 18 months). Furthermore, mothers of low-risk premature infants more often had disengaged representations, whereas distorted representations were more frequent in the high-risk group of premature children. These findings suggest that the parental response to a premature birth is linked to the severity of postnatal risks. The fact that secure attachment representations are affected in mothers of low-risk infants just as much as they are in mothers of high-risk infants points to the need to conduct further studies aimed at evaluating whether preventive intervention for both low-risk and high-risk premature will be helpful.
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Affiliation(s)
- Ayala Borghini
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Lausanne
| | | | | | - Carole Muller-Nix
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Lausanne
| | | | - François Ansermet
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Lausanne
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