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Bilgin A, Wolke D, Trower H, Baumann N, Räikkönen K, Heinonen K, Kajantie E, Schnitzlein D, Lemola S. Problems in peer relationships and low engagement in romantic relationships in preterm born adolescents: effects of maternal warmth in early childhood. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02399-6. [PMID: 38492017 DOI: 10.1007/s00787-024-02399-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 02/15/2024] [Indexed: 03/18/2024]
Abstract
This study examined whether maternal warmth in early childhood moderates the association between preterm birth and problems in peer relationships and low engagement in romantic relationships in adolescence. We studied 9193 individuals from the Millennium Cohort Study in the United Kingdom, 99 (1.1%) of whom were born very preterm (VPT; < 32 weeks of gestation) and 629 (6.8%) moderate-to-late preterm (MLPT; 32-36 weeks gestation). Maternal warmth was reported by the mothers when their children were 3 years old. Peer relationship problems were reported by both the participants and their mothers at 14 and 17 years. Further, participants reported their engagement in romantic relationships at 14 and 17 years. All outcome variables were z-standardized, and the moderation effect was examined via hierarchical linear regressions. Compared to full-term birth, both MLPT and VPT birth were associated with lower engagement in romantic relationships at 17 years of age (b = .04, p = .02; b = .11, p = .02, respectively), and VPT birth was associated with increased peer relationship problems at 14 (b = .29, p = .01) and 17 years of age (b = .22, p = .046). Maternal warmth in early childhood was similarly associated with lower peer relationship problems in MLPT, VPT and full-term born adolescents. However, there was no influence of maternal warmth on engagement in romantic relationships at 17 years of age. There is no major modifying effect of maternal warmth in early childhood on the association between PT birth and peer relationship problems and low engagement in romantic relationships at 14 and 17 years of ages.
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Affiliation(s)
- Ayten Bilgin
- Department of Psychology, University of Essex, Colchester, CO4 3SQ, UK.
| | - Dieter Wolke
- Department of Psychology, University of Warwick, Coventry, UK
- Division of Health Sciences, Warwick Medical School, Mental Health and Wellbeing Unit, University of Warwick, Coventry, UK
| | - Hayley Trower
- Division of Health Sciences, Warwick Medical School, Mental Health and Wellbeing Unit, University of Warwick, Coventry, UK
| | - Nicole Baumann
- Department of Psychology, University of Warwick, Coventry, UK
- Department of Population Health Sciences, University of Leicester, Leicester, UK
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| | - Katri Räikkönen
- Department of Psychology & Logopedics, University of Helsinki, Helsinki, Finland
| | - Kati Heinonen
- Psychology/Welfare Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Eero Kajantie
- Finnish Institute for Health and Welfare, Helsinki, Finland
- Clinical Medicine Research Unit, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Pediatric Research Center, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Daniel Schnitzlein
- Leibniz University of Hannover, Hannover, Germany
- IZA Bonn, Bonn, Germany
| | - Sakari Lemola
- Department of Psychology, University of Warwick, Coventry, UK
- Department of Psychology, Bielefeld University, Bielefeld, Germany
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Fitzallen GC, Griffin A, Taylor HG, Kirby JN, Liley HG, Bora S. Risk profiles of the preterm behavioral phenotype in children aged 3 to 18 years. Front Pediatr 2023; 11:1084970. [PMID: 37928359 PMCID: PMC10620930 DOI: 10.3389/fped.2023.1084970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 08/22/2023] [Indexed: 11/07/2023] Open
Abstract
Objective Characterize the Preterm Behavioral Phenotype in children born preterm by identifying distinct profiles based on patterns of symptomatology or severity of the risk for attention-deficit/hyperactivity disorder, autism spectrum disorder, and anxiety, and determine their associations with child sex, gestational age, and chronological age. Methods Sample comprised 2,406 children born preterm aged 3-18 years with primary caregiver behavioral ratings on the standardized Strengths and Weaknesses of ADHD Symptoms and Normal Behavior Scale, Social Responsiveness Scale, and Preschool Anxiety Scale or Screen for Child Anxiety and Related Emotional Disorders. Results Statistical fit indices of latent profile analysis supported a 3-profile model as optimal. Using this model, 75% of children born preterm were identified as having low expression, 20% moderate expression, and 5% high expression profiles of the Preterm Behavioral Phenotype described as co-occurring symptomatology of attention-deficit/hyperactivity disorder, autism spectrum disorder, and anxiety. Male children were more likely than females to be categorized in the moderate expression [Relative Risk Ratio (RRR) = 1.29, 95% CI = 1.05-1.59], and high expression profiles (RRR = 1.77, 95% CI = 1.17-2.66). Children born extremely preterm were more likely than those born moderate/late preterm to be categorized in the moderate expression (RRR = 1.68, 95% CI = 1.30-2.19) and high expression profiles (RRR = 2.06, 95% CI = 1.31-3.25). Finally, those in the school-age (RRR = 1.68, 95% CI = 1.32-2.14; RRR = 1.95, 95% CI = 1.21-3.13), early adolescence (RRR = 1.85, 95% CI = 1.38-2.48; RRR = 2.61, 95% CI = 1.53-4.44) and late adolescence (RRR = 2.09, 95% CI = 1.38-3.19; RRR = 2.28, 95% CI = 1.02-5.08) periods were more likely than those in the preschool period to be categorized in the moderate and high expression profiles, respectively. Conclusion A quarter of children born preterm were at elevated risk for manifesting symptomatology across all three domains of the Preterm Behavioral Phenotype. Findings emphasize accounting for symptom co-occurrence of this phenotype in neurodevelopmental follow-up and psychosocial interventions to optimize child outcomes.
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Affiliation(s)
- Grace C. Fitzallen
- School of Psychological Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS, Australia
- Mater Research Institute, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
- School of Psychology, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Alison Griffin
- Statistics Unit, QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
| | - H. Gerry Taylor
- Center for Biobehavioral Health, Abigail Wexner Research Institute at Nationwide Children's Hospital, and Department of Pediatrics, The Ohio State University, Columbus, OH, United States
| | - James N. Kirby
- School of Psychology, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Helen G. Liley
- Mater Research Institute, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Samudragupta Bora
- Mater Research Institute, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
- School of Psychology, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD, Australia
- Department of Pediatrics, University Hospitals Rainbow Babies & Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, OH, United States
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Moor S, Williman J, Harris S, Ellis N, Graham P, Austin N. Late effects of prematurity: Psychiatric outcomes of 17-year-olds born very preterm. J Paediatr Child Health 2023; 59:1122-1128. [PMID: 37448299 DOI: 10.1111/jpc.16467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 06/30/2023] [Accepted: 07/03/2023] [Indexed: 07/15/2023]
Abstract
AIM Very preterm (VPT) birth is a known early vulnerability factor, impacting both physical and mental health over the life-span. The additional burden of psychiatric illness in VPT adolescents is likely to adversely affect critical developmental tasks and personal, social and academic/vocational trajectories. Our aim was to examine the magnitude and extent of the risk of psychological burden by determining the prevalence of psychiatric disorders in our prospectively followed-up VPT and full-term (FT) control cohorts, in this period of developmental transition at age 17 years. METHODS Rates of psychiatric disorder in the VPT and FT control cohorts were ascertained at clinical interview of the adolescents and their care giver(s) by an adolescent psychiatrist. RESULTS VPT birth was associated with a greater risk of generalised anxiety disorder (VPT vs. FT risk ratio (RR) 2.33; 95% confidence interval (CI): 1.16, 4.67, P = 0.02), as well as attentional problems (VPT vs. FT RR 3.46; 95% CI: 1.01, 11.88, P = 0.03). Although care givers of VPT adolescents reported many social and communication difficulties, and observation at clinical interview supported this, our data did not reach clinical threshold for group differences in autistic spectrum disorder. For all other psychiatric disorders, there was no difference between VPT and FT control adolescents. CONCLUSION Our longitudinal cohort follow-up study examining the late effects of VPT birth has demonstrated increased rates of clinically significant psychiatric disorder in this period of important developmental transition. Families and health professionals need to be aware of the increased risk so they can monitor for symptoms and seek effective mental health treatments and support.
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Affiliation(s)
- Stephanie Moor
- Burwood Hospital, Te Whatu Ora, Health New Zealand, New Zealand
| | - Jonathan Williman
- Department of Population Health, University of Otago, Christchurch, New Zealand
| | - Sarah Harris
- Department of Paediatrics, University of Otago, Christchurch, New Zealand
| | - Nicola Ellis
- Christchurch Women's Hospital, Te Whatu Ora, Health New Zealand, Christchurch, New Zealand
| | - Patricia Graham
- Christchurch Women's Hospital, Te Whatu Ora, Health New Zealand, Christchurch, New Zealand
| | - Nicola Austin
- Christchurch Women's Hospital, Te Whatu Ora, Health New Zealand, Christchurch, New Zealand
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Taylor HG, Hoskinson KR, Vrantsidis DM, Minich NM, Busch T, Horn T, Mattson WI, Nelson EE. Quality of Social Relationships with Parents and Peers in Adolescents Born Extremely Preterm. J Dev Behav Pediatr 2023; 44:e218-e224. [PMID: 36943202 DOI: 10.1097/dbp.0000000000001165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 12/05/2022] [Indexed: 03/23/2023]
Abstract
OBJECTIVE Adolescents born extremely preterm (EPT, gestational age [GA] <28 weeks) are at higher risk for problems in peer socialization than those born full-term (FT, GA >36 weeks). This study was designed to examine the possibility that adolescents born EPT may also have difficulty in transitioning from parents to peers for socialization, a process referred to as "social reorienting." A secondary aim was to investigate associations of social reorienting with other neurodevelopmental characteristics. METHODS The Network of Relationships Inventory, Relationship Quality Version was administered to 24 adolescents (ages 11-16 years) born EPT and 29 born FT to obtain self-ratings of closeness and discord with parents and peers. Measures of other neurodevelopmental characteristics included tests of cognitive and social skills, adolescent self-ratings of adjustment and victimization, and parent ratings of youth behavior and adaptive skills. Mixed model analyses controlling for sex, socioeconomic status, and race were conducted to examine group differences in measures of relationship quality and their associations with other neurodevelopmental characteristics. RESULTS The EPT group had higher ratings of closeness with parents than the FT group. For adolescents from lower socioeconomic backgrounds, those born EPT had lower closeness with peers. Higher closeness with parents was associated with lower test scores. Lower closeness and more discord with peers were associated with more behavior problems. CONCLUSION Findings suggest that adolescents born EPT have difficulties in social reorientation toward peers and identify factors related to these difficulties. Results imply a need for interventions to improve peer socialization in youth born EPT.
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Affiliation(s)
- H Gerry Taylor
- Center for Biobehavioral Health, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH
- Department of Pediatrics, The Ohio State University, Columbus, OH
| | - Kristen R Hoskinson
- Center for Biobehavioral Health, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH
- Department of Pediatrics, The Ohio State University, Columbus, OH
| | - Daphne M Vrantsidis
- Center for Biobehavioral Health, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH
- Department of Pediatrics, The Ohio State University, Columbus, OH
| | | | - Tyler Busch
- Department of Pediatrics, Case Western Reserve University, Cleveland, OH
| | - Timothy Horn
- Center for Biobehavioral Health, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH
| | - Whitney I Mattson
- Center for Biobehavioral Health, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH
| | - Eric E Nelson
- Center for Biobehavioral Health, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH
- Department of Pediatrics, The Ohio State University, Columbus, OH
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Motor Performance in Association with Perceived Loneliness and Social Competence in 11-Year-Old Children Born Very Preterm. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9050660. [PMID: 35626837 PMCID: PMC9139346 DOI: 10.3390/children9050660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 04/29/2022] [Accepted: 05/02/2022] [Indexed: 11/30/2022]
Abstract
Background: Very preterm birth may affect motor performance and social competence up to adulthood. Our objective was to describe perceived loneliness and social competence in children born very preterm in relation to motor impairment. Methods: 165 children born very preterm (birth weight ≤ 1500 g and/or gestational age < 32 weeks) were assessed at 11 years of age. Cerebral palsy (CP) was diagnosed by 2 years of age. At 11 years of age, motor outcome was assessed using the Movement Assessment Battery for Children—Second edition (Movement ABC-2). Loneliness was evaluated by using the Peer Network and Dyadic Loneliness scale and social competence by using the Multisource Assessment of Children’s Social Competence Scale. Results: In total, 6 (4%) children had CP, 18 (11%) had Developmental Coordination Disorder (DCD) (Movement ABC-2 ≤ 5th percentiles), and 141 (85%) had typical motor development. There was no correlation between percentiles for total scores of the Movement ABC-2 and perceived loneliness or social competence when the children with motor impairment (CP or DCD) were excluded. Children with DCD reported less perceived loneliness, but more problems with social competence compared to children with CP. Conclusions: It is important to recognize children born very preterm with DCD to provide interventions and support services to prevent social exclusion.
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Affiliation(s)
- Andrei S Morgan
- Université de Paris, Epidemiology and Statistics Research Center/CRESS, INSERM U1153 EPOPé, INRA, Paris, France
- Elizabeth Garrett Anderson Institute for Women's Health London, University College London, London, UK
- Department of Neonatal Medicine, Maternité Port-Royal, Association Publique des Hôpitaux de Paris (APHP), Paris, France
| | - Marina Mendonça
- Department of Psychology, University of Warwick, Coventry, UK
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
| | - Nicole Thiele
- European Foundation for Care of the Newborn Infant, Munich, Germany
| | - Anna L David
- Elizabeth Garrett Anderson Institute for Women's Health London, University College London, London, UK
- National Institute for Health Research, University College London Hospital Biomedical Research Centre, London, UK
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7
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Ni Y, Mendonça M, Baumann N, Eves R, Kajantie E, Hovi P, Tikanmäki M, Räikkönen K, Heinonen K, Indredavik MS, Evensen KAI, Johnson S, Marlow N, Wolke D. Social Functioning in Adults Born Very Preterm: Individual Participant Meta-analysis. Pediatrics 2021; 148:peds.2021-051986. [PMID: 34702720 DOI: 10.1542/peds.2021-051986] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/22/2021] [Indexed: 11/24/2022] Open
Abstract
CONTEXT There is a lack of research on individual perceptions of social experiences and social relationships among very preterm (VP) adults compared with term-born peers. OBJECTIVE To investigate self-perceived social functioning in adults born VP (<32 weeks' gestation) and/or with very low birth weight (VLBW) (<1500g) compared with term-born adults (≥37 weeks' gestation) using an individual participant data (IPD) meta-analysis. DATA SOURCES Two international consortia: Research on European Children and Adults born Preterm and Adults Born Preterm International Collaboration. STUDY SELECTION Cohorts with outcomes assessed by using the Adult Self-Report Adaptive Functioning scales (friends, spouse/partner, family, job, and education) in both groups. DATA EXTRACTION IPD from 5 eligible cohorts were collected. Raw-sum scores for each scale were standardized as z scores by using mean and SD of controls for each cohort. Pooled effect size was measured by difference (Δ) in means between groups. RESULTS One-stage analyses (1285 participants) revealed significantly lower scores for relationships with friends in VP/VLBW adults compared with controls (Δ -0.37, 95% confidence interval [CI]: -0.61 to -0.13). Differences were similar after adjusting for sex, age, and socioeconomic status (Δ -0.39, 95% CI: -0.63 to -0.15) and after excluding participants with neurosensory impairment (Δ -0.34, 95% CI: -0.61 to -0.07). No significant differences were found in other domains. LIMITATIONS Generalizability of research findings to VP survivors born in recent decades. CONCLUSIONS VP/VLBW adults scored their relationship with friends lower but perceived their family and partner relationships, as well as work and educational experiences, as comparable to those of controls.
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Affiliation(s)
- Yanyan Ni
- Department of Psychology, University of Warwick, Coventry, United Kingdom.,EGA Institute for Women's Health, University College London, London, United Kingdom
| | - Marina Mendonça
- Department of Psychology, University of Warwick, Coventry, United Kingdom
| | - Nicole Baumann
- Department of Psychology, University of Warwick, Coventry, United Kingdom
| | - Robert Eves
- Department of Psychology, University of Warwick, Coventry, United Kingdom
| | - Eero Kajantie
- Department of Chronic Disease Prevention, Finnish Institute for Health and Welfare, Helsinki, Finland.,Research Unit for Pediatrics, Pediatric Neurology, Pediatric Surgery, Child Psychiatry, Dermatology, Clinical Genetics, Obstetrics and Gynecology, Otorhinolaryngology and Ophthalmology, Faculty of Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Children's Hospital, Helsinki University Hospital
| | - Petteri Hovi
- Department of Chronic Disease Prevention, Finnish Institute for Health and Welfare, Helsinki, Finland.,Children's Hospital, Helsinki University Hospital
| | - Marjaana Tikanmäki
- Department of Chronic Disease Prevention, Finnish Institute for Health and Welfare, Helsinki, Finland.,Research Unit for Pediatrics, Pediatric Neurology, Pediatric Surgery, Child Psychiatry, Dermatology, Clinical Genetics, Obstetrics and Gynecology, Otorhinolaryngology and Ophthalmology, Faculty of Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Katri Räikkönen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Kati Heinonen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Programs in Psychology and Comparative Social Policy and Welfare, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Marit S Indredavik
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kari-Anne I Evensen
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Unit for Physiotherapy Services, Trondheim Municipality, Trondheim, Norway.,Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Samantha Johnson
- Department of Health Sciences, University of Leicester, George Davies Centre, Leicester, United Kingdom
| | - Neil Marlow
- EGA Institute for Women's Health, University College London, London, United Kingdom
| | - Dieter Wolke
- Department of Psychology, University of Warwick, Coventry, United Kingdom
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Heuser-Spura KM, Jaekel J, Wolke D. The Impact of Formal School Entry on Children's Social Relationships with Parents, Siblings, and Friends. CHILDREN (BASEL, SWITZERLAND) 2021; 8:891. [PMID: 34682156 PMCID: PMC8535132 DOI: 10.3390/children8100891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/24/2021] [Accepted: 10/02/2021] [Indexed: 11/17/2022]
Abstract
The normative transition to formal schooling confronts children with social challenges but also opportunities. Longitudinal research on how school entry impacts children's family and friend-ship relationships is scarce. This study investigated social relationship qualities with parents, siblings, and friends among 1110 children (49.9% female) from the prospective, population-based Bavarian Longitudinal Study at 6 years (before school entry) and 8 years using a forced-choice card-sorting task. Multivariate analyses of variance revealed significant effects of age (i.e., school entry) on social relationship qualities with mothers (Pillai's Trace (PT) = 0.28, F(9, 1101) = 47.73, p < 0.001), fathers (PT = 0.14, F(9, 1101) = 19.47, p < 0.001), siblings (PT = 0.27, F(9, 1101) = 46.14, p < 0.001), and friends (PT = 0.21, F(9, 1101) = 32.57, p < 0.001). On average, children reported higher levels of parental comfort after school entry. Companionable qualities increased in relationships with friends, whereas sibling relationships became more conflictual from preschool to early school age. Findings provide unique insights into how social relationships develop from preschool to early school age, supporting evidence of the growing importance of friends. Conflict was predominant and increasing in sibling relationships and should be considered more in future research.
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Affiliation(s)
- Katharina M. Heuser-Spura
- Department of Pediatrics I, Neonatology, Pediatric Intensive Care and Pediatric Neurology, University Hospital Essen, University of Duisburg-Essen, 45122 Essen, Germany
- Faculty of Psychology, Ruhr-University Bochum, 44801 Bochum, Germany
| | - Julia Jaekel
- Unit of Psychology, Faculty of Education, University of Oulu, 90570 Oulu, Finland;
- Department of Psychology, University of Warwick, Coventry CV4 7AL, UK;
| | - Dieter Wolke
- Department of Psychology, University of Warwick, Coventry CV4 7AL, UK;
- Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
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9
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Freitas NFD, Nunes CRDN, Rodrigues TM, Valadares GC, Alves FL, Leal CRV, Luz NMCD, Rabello MDO, Machado MGP, Bouzada MCF. Neuropsychomotor development in children born preterm at 6 and 12 months of corrected gestational age. ACTA ACUST UNITED AC 2021; 40:e2020199. [PMID: 34495271 PMCID: PMC8432070 DOI: 10.1590/1984-0462/2022/40/2020199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 10/18/2020] [Indexed: 11/21/2022]
Abstract
Objective: To assess the incidence of neuropsychomotor developmental delay at 6 and 12 months of corrected gestational age in children born at 32 gestational weeks or less. Methods: A descriptive and prospective study was carried out at two public maternity hospitals. Between April 2017 and January 2019, we assessed 133 children without any known risk factors for neuropsychomotor developmental delay. The Bayley III scale was used to evaluate cognitive and motor development. The p value of the numerical variables was calculated using the Mann-Whitney test, whereas proportions of categorical variables were compared using the Z-test. Results: The mean maternal age was 26±6.9 years,78.8% were from middle and lower economic classes, and 57.1% of the analyzed children were female. Children presented with a higher incidence of delay at 12 months than at 6 months (10.3 and 2.3% at 12 and 6 months, respectively, for the cognitive score; 22.7 and 12% at 12 and 6 months, respectively, for the composite motor score; and 24.7 and 8.4% at 12 and 6 months, respectively, for the fine motor score). Conclusions: Cognitive and motor developmental delays were significant, with the highest incidence at 12 months. The results of this study encourage further research on this topic, since the exclusion criteria were comprehensive and the delays in neuropsychomotor development were significant.
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10
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Kennedy E, O'Nions E, Wolke D, Johnson S. Editorial: Is Preterm Birth Overlooked in Child and Adolescent Psychiatry? J Am Acad Child Adolesc Psychiatry 2021; 60:1066-1068. [PMID: 33340645 DOI: 10.1016/j.jaac.2020.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 12/10/2020] [Indexed: 11/15/2022]
Abstract
Obstetric factors have long been recognized as risk factors for the later development of poor mental health. One of the most consistently reported of these associations is for preterm birth (birth before 37 weeks' gestation), a form of early adversity that impacts health and development across the life course. Preterm birth is not uncommon: in 2014, 10.6% of live births globally (nearly 15 million babies) were preterm.1 Advances in neonatal care since the early 1990s have dramatically increased the numbers of babies who survive extreme preterm birth (birth at <28 weeks' gestation) in high-income countries. This has led to growing interest in how extreme preterm birth impacts longer term outcomes including psychosocial development across the life span.
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Affiliation(s)
- Eilis Kennedy
- The Tavistock and Portman NHS Foundation Trust, London, and University College London, London, United Kingdom.
| | - Elizabeth O'Nions
- The Tavistock and Portman NHS Foundation Trust, London, and University College London, London, United Kingdom
| | - Dieter Wolke
- University of Warwick and Warwick Medical School, Coventry, United Kingdom
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11
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Knudsen K, McGill G, Ann Waitzman K, Powell J, Carlson M, Shaffer G, Morris M. Collaboration to Improve Neuroprotection and Neuropromotion in the NICU: Team Education and Family Engagement. Neonatal Netw 2021; 40:212-223. [PMID: 34330871 DOI: 10.1891/11-t-680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2020] [Indexed: 11/25/2022]
Abstract
The number of babies born extremely low birth weight surviving to be discharged home after experiencing the NICU continues to improve. Unfortunately, early sensory development for these babies occurs in an environment vastly different from the intended in-utero environment and places them at high risk of long-term neurodevelopmental and neurocognitive challenges. Our goal in the NICU must transition from simply discharge home to supporting the neurosensory development necessary for a thriving lifetime. To accomplish a goal of thriving families and thriving babies, it is clear the NICU interprofessional team must share an understanding of neurosensory development, the neuroprotective strategies safeguarding development, the neuropromotive strategies supporting intended maturational development, and the essential nature of family integration in these processes. We share the educational endeavors of 11 center collaboratives in establishing the foundational knowledge necessary to support preterm babies and their families.
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12
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Knudsen K, Steffen E, Sampson L, Bong K, Morris M. Collaboration to Improve Neuroprotection and Neuropromotion in the NICU: A Quality Improvement Initiative. Neonatal Netw 2021; 40:201-209. [PMID: 34330870 DOI: 10.1891/11-t-700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2020] [Indexed: 11/25/2022]
Abstract
Implementation of neuroprotective and neuropromotive (NP2) strategies is essential to optimize outcomes for premature infants. Developmental care, once an addition to medical care, is now recognized by the NICU team as foundational to support long-term neurodevelopment of micropremature infants. A group approach to education and sharing implementation processes can result in collaborative and individual center improvements. This article includes examples of quality improvement (QI) education and tools inspired by implementation of NP2 strategies in a consortium of 11 NICUs in the United States and Canada. Process change guided by potentially better practices are key; however, consistency of application must be included to ensure success. Assessment of NP2 practices via use of surveys and practice audits are described. Increases occurred in family NP2 education and provision of support during painful experiences. There were also increases in skin-to-skin holding, 2-person caregiving, and focus on reducing unnecessary painful procedures.
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Dean B, Ginnell L, Boardman JP, Fletcher-Watson S. Social cognition following preterm birth: A systematic review. Neurosci Biobehav Rev 2021; 124:151-167. [PMID: 33524414 DOI: 10.1016/j.neubiorev.2021.01.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 12/22/2020] [Accepted: 01/04/2021] [Indexed: 01/15/2023]
Abstract
Social cognitive abilities are affected by preterm birth, but pathways to, and risk factors for this outcome are not well mapped. We examined direct assessment tasks including objective coding of parent-child play to chart social development in infancy and pre-school years. A systematic search and data-extraction procedure yielded seventy-nine studies (4930 preterm and 2109 term children, aged birth - five years), for inclusion. We detected a pattern of reduced social attention in the first 12 months of life with evidence of reduced performance in social cognitive tasks later in the preschool years. However, we did not identify a consistent, distinctive preterm social phenotype in early life. Instead, the interactive behaviour of preterm infants reflects factors from outside the social cognitive domain, such as attention, language, and socioeconomic status. By combining data across samples and measures we revealed the role of domain-general skills, which may in future prove fruitful intervention targets.
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Affiliation(s)
- Bethan Dean
- MRC Centre for Reproductive Health, University of Edinburgh, UK
| | - Lorna Ginnell
- MRC Centre for Reproductive Health, University of Edinburgh, UK
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Church PT, Banihani R, Watson J, Chen WTN, Ballantyne M, Asztalos E. The E-Nurture Project: A Hybrid Virtual Neonatal Follow Up Model for 2021. CHILDREN-BASEL 2021; 8:children8020139. [PMID: 33673246 PMCID: PMC7918063 DOI: 10.3390/children8020139] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 01/29/2021] [Accepted: 02/08/2021] [Indexed: 12/31/2022]
Abstract
Neonatal follow-up has long focused on a model of surveillance and identification of short-term outcomes. This model has long become outdated, with evidence documenting the need for longer follow-up with known school-based challenges and significant gaps in knowledge by educators. This article reviews the history of neonatal follow-up and demonstrates a novel approach to neonatal follow-up, built largely with a hybrid virtual platform, which then became essential with the declaration of the pandemic in 2020.
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Affiliation(s)
- Paige Terrien Church
- Department of Newborn and Developmental Paediatrics, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada; (R.B.); (J.W.); (W.T.N.C.); (E.A.)
- Correspondence:
| | - Rudaina Banihani
- Department of Newborn and Developmental Paediatrics, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada; (R.B.); (J.W.); (W.T.N.C.); (E.A.)
| | - Jo Watson
- Department of Newborn and Developmental Paediatrics, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada; (R.B.); (J.W.); (W.T.N.C.); (E.A.)
| | - Wan Ting Nancy Chen
- Department of Newborn and Developmental Paediatrics, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada; (R.B.); (J.W.); (W.T.N.C.); (E.A.)
| | | | - Elizabeth Asztalos
- Department of Newborn and Developmental Paediatrics, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada; (R.B.); (J.W.); (W.T.N.C.); (E.A.)
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15
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Baggett KM, Davis B, Landry SH, Feil EG, Whaley A, Schnitz A, Leve C. Understanding the Steps Toward Mobile Early Intervention for Mothers and Their Infants Exiting the Neonatal Intensive Care Unit: Descriptive Examination. J Med Internet Res 2020; 22:e18519. [PMID: 32960178 PMCID: PMC7539159 DOI: 10.2196/18519] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 07/13/2020] [Accepted: 07/26/2020] [Indexed: 11/17/2022] Open
Abstract
Background Neonatal intensive care unit (NICU) history, combined with systemic inequities for mothers of nondominant cultures and mothers who are socioeconomically disadvantaged, places infants at an extraordinary risk for poor developmental outcomes throughout life. Although receipt of early intervention (EI) is the best single predictor of developmental outcomes among children with and at risk for early developmental delays, mothers and infants with the greatest needs are least likely to receive EI. Mobile internet-based interventions afford substantial advantages for overcoming logistical challenges that often prevent mothers who are economically disadvantaged from accessing EI. However, the bridge from the NICU to a mobile internet intervention has been virtually unexplored. Objective This study aims to examine progression flow from NICU exit referral to an early mobile internet intervention to increase EI access and promote parent mediation of infant social-emotional and communication development. Methods Three NICUs serving the urban poor in a Midwestern city were provided support in establishing an electronic NICU exit referral mechanism into a randomized controlled trial of a mobile internet intervention for mothers and their infants. Measurement domains to reflect the bridge to service included each crucial gateway required for navigating the path into Part C EI, including referral, screening, assessment, and intervention access. An iterative process was used and documented to facilitate each NICU in establishing an individualized accountability plan for sharing referral materials with mothers before their NICU exit. Subsequent to the referral, progression flow was documented on the basis of a real-time electronic recording of service receipt and contact records. Mother and infant risk characteristics were also assessed. Descriptive analyses were conducted to summarize and characterize each measurement domain. Results NICU referral rates for EI were 3 to 4 times higher for open-shared versus closed-single gatekeeper referral processes. Of 86 referred dyads, 67 (78%) were screened, and of those screened, 51 (76%) were eligible for assessment. Of the 51 assessment-eligible mothers and infants, 35 dyads (69%) completed the assessment and 31 (89%) went on to complete at least one remote coaching intervention session. The dyads who accessed and engaged in intervention were racially and ethnically diverse and experiencing substantial adversity. Conclusions The transition from the NICU to home was fraught with missed opportunities for an EI referral. Beyond the referral, the most prominent reason for not participating in screening was that mothers could not be located after exiting the NICU. Stronger NICU referral mechanisms for EI are needed. It may be essential to initiate mobile interventions before exiting the NICU for maintaining post-NICU contact with some mothers. In contrast to a closed, single point of referral gatekeeper systems in NICUs, open, shared referral gating systems may be less stymied by individual service provider biases and disruptions.
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Affiliation(s)
- Kathleen M Baggett
- Mark Chaffin Center for Healthy Development, School of Public Health, Georgia State Universtiy, Atlanta, GA, United States
| | - Betsy Davis
- Oregon Research Institute, Eugene, OR, United States
| | - Susan H Landry
- University of Texas Health Sciences Center- Houston, Houston, TX, United States
| | - Edward G Feil
- Oregon Research Institute, Eugene, OR, United States
| | - Anna Whaley
- University of Kansas, Kansas City, KS, United States
| | - Alana Schnitz
- Juniper Gardens Children's Project, University of Kansas, Kansas City, KS, United States
| | - Craig Leve
- Oregon Research Institute, Eugene, OR, United States
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16
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Lind A, Salomäki S, Parkkola R, Haataja L, Rautava P, Junttila N, Koikkalainen J, Lötjönen J, Saunavaara V, Korja R. Brain volumes in relation to loneliness and social competence in preadolescents born very preterm. Brain Behav 2020; 10:e01640. [PMID: 32333525 PMCID: PMC7303371 DOI: 10.1002/brb3.1640] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 03/02/2020] [Accepted: 03/28/2020] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION The aim of the present study was to assess how regional brain volumes associate with self-experienced social and emotional loneliness and social competence in very preterm and term-born preadolescents. MATERIALS AND METHODS Thirty-four very preterm subjects (birthweight ≤1,500 g and/or gestational age <32 weeks) without neurodevelopmental impairments and/or major brain pathologies and 31 term-born subjects underwent magnetic resonance imaging at 12 years of age. Regional brain volumes were measured using an automated image quantification tool. At 11 years of age, social and emotional loneliness were assessed with the Peer Network and Dyadic Loneliness Scale-self-report questionnaire and cooperating skills, empathy, impulsivity, and disruptiveness with the Multisource Assessment of Children's Social Competence Scale-self-report questionnaire. RESULTS In the very preterm group, a number of significant associations were found between smaller regional brain volumes and self-experienced emotional loneliness, more impulsivity and more disruptiveness. In the control group, brain volumes and loneliness were not associated, and brain volumes and social competence were associated with a lesser degree than in the very preterm group. CONCLUSION Experiences of emotional loneliness and poorer social competence appear to be more related to brain volumes in very preterm preadolescents than in those born full-term. It also appears that in very preterm preadolescents, emotional loneliness may be more reflected in brain development than social loneliness.
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Affiliation(s)
- Annika Lind
- Department of Psychology, University of Turku, Turku, Finland.,Turku Institute for Advanced Studies (TIAS), University of Turku, Turku, Finland
| | | | - Riitta Parkkola
- Department of Radiology, University of Turku and Turku University Hospital, Turku, Finland
| | - Leena Haataja
- Children's Hospital and Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Päivi Rautava
- Public Health, University of Turku and Clinical Research Centre of Turku University Hospital, Turku, Finland
| | - Niina Junttila
- Department of Teacher Education, University of Turku, Turku, Finland.,Finnish National Agency for Education, Helsinki, Finland
| | | | | | - Virva Saunavaara
- Division of Medical Imaging, Department of Medical Physics, Turku University Hospital, Turku, Finland.,Turku PET Center, University of Turku and Turku University Hospital, Turku, Finland
| | - Riikka Korja
- Department of Psychology, University of Turku, Turku, Finland
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17
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Abstract
Social problems are an important feature of the preterm behavioral phenotype but are diverse and multidimensional. A model of social competence comprised of the three interrelated components of social cognition, social interaction, and social adjustment is useful in conceptualizing these problems. Weaknesses in social cognition in very preterm (VPT) children, although rarely studied, are found on tasks involving interpretation of social cues. Difficulties in social interaction in VPT infants and young children are documented by structured observations of their interactions with adults. Problems in social adjustment are endorsed on parent and teacher ratings of VPT infants and youth and on self-reports of VPT adults. These multiple deficits likely stem from early disruptions in neural development, are related to other consequences of preterm birth, and subject to postnatal environment influences. Further research is needed to more fully account for the effects of VPT birth on the development of social competence.
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Affiliation(s)
- H Gerry Taylor
- Abigail Wexner Research Institute at Nationwide Children's Hospital and The Ohio State University, Columbus, OH, USA.
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18
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Abstract
Around 15 million children are born preterm (<37 weeks of gestation) every year. Of these, 15% or 2.25 million are born very preterm (VP; <32 weeks of gestation). Here, the developmental outcomes of VP babies in diverse domains from motor, cognitive, and social function to mental health and well-being throughout childhood and adolescence are reviewed. Their life course adaptation in terms of romantic relationships, employment, and quality of life into adulthood is also considered. Some adverse effects reduce as individuals age, and others remain remarkably stable from childhood into adulthood. We argue that to advance understanding of developmental mechanisms and direct resources for intervention more effectively, social factors need to be assessed more comprehensively, and genetically sensitive designs should be considered with neuroimaging integrated to test alternative developmental models. As current evidence is based almost exclusively on studies from high-income countries, research from low- and middle-income countries is urgently needed.
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Affiliation(s)
- Dieter Wolke
- Department of Psychology, University of Warwick, Coventry CV4 7AL, United Kingdom;,
- Mental Health and Wellbeing, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry CV4 7AL, United Kingdom
| | - Samantha Johnson
- Department of Health Sciences, University of Leicester, Leicester LE1 7RH, United Kingdom
| | - Marina Mendonça
- Department of Psychology, University of Warwick, Coventry CV4 7AL, United Kingdom;,
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