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Pascual A, Wielenga JM, Ruhe K, van Kaam AH, Denswil NP, Maaskant JM. The fundamentals of a parental peer-to-peer support program in the NICU: a scoping review. Matern Health Neonatol Perinatol 2024; 10:19. [PMID: 39354584 PMCID: PMC11445949 DOI: 10.1186/s40748-024-00190-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Accepted: 08/31/2024] [Indexed: 10/03/2024] Open
Abstract
PURPOSE AND BACKGROUND Parental peer support is part of the Family Integrated Care model in NICUs. However, little attention has been devoted to the specific content and organization of parental peer support programs. This scoping review aimed to identify (1) the preferred content of a parental peer support intervention, (2) the organizational processes, and (3) the suggested educational curriculum for peer support providers within existing programs in neonatal care. DISCUSSION Parental peer support programs have the goal to provide emotional support, information and assistance, and are to empower parents in the NICU. To achieve these goals, veteran parents receive training in communication skills, roles and boundaries, mental health, (non)medical aspects in the NICU and post-discharge preparation. Data on the organizational components remain limited. Hence, the question remains how the organization of a parental peer support program, and the training and supervision of veteran parents should be managed. IMPLICATIONS FOR RESEARCH AND PRACTICE This scoping review provides a variety of aspects that should be considered when developing and implementing a parental peer support program in the NICU. Program development preferably involves NICU staff at an early stage. Future research should focus on the support of diverse populations in terms of culture, social economic status and gender, and on the effects of parental peer support on parent and infant.
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Affiliation(s)
- A Pascual
- Department of Neonatology, Emma Children's Hospital, Amsterdam UMC, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands.
| | - J M Wielenga
- Department of Neonatology, Emma Children's Hospital, Amsterdam UMC, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands
| | - K Ruhe
- Department of Neonatology, Emma Children's Hospital, Amsterdam UMC, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands
| | - A H van Kaam
- Department of Neonatology, Emma Children's Hospital, Amsterdam UMC, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands
- Amsterdam Reproduction & Development Research Institute, Amsterdam, The Netherlands
| | - N P Denswil
- Medical Library, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
| | - J M Maaskant
- Department of Pediatrics, Amsterdam UMC, Emma Children's Hospital, University of Amsterdam, Amsterdam, The Netherlands
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2
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Ramirez Y, Castillo Y, Acea S, Pagani LS. Auditory Risk Factors at Birth and Language Development at 2 Years of Age: A Longitudinal Analysis. Glob Pediatr Health 2024; 11:2333794X241273201. [PMID: 39257634 PMCID: PMC11384531 DOI: 10.1177/2333794x241273201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 05/27/2024] [Accepted: 07/05/2024] [Indexed: 09/12/2024] Open
Abstract
Aim. To analyze the relationship between auditory risk factors at birth and subsequent language development in toddlerhood. Methods. Participants are 136 children from a longitudinal birth cohort follow-up at age 2 years. They were divided into 2 groups: One comprising 105 children without hearing risk factors at birth and another comprising 31 children with auditory risk factors at birth but normal hearing. Results. In children with and without risk factors, the combination of socio-emotional, socio-economic, and auditory risk factors at birth significantly predicted language development at age 2 years. Family socio-economic status had a significant impact on overall child development, even after controlling for socio-emotional development and the presence of risk factors. Conclusions. The study was conducted in an upper-middle income country with a socialized health care system. It underscores the importance of a holistic approach to early childhood language development, taking into account biological, socioeconomic, and emotional factors.
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Affiliation(s)
- Yaser Ramirez
- Centro Universitario Municipal Rodas. Universidad de Cienfuegos, Cienfuegos, Cuba
| | | | - Shuyeng Acea
- Centro Auditivo Provincial de Cienfuegos, Cienfuegos, Cuba
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3
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Retsa C, Turpin H, Geiser E, Ansermet F, Müller-Nix C, Murray MM. Longstanding Auditory Sensory and Semantic Differences in Preterm Born Children. Brain Topogr 2024; 37:536-551. [PMID: 38010487 PMCID: PMC11199270 DOI: 10.1007/s10548-023-01022-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 11/06/2023] [Indexed: 11/29/2023]
Abstract
More than 10% of births are preterm, and the long-term consequences on sensory and semantic processing of non-linguistic information remain poorly understood. 17 very preterm-born children (born at < 33 weeks gestational age) and 15 full-term controls were tested at 10 years old with an auditory object recognition task, while 64-channel auditory evoked potentials (AEPs) were recorded. Sounds consisted of living (animal and human vocalizations) and manmade objects (e.g. household objects, instruments, and tools). Despite similar recognition behavior, AEPs strikingly differed between full-term and preterm children. Starting at 50ms post-stimulus onset, AEPs from preterm children differed topographically from their full-term counterparts. Over the 108-224ms post-stimulus period, full-term children showed stronger AEPs in response to living objects, whereas preterm born children showed the reverse pattern; i.e. stronger AEPs in response to manmade objects. Differential brain activity between semantic categories could reliably classify children according to their preterm status. Moreover, this opposing pattern of differential responses to semantic categories of sounds was also observed in source estimations within a network of occipital, temporal and frontal regions. This study highlights how early life experience in terms of preterm birth shapes sensory and object processing later on in life.
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Affiliation(s)
- Chrysa Retsa
- The Radiology Department, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
- The Sense Innovation and Research Center, Lausanne and Sion, Lausanne, Switzerland.
- CIBM Center for Biomedical Imaging, Lausanne, Switzerland.
| | - Hélène Turpin
- The Radiology Department, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- University Service of Child and Adolescent Psychiatry, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland
| | - Eveline Geiser
- The Radiology Department, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - François Ansermet
- University Service of Child and Adolescent Psychiatry, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland
- Department of Child and Adolescent Psychiatry, University Hospital, Geneva, Switzerland
| | - Carole Müller-Nix
- University Service of Child and Adolescent Psychiatry, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland
| | - Micah M Murray
- The Radiology Department, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- The Sense Innovation and Research Center, Lausanne and Sion, Lausanne, Switzerland
- CIBM Center for Biomedical Imaging, Lausanne, Switzerland
- Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, TN, USA
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4
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Sandnes R, Le Floch M, Riquin E, Nocus I, Müller JB, Bacro F. Parental stress and mental health outcomes following very preterm birth: A systematic review of recent findings. J Affect Disord 2024; 355:513-525. [PMID: 38556094 DOI: 10.1016/j.jad.2024.03.154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 03/06/2024] [Accepted: 03/25/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND In recent years, there has been a wide array of research studies published on parental mental health and stress following very preterm birth. This review aims at reviewing the prevalence and risk factors of long-term parental depression, anxiety, post-traumatic stress symptoms and parenting stress following very preterm birth. METHODS We searched PubMed, PsychINFO and Web of Science for descriptive, cross-sectional and longitudinal studies published between January 2013 and August 2022. RESULTS 45 studies met our inclusion criteria. In the first two years, depression, anxiety, post-traumatic stress symptoms and parenting stress were present in ∼20 % of mothers of extreme and very low birth weight (E/VLBW) infants. Long-term psychological distress symptoms could be observed, although few studies have focused on symptoms into school age and longer. Fathers of VLBW infants might experience more psychological distress as well, however, they were only included in ten studies. We found that parental distress is more common when the co-parent is struggling with mental health symptoms. Many risk factors were identified such as social risk, history of mental illness, interpersonal factors (i.e. social support) and child-related factors (i.e. intraventricular hemorrhage, disability, use of medical equipment at home). LIMITATIONS Several studies have methodological issues, such as a lack of control of known confounders and there is a large variety of measures employed. CONCLUSION Important risk factors for stress and mental health symptoms were identified. More evidence is needed to determine if long-term symptoms persist into school age. Research should focus on taking a family-based approach in order to identify preventive strategies and resilience factors in parents of VLBW infants.
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Affiliation(s)
- Ramona Sandnes
- Faculty of Psychology, Centre de Recherche en Education de Nantes (CREN - UR 2661), Nantes University, Nantes, France.
| | - Marine Le Floch
- Department of Child and Adolescent Psychiatry, University Hospital of Angers, France
| | - Elise Riquin
- Department of Child and Adolescent Psychiatry, University Hospital of Angers, France; Univ Angers, [CHU Angers], LPPL EA4638, F-49000 Angers, France; Fondation de Santé des Étudiants de France, clinique de Sablé sur Sarthe, Sablé sur Sarthe, France
| | - Isabelle Nocus
- Faculty of Psychology, Centre de Recherche en Education de Nantes (CREN - UR 2661), Nantes University, Nantes, France
| | - Jean Baptiste Müller
- Loire Infant Follow-Up Team (LIFT) Network, Pays de Loire, France; Department of Neonatal Medicine, Nantes University Hospital, Nantes, France
| | - Fabien Bacro
- Faculty of Psychology, Centre de Recherche en Education de Nantes (CREN - UR 2661), Nantes University, Nantes, France
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5
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Du F, Zha J, Li Y, Fang L, Xia S, Yu Y. Risk factors for postpartum posttraumatic stress disorder after emergency admission. World J Emerg Med 2024; 15:121-125. [PMID: 38476530 PMCID: PMC10925529 DOI: 10.5847/wjem.j.1920-8642.2024.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 11/03/2023] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Postpartum posttraumatic stress disorder (PTSD) can occur in women who give birth after emergency admission. The identification of risk factors for this condition is crucial for developing effective preventive measures. This retrospective study aimed to explore the incidence and risk factors for postpartum PTSD in women who give birth after emergency admission. METHODS Medical records of women who gave birth after emergency admission were collected between March 2021 and April 2023. The patients' general conditions and perinatal clinical indicators were recorded. The puerperae were divided into PTSD group and control group based on symptom occurrence at six weeks postpartum. Multivariate logistic regression analysis was performed to identify risk factors. RESULTS A total of 276 puerperae were included, with a PTSD incidence of 20.3% at six weeks postpartum. Multivariate logistic regression analysis identified emergency cesarean section (odds ratio [OR]=2.102; 95% confidence interval [CI]: 1.114-3.966, P=0.022), admission to the emergency department after midnight (12:00 AM) (OR=2.245; 95%CI: 1.170-4.305, P<0.001), and cervical dilation (OR=3.203; 95%CI: 1.670-6.141, P=0.039) as independent risk factors for postpartum PTSD. Analgesia pump use (OR= 0.500; 95%CI: 0.259-0.966, P=0.015) was found to be a protective factor against postpartum PTSD. CONCLUSION Emergency cesarean section, admission to the emergency department after midnight, and cervical dilation were identified as independent risk factors for postpartum PTSD, while analgesic pump use was a protective factor. These findings provide insights for developing more effective preventive measures for women who give birth after emergency admission.
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Affiliation(s)
- Fengxia Du
- Department of Obstetrics, Suzhou Xiangcheng People’s Hospital, Suzhou 215131, China
| | - Jun Zha
- Department of Anesthesiology, the Second Affiliated Hospital of Wannan Medical College, Wuhu 241000, China
| | - Yan Li
- Department of Anesthesiology, Suzhou Xiangcheng People’s Hospital, Suzhou 215131, China
| | - Lichao Fang
- Department of Emergency and Intensive Care Unit, Suzhou Xiangcheng People’s Hospital, Suzhou 215131, China
| | - Shuyu Xia
- Department of Obstetrics, Suzhou Xiangcheng People’s Hospital, Suzhou 215131, China
| | - Youjia Yu
- Department of Anesthesiology, Suzhou Xiangcheng People’s Hospital, Suzhou 215131, China
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6
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Fathima A, Jeevanandan G. Interrelationship Between Intelligence Quotient and Space Maintainers Among Children: A Cross-Sectional Comparative Study. Cureus 2023; 15:e50752. [PMID: 38239514 PMCID: PMC10794789 DOI: 10.7759/cureus.50752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 12/17/2023] [Indexed: 01/22/2024] Open
Abstract
Introduction Intelligence quotient (IQ) is an indicator to measure a child's cognitive ability to learn or understand and to deal with new situations with their logical and analytical skills. Children with better IQ exhibit increased cooperation when undergoing dental treatments, leading to a positive attitude toward dental care. The primary aim of the study was to assess the interrelationship between the IQ of children, space maintainer therapy, and the behavior of children aged 6-10 years. Materials and methods A total of 104 children were divided into two groups: group 1 included children undergoing space maintainer therapy and group 2 included children who did not undergo space maintainer therapy. Their IQ scores were assessed using Raven's Coloured Progressive Matrices and behavior and the Frankl behavior rating scale. The data were analyzed by SPSS Version 23 (IBM Corp., Armonk, NY). Independent t-tests were used to evaluate the differences between IQ and children with space maintainers, and Mann-Whitney U tests were used to assess the differences between behavior and space maintainers. Results The mean age of the participants was approximately 8.28 years. The mean IQ score of the group of children undergoing the space maintainer therapy was 90.69 ± 7.65 and that of the control group was 105.59±10.71. Based on the Frankl behavior rating scale, the mean score in the space maintainer group was 35.44 and that of the control group was 69.56. There was a significant association between IQ, behavior, and the presence of space maintainers. Conclusion The group of children undergoing space maintainer therapy demonstrated comparatively lesser IQ, and the majority of children exhibited negative behavior. Also, children wearing space maintainers had undergone one or multiple extractions, which is traumatic for children and may lead to them likely exhibiting a negative behavior than children in the control group. Hence, it may be concluded that intelligence, behavior, and space maintainers are all significantly associated with each other.
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Affiliation(s)
- Ayesha Fathima
- Pediatric and Preventive Dentistry, Saveetha Dental College And Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Ganesh Jeevanandan
- Pediatric and Preventive Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
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7
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Deindl P, Witting A, Dür M, Berger A, Klebermass-Schrehof K, Singer D, Giordano V, Fuiko R. Perceived stress of mothers and fathers on two NICUs before and during the SARS-CoV-2 pandemic. Sci Rep 2023; 13:14540. [PMID: 37666877 PMCID: PMC10477236 DOI: 10.1038/s41598-023-40836-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 08/17/2023] [Indexed: 09/06/2023] Open
Abstract
Parents of very low birth weight (VLBW) infants in a neonatal intensive care unit experienced additional stress during the SARS-CoV-2 pandemic due to the related restrictions in hospital visiting policies. Our study aimed to compare parents' burdens before and during the pandemic. This survey included 121 parents of 76 VLBW infants in two European Level IV perinatal centers before and during the pandemic. We performed standardized parent questionnaires with mothers and fathers separately to evaluate their emotional stress and well-being. The pandemic worsened the emotional well-being of parents of VLBW infants, particularly of mothers. During the pandemic, mothers reported significantly higher state anxiety levels (48.9 vs. 42.9, p = 0.026) and hampered bonding with the child (6.3 vs. 5.2, 0 = 0.003) than before. In addition, mothers felt more personally restricted than fathers (6.1 vs. 5.2, p = 0.003). Fathers experienced lower levels of stress than mothers; they were equally burdened before and during the pandemic. Restrictions in visiting policies for families of VLBW infants during the SARS-CoV-2 pandemic have a significant negative impact on parental stress and should therefore be applied cautiously.
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Affiliation(s)
- Philipp Deindl
- Department of Neonatology and Pediatric Intensive Care Medicine, University Children's Hospital, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Andrea Witting
- Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Mona Dür
- Duervation, Krems, Austria
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Angelika Berger
- Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Katrin Klebermass-Schrehof
- Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Dominique Singer
- Department of Neonatology and Pediatric Intensive Care Medicine, University Children's Hospital, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Vito Giordano
- Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria.
| | - Renate Fuiko
- Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
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8
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Lacalle L, Martínez-Shaw ML, Marín Y, Sánchez-Sandoval Y. Intelligence Quotient (IQ) in school-aged preterm infants: A systematic review. Front Psychol 2023; 14:1216825. [PMID: 37560105 PMCID: PMC10409487 DOI: 10.3389/fpsyg.2023.1216825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 06/30/2023] [Indexed: 08/11/2023] Open
Abstract
UNLABELLED Preterm birth (before 37 weeks of gestational age) is associated with certain risks to child development. The aim of this systematic review was to summarize available and updated empirical evidence on prematurity as a risk factor for cognitive development in school age. Thus, we attempted to identify similarities and differences with the full-term population and to point out possible risk or protective factors among the biological, psychosocial and family variables. The conceptualization and methodology of this review followed the PRISMA recommendations. The search was carried out in Web of Science, Scopus, PsycInfo, and Dialnet databases, in May 2022. The search was limited to journal articles, published between 2012 and 2022, in English and Spanish. Research articles selected were those focused on the intelligence quotient (IQ) of preterm children aged 6-12 years. The review included studies with cross-sectional or longitudinal cohorts, compared to a control group of children born at term or to standardized scales. The quality of evidence of the selected studies was verified with the Mixed Methods Appraisal Tool (MMAT). The initial search identified 1,040 articles. Forty articles met the inclusion criteria and were finally included in this review. These studies involved 5,396 preterm children from 37 different cohorts. Despite the diversity found among the results, in general, total IQ scores were within the normative mean for premature children; however, compared to their full-term peers, these scores were lower. The most studied variables in relation to IQ are perinatal (e.g., gestational age and birth weight) and family (e.g., socioeconomic level and education level of the mother). Recent studies corroborate that premature birth affects cognitive development in school age, and identify associated perinatal and family variables. SYSTEMATIC REVIEW REGISTRATION https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=337371; identifier: CRD42022337371.
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Affiliation(s)
- Laura Lacalle
- Department of Psychology, University of Cádiz, Cádiz, Spain
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cádiz, Spain
| | - Melissa Liher Martínez-Shaw
- Department of Psychology, University of Cádiz, Cádiz, Spain
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cádiz, Spain
| | - Yolanda Marín
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cádiz, Spain
| | - Yolanda Sánchez-Sandoval
- Department of Psychology, University of Cádiz, Cádiz, Spain
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cádiz, Spain
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9
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Van Assche IA, Huis In 't Veld EA, Van Calsteren K, van Gerwen M, Blommaert J, Cardonick E, Halaska MJ, Fruscio R, Fumagalli M, Lemiere J, van Dijk-Lokkart EM, Fontana C, van Tinteren H, De Ridder J, van Grotel M, van den Heuvel-Eibrink MM, Lagae L, Amant F. Cognitive and Behavioral Development of 9-Year-Old Children After Maternal Cancer During Pregnancy: A Prospective Multicenter Cohort Study. J Clin Oncol 2023; 41:1527-1532. [PMID: 36634293 PMCID: PMC10022854 DOI: 10.1200/jco.22.02005] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned co-primary or secondary analyses are not yet available. Clinical Trial Updates provide an opportunity to disseminate additional results from studies, published in JCO or elsewhere, for which the primary end point has already been reported.This multicenter cohort study reports on the long-term effects of prenatal exposure to maternal cancer and its treatment on cognitive and behavioral outcomes in 9-year-old children. In total, 151 children (mean age, 9.3 years; range, 7.8-10.6 years) were assessed using a neurocognitive test battery and parent-report behavioral questionnaires. During pregnancy, 109 children (72.2%) were exposed to chemotherapy (only or in combination with other treatment modalities), 18 (11.9%) to surgery only, 16 (10.6%) to radiotherapy, one to trastuzumab, and 16 (10.6%) were not exposed to oncologic treatment. Mean cognitive and behavioral outcomes were within normal ranges. Gestational age at birth showed a positive association with Full Scale Intelligence Quotient (FSIQ), with the average FSIQ score increasing by 1.6 points for each week increase in gestational age (95% CI, 0.7 to 2.5; P < .001). No difference in FSIQ was found between treatment types (F[4,140] = 0.45, P = .776). In children prenatally exposed to chemotherapy, no associations were found between FSIQ and chemotherapeutic agent, exposure level, or timing during pregnancy. These results indicate a reassuring follow-up during the critical maturational period of late childhood, when complex functions develop and rely on the integrity of early brain development. However, associations were observed with preterm birth, maternal death, and maternal education.
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Affiliation(s)
- Indra A Van Assche
- Department of Development and Regeneration, Unit of Woman and Child, KU Leuven, Belgium
| | - Evangeline A Huis In 't Veld
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.,Center for Gynecological Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Kristel Van Calsteren
- Department of Development and Regeneration, Unit of Woman and Child, KU Leuven, Belgium.,Division of Foetomaternal Medicine, Department of Obstetrics and Gynaecology, UZ Leuven, Belgium
| | - Mathilde van Gerwen
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.,Center for Gynecological Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands.,Department of Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam UMC, University of Amsterdam, the Netherlands
| | - Jeroen Blommaert
- Department of Oncology, Unit of Pediatric Oncology, KU Leuven, Belgium.,Department of Oncology, Unit of Gynaecological Oncology, KU Leuven, Belgium.,Department of Oncology, Laboratory of Experimental Radiotherapy, KU Leuven, Belgium
| | - Elyce Cardonick
- Department of Obstetrics and Gynecology, Cooper University Health Care, Camden, NJ
| | - Michael J Halaska
- Department of Obstetric Gynecology, University Hospital Kralovske Vinohrady and 3rd Medical Faculty, Charles University, Prague, Czech Republic
| | - Robert Fruscio
- Department of Medicine and Surgery, Clinic of Obstetrics and Gynecology, University of Milan-Bicocca, San Gerardo Hospital, Monza, Italy
| | - Monica Fumagalli
- Department of Clinical Sciences and Community Health, University of Milan, Milano, Italy.,Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milano, Italy
| | - Jurgen Lemiere
- Department of Oncology, Unit of Pediatric Oncology, KU Leuven, Belgium.,Division of Pediatric Hemato-Oncology, Department of Pediatrics, UZ Leuven, Belgium
| | - Elisabeth M van Dijk-Lokkart
- Department of Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam UMC, University of Amsterdam, the Netherlands.,Amsterdam Reproduction and Development, Child Development, Amsterdam, the Netherlands
| | - Camilla Fontana
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milano, Italy
| | - Harm van Tinteren
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Jessie De Ridder
- Division of Pediatric Neurology, Department of Pediatrics, UZ Leuven, Belgium.,Department of Development and Regeneration, Unit Locomotor and Neurological Disorders, KU Leuven, Belgium
| | | | - Marry M van den Heuvel-Eibrink
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.,UMCU-Wilhelmina Children's Hospital, Utrecht, the Netherlands
| | - Lieven Lagae
- Department of Development and Regeneration, Unit of Woman and Child, KU Leuven, Belgium.,Division of Pediatric Neurology, Department of Pediatrics, UZ Leuven, Belgium
| | - Frédéric Amant
- Center for Gynecological Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands.,Department of Oncology, Unit of Gynaecological Oncology, KU Leuven, Belgium.,Division of Gynaecological Oncology, Department of Obstetrics and Gynaecology, UZ Leuven, Belgium
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10
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TwinEDA: a sustainable deep-learning approach for limb-position estimation in preterm infants' depth images. Med Biol Eng Comput 2023; 61:387-397. [PMID: 36441288 DOI: 10.1007/s11517-022-02696-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 10/08/2022] [Indexed: 11/29/2022]
Abstract
Early diagnosis of neurodevelopmental impairments in preterm infants is currently based on the visual analysis of newborns' motion patterns by trained operators. To help automatize this time-consuming and qualitative procedure, we propose a sustainable deep-learning algorithm for accurate limb-pose estimation from depth images. The algorithm consists of a convolutional neural network (TwinEDA) relying on architectural blocks that require limited computation while ensuring high performance in prediction. To ascertain its low computational costs and assess its application in on-the-edge computing, TwinEDA was additionally deployed on a cost-effective single-board computer. The network was validated on a dataset of 27,000 depth video frames collected during the actual clinical practice from 27 preterm infants. When compared to the main state-of-the-art competitor, TwinEDA is twice as fast to predict a single depth frame and four times as light in terms of memory, while performing similarly in terms of Dice similarity coefficient (0.88). This result suggests that the pursuit of efficiency does not imply the detriment of performance. This work is among the first to propose an automatic and sustainable limb-position estimation approach for preterm infants. This represents a significant step towards the development of broadly accessible clinical monitoring applications.
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11
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Bowe AK, Lightbody G, Staines A, Murray DM. Big data, machine learning, and population health: predicting cognitive outcomes in childhood. Pediatr Res 2023; 93:300-307. [PMID: 35681091 PMCID: PMC7614199 DOI: 10.1038/s41390-022-02137-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 05/05/2022] [Accepted: 05/17/2022] [Indexed: 11/09/2022]
Abstract
The application of machine learning (ML) to address population health challenges has received much less attention than its application in the clinical setting. One such challenge is addressing disparities in early childhood cognitive development-a complex public health issue rooted in the social determinants of health, exacerbated by inequity, characterised by intergenerational transmission, and which will continue unabated without novel approaches to address it. Early life, the period of optimal neuroplasticity, presents a window of opportunity for early intervention to improve cognitive development. Unfortunately for many, this window will be missed, and intervention may never occur or occur only when overt signs of cognitive delay manifest. In this review, we explore the potential value of ML and big data analysis in the early identification of children at risk for poor cognitive outcome, an area where there is an apparent dearth of research. We compare and contrast traditional statistical methods with ML approaches, provide examples of how ML has been used to date in the field of neurodevelopmental disorders, and present a discussion of the opportunities and risks associated with its use at a population level. The review concludes by highlighting potential directions for future research in this area. IMPACT: To date, the application of machine learning to address population health challenges in paediatrics lags behind other clinical applications. This review provides an overview of the public health challenge we face in addressing disparities in childhood cognitive development and focuses on the cornerstone of early intervention. Recent advances in our ability to collect large volumes of data, and in analytic capabilities, provide a potential opportunity to improve current practices in this field. This review explores the potential role of machine learning and big data analysis in the early identification of children at risk for poor cognitive outcomes.
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Affiliation(s)
- Andrea K. Bowe
- grid.7872.a0000000123318773INFANT Research Centre, University College Cork, Cork, Ireland
| | - Gordon Lightbody
- grid.7872.a0000000123318773INFANT Research Centre, University College Cork, Cork, Ireland ,grid.7872.a0000000123318773Department of Electrical and Electronic Engineering, University College Cork, Cork, Ireland
| | - Anthony Staines
- grid.15596.3e0000000102380260School of Nursing, Psychotherapy, and Community Health, Dublin City University, Dublin, Ireland
| | - Deirdre M. Murray
- grid.7872.a0000000123318773INFANT Research Centre, University College Cork, Cork, Ireland
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12
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deRegnier RA. Disparities in Neurodevelopmental Services Between Children with Congenital Heart Disease and Children Born Very Preterm. J Pediatr 2022; 250:9-10. [PMID: 35944712 DOI: 10.1016/j.jpeds.2022.07.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 07/29/2022] [Indexed: 11/15/2022]
Affiliation(s)
- Raye-Ann deRegnier
- Neonatology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois.
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13
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Boissel L, Pinchaux E, Guilé M, Corde P, Crovetto C, Diouf M, Mariana C, Meynier J, Picard C, Scoury D, Cohen D, Benarous X, Viaux-Savelon S, Guilé JM. Development and reliability of the coding system evaluating maternal sensitivity to social interactions with 34- to 36-week postmenstrual age preterm infants. Front Psychiatry 2022; 13:938482. [PMID: 36276306 PMCID: PMC9579434 DOI: 10.3389/fpsyt.2022.938482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 08/01/2022] [Indexed: 11/13/2022] Open
Abstract
UNLABELLED Maternal sensitivity (MS), the ability to perceive and synchronously respond to the social signals (SSs), is affected by prematurity. The development of early supportive psychotherapy to foster MS, before discharge of the infant from the neonatal intensive care unit (NICU) is a major challenge in the prevention of subsequent developmental and mental disorders in the child. There are currently no reliable methods for evaluating MS to social interactions with very to moderate preterm infants. We investigated the reliability of a newly developed procedure for assessing MS in interactions between the mother and her 34- to 36-week postmenstrual age (PMA) preterm infant: the Preterm Infant Coding System for Maternal Sensitivity (PRICOSMAS). METHOD This study encompassed three steps: testing of the capacity to videorecord SSs in very to moderate preterm infants, selection, by an expert committee, of the recordable and relevant SSs, and investigation of the internal consistency and interrater reliability. The synchronicity between infant and mother's SSs was determined on a 1 s period basis, using ELAN software. Preterm infants born after 25-weeks gestational age (GA) were included while being between 34- and 36-weeks PMA. A perinatal risk inventory score > 10 for the infant precluded from inclusion. Interrater reliabilities were assessed independently by two raters blind to the clinical situation of the mother and infant. RESULTS The resulting PRICOSMAS encompassed two four-item SS sections, one covering the preterm infant's SSs and the other, the mother's SSs. Reliability was assessed on a sample of 26 videorecorded observations for 13 mother-preterm infant dyads. Infants' mean age at birth was 30.4 ± 3.1-weeks GA (range: 26.4-35) and PMA at the time of the test was 34.7-weeks (±0.8). Internal consistency ranged from 0.81 to 0.89. Interrater reliability ranged from substantial to almost perfect (0.73-0.88). CONCLUSION This study shows that the infants' SSs and MS can be reliably scored in preterm infants as young as 34- to 36-weeks PMA. Our findings suggest that the PRICOSMAS is sufficiently reliable for use, including in NICU, by healthcare professionals or researchers for coding early parent-infant interactions with 34- to 36-week PMA preterm infants.
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Affiliation(s)
- Laure Boissel
- Department of Psychiatry, Université Picardie Jules Verne, Amiens, France
| | - Emeric Pinchaux
- Department of Psychiatry, Université Picardie Jules Verne, Amiens, France.,Department of Medicine, Université Libre de Bruxelles, Brussels, Belgium
| | - Marine Guilé
- Department of Psychiatry, Université Picardie Jules Verne, Amiens, France.,Department of Medicine, Université Paris Descartes, Paris, France
| | - Pascal Corde
- Child and Adolescent Psychiatry Services, University Hospital Centre (CHU), Amiens, France
| | - Cécile Crovetto
- Child and Adolescent Psychiatry Services, University Hospital Centre (CHU), Amiens, France
| | - Momar Diouf
- Child and Adolescent Psychiatry Services, University Hospital Centre (CHU), Amiens, France
| | - Charlotte Mariana
- Child and Adolescent Psychiatry Services, University Hospital Centre (CHU), Amiens, France
| | - Jonathan Meynier
- Child and Adolescent Psychiatry Services, University Hospital Centre (CHU), Amiens, France
| | - Carl Picard
- Child and Adolescent Psychiatry Services, University Hospital Centre (CHU), Amiens, France
| | - Daphné Scoury
- Department of Psychiatry, Université Picardie Jules Verne, Amiens, France
| | - David Cohen
- Child and Adolescent Psychiatry Services, APHP-GHPS, Sorbonne Université, Paris, France
| | - Xavier Benarous
- Department of Psychiatry, Université Picardie Jules Verne, Amiens, France.,Child and Adolescent Psychiatry Services, University Hospital Centre (CHU), Amiens, France
| | - Sylvie Viaux-Savelon
- Child and Adolescent Psychiatry Services, Hospices civils de Lyon, Hôpital de la Croix Rousse, Université Lyon 1, Lyon, France
| | - Jean-Marc Guilé
- Department of Psychiatry, Université Picardie Jules Verne, Amiens, France.,Child and Adolescent Psychiatry Services, University Hospital Centre (CHU), Amiens, France.,Department of Psychiatry, McGill University, Montreal, QC, Canada
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14
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Meesters N, van Dijk M, Sampaio de Carvalho F, Haverman L, Reiss IKM, Simons SHP, van den Bosch GE. COVID-19 lockdown impacts the wellbeing of parents with infants on a Dutch neonatal intensive care unit. J Pediatr Nurs 2022; 62:106-112. [PMID: 34642075 PMCID: PMC8482115 DOI: 10.1016/j.pedn.2021.09.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 09/23/2021] [Accepted: 09/23/2021] [Indexed: 01/08/2023]
Abstract
PURPOSE Parents of infants admitted to a neonatal intensive care unit (NICU) experience additional stress due to restrictions on their presence and visits by other family members during the COVID-19 pandemic. Our study aims to describe how this impacted parents and how NICU staff could support them. DESIGN AND METHODS This was a cross-sectional study in which 25 parents (16 mothers, 9 fathers) of infants admitted to our NICU during the first COVID-19 lockdown completed online questionnaires with socio-demographic questions, the Parental Stressor Scale:NICU (PSS:NICU) and questions related to COVID-19. RESULTS Being separated from, and not being able to hold their infant at all times were among the most important PSS:NICU stressors. Parents experienced additional stress because other family members were not allowed to visit. They indicated that NICU staff could support them by clearly explaining the reasons for visitor restrictions and by ensuring that they felt heard. Most parents supported the restrictions, but also mentioned that less strict measures would really help them. CONCLUSIONS Parents who participated in this study found it very stressful that they could not be with their infant together with their partner and other family members. Furthermore, parents recommended the hospital management to continuously reconsider whether particular restrictions could be lifted in case of a new lockdown. Together with clear communication, this would result in less parenteral stress. PRACTICE IMPLICATIONS Hospital management should be cautious on restricting the presence of parents and other family members and scale restrictions back whenever possible.
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Affiliation(s)
- Naomi Meesters
- Department of Pediatrics, Division of Neonatology, Erasmus MC -Sophia Children's Hospital, Rotterdam, the Netherlands.
| | - Monique van Dijk
- Intensive Care and Department of Pediatric Surgery, Erasmus MC -Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Fernanda Sampaio de Carvalho
- Department of Pediatrics, Division of Neonatology, Erasmus MC -Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Lotte Haverman
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, Amsterdam, the Netherlands
| | - Irwin K M Reiss
- Department of Pediatrics, Division of Neonatology, Erasmus MC -Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Sinno H P Simons
- Department of Pediatrics, Division of Neonatology, Erasmus MC -Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Gerbrich E van den Bosch
- Department of Pediatrics, Division of Neonatology, Erasmus MC -Sophia Children's Hospital, Rotterdam, the Netherlands
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15
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Urfer A, Turpin H, Dimitrova N, Borghini A, Plessen KJ, Morisod Harari M, Urben S. Consequences of Prematurity on Cortisol Regulation and Adjustment Difficulties: A 9-Year Longitudinal Study. CHILDREN (BASEL, SWITZERLAND) 2021; 9:9. [PMID: 35053633 PMCID: PMC8774148 DOI: 10.3390/children9010009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/20/2021] [Accepted: 12/22/2021] [Indexed: 11/17/2022]
Abstract
A preterm birth represents a stressful event having potentially negative long-term consequences. Thirty-three children born preterm (<33 weeks gestational age) and eleven full-term children participated in a nine-year longitudinal study. Perinatal Risk Inventory (PERI) was used at birth to assess the perinatal stress. Salivary cortisol, collected four times a day over two consecutive days, was measured with radioimmunoassay technique at six months and nine years to assess the hypothalamic-pituitary-adrenal (HPA) axis. Mothers reported post-traumatic symptoms on a self-report questionnaire 12 months after their child's birth and children's adjustment problems at 9 years of child age on the Child Behavior Checklist. Results showed a significant difference in cortisol regulation at nine years between preterm and full-term children but no differences in adjustment problems. Whereas biological factors (i.e., PERI, cortisol regulation at six months) explained cortisol at nine years, maternal post-traumatic symptoms were predictive of adjustment problems in their child. In conclusion, very preterm birth has some long-term consequences on the HPA-axis regulation at nine years. Although cortisol regulation is mostly influenced by biological factors, the presence of maternal post-traumatic symptoms predicts the manifestation of adjustment problems in both groups. This shows the importance of maternal psychological well-being for child development. Further research is needed to understand the exact consequences of premature birth on cortisol regulation and the implication for the child's development and health.
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16
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Doctor PN, Kamat D, Sood BG. Changes in Clinical Care of the Newborn During COVID-19 Pandemic: From the Womb to First Newborn Visit. Pediatr Clin North Am 2021; 68:1055-1070. [PMID: 34538298 PMCID: PMC8133491 DOI: 10.1016/j.pcl.2021.05.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
COVID-19 has afflicted the health of children and women across all age groups. Since the outbreak of the pandemic in December 2019, various epidemiologic, immunologic, clinical, and pharmaceutical studies have been conducted to understand its infectious characteristics, pathogenesis, and clinical profile. COVID-19 affects pregnant women more seriously than nonpregnant women, endangering the health of the newborn. Changes have been implemented to guidelines for antenatal care of pregnant women, delivery, and newborn care. We highlight the current trends of clinical care in pregnant women and newborns during the COVID-19 pandemic.
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Affiliation(s)
- Pezad N. Doctor
- Department of Pediatrics, Children’s Hospital of Michigan, 3901, Beaubien Boulevard, Detroit, MI 48201, USA,Corresponding author. Office of Pediatric education, 3901 Beaubien, Detroit, MI 48201
| | - Deepak Kamat
- Department of Pediatrics, UT Health Science Center, UT Health San Antonio, San Antonio, TX 78229, USA
| | - Beena G. Sood
- Department of Pediatrics, Wayne State University School of Medicine, 540E Canfield Street, Detroit, Michigan 48201, USA
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17
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Psychological Wellbeing of Parents with Infants Admitted to the Neonatal Intensive Care Unit during SARS-CoV-2 Pandemic. CHILDREN-BASEL 2021; 8:children8090755. [PMID: 34572187 PMCID: PMC8471119 DOI: 10.3390/children8090755] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 08/25/2021] [Accepted: 08/26/2021] [Indexed: 01/25/2023]
Abstract
The current SARS-CoV-2 disease (COVID-19) pandemic is a sudden major stressor superimposed on pre-existing high distress in parents of infants admitted to the neonatal intensive care unit (NICU). This study aimed to investigate the psychological wellbeing of NICU parents during the COVID-19 pandemic. Forty-four parents of 25 inpatients of the Padua University Hospital NICU were included from June 2020 to February 2021. At 7–14 days postpartum parents completed the Edinburgh Postnatal Depression Scale (EPDS), State-Trait Anxiety Inventory (STAI), Parental Stressor Scale: NICU (PSS:NICU) and an ad-hoc questionnaire measuring parental COVID-19 related stress. About one third of parents reported extreme/high stress and a relevant negative impact on parenthood experience. Less time (82%) and less physical contact (73%) with infants due to COVID-19 preventive measures were the most frequent negative factors. Higher COVID-19 related parental stress was positively associated with anxiety, depression, NICU parental stress, stress related to NICU environment, and parental role alterations. Depression symptoms, stress related to infant condition and parental role alterations were higher in mothers. The pandemic affected parental emotional and relational wellbeing directly through additional stress due to COVID-19 concerns and indirectly through the impact of restrictions on the experience of becoming parents.
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18
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Walczak-Kozłowska T, Chrzan-Dętkoś M, Harciarek M. Heterogeneity of the attentional system's efficiency among very prematurely born pre-schoolers. Child Neuropsychol 2021; 28:120-142. [PMID: 34348594 DOI: 10.1080/09297049.2021.1961702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Very preterm birth increases the risk of ADHD as well as other neurodevelopmental disorders. Deficits within the attentional system were previously signaled in preterm children; however, studies lacked in consideration of an intragroup differentiation. Thus, this study aimed to verify whether deficits in the attentional mechanisms are inter-individually differentiated among very prematurely born children and if so, which biomedical and non-biomedical factors are associated with the profile of deficits within the attentional system. We tested the efficiency of attentional processes among 5-year-old children with the Attention Network Task - Child Version. The results have indicated that 26% of very preterm children presented with the suboptimal functioning of the attentional system (more than 1 SD below mean score of full-term children in attentional alerting and orienting), whereas 74% were characterized by the normal efficiency of attention. The profile of attentional deficits observed among very preterm preschoolers was associated with significantly lower birth weight and decreased family living standard. Very prematurely born children are thus a relatively heterogeneous group in terms of the efficiency of attentional system and deficits apply to only some of those children. Early developmental support aimed at enhancing attentional functioning should be addressed to children with lower birth weight in the first place.
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Affiliation(s)
- Tamara Walczak-Kozłowska
- Division of Neuropsychology, Institute of Psychology, Department of the Social Sciences, University of Gdańsk, Gdańsk, Poland
| | - Magdalena Chrzan-Dętkoś
- Division of Developmental Psychology and Psychopathology, Institute of Psychology, Department of the Social Sciences, University of Gdańsk, Gdańsk, Poland
| | - Michał Harciarek
- Division of Neuropsychology, Institute of Psychology, Department of the Social Sciences, University of Gdańsk, Gdańsk, Poland
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19
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Chifa M, Hadar T, Politimou N, Reynolds G, Franco F. The Soundscape of Neonatal Intensive Care: A Mixed-Methods Study of the Parents' Experience. CHILDREN-BASEL 2021; 8:children8080644. [PMID: 34438535 PMCID: PMC8391440 DOI: 10.3390/children8080644] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 07/21/2021] [Accepted: 07/23/2021] [Indexed: 12/03/2022]
Abstract
Parents who have infants hospitalised in neonatal intensive care units (NICUs) experience high levels of stress, including post-traumatic stress disorder (PTSD) symptoms. However, whether sounds contribute to parents’ stress remains largely unknown. Critically, researchers lack a comprehensive instrument to investigate the relationship between sounds in NICUs and parental stress. To address this gap, this report presents the “Soundscape of NICU Questionnaire” (SON-Q), which was developed specifically to capture parents’ perceptions and beliefs about the impact that sound had on them and their infants, from pre-birth throughout the NICU stay and in the first postdischarge period. Parents of children born preterm (n = 386) completed the SON-Q and the Perinatal PTSD Questionnaire (PPQ). Principal Component Analysis identifying underlying dimensions comprising the parental experience of the NICU soundscape was followed by an exploration of the relationships between subscales of the SON-Q and the PPQ. Moderation analysis was carried out to further elucidate relationships between variables. Finally, thematic analysis was employed to analyse one memory of sounds in NICU open question. The results highlight systematic associations between aspects of the NICU soundscape and parental stress/trauma. The findings underscore the importance of developing specific studies in this area and devising interventions to best support parents’ mental health, which could in turn support infants’ developmental outcomes.
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Affiliation(s)
- Maria Chifa
- Psychology Department, Faculty of Science and Technology, Middlesex University, London NW4 4BT, UK; (M.C.); (G.R.)
| | - Tamar Hadar
- Division of Expressive Therapies, Graduate School of Arts & Social Sciences, Lesley University, Cambridge, MA 02138, USA;
| | - Nina Politimou
- Institute of Education, University College London, London WC1H 0AA, UK;
| | - Gemma Reynolds
- Psychology Department, Faculty of Science and Technology, Middlesex University, London NW4 4BT, UK; (M.C.); (G.R.)
| | - Fabia Franco
- Psychology Department, Faculty of Science and Technology, Middlesex University, London NW4 4BT, UK; (M.C.); (G.R.)
- Correspondence:
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20
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Cena L, Biban P, Janos J, Lavelli M, Langfus J, Tsai A, Youngstrom EA, Stefana A. The Collateral Impact of COVID-19 Emergency on Neonatal Intensive Care Units and Family-Centered Care: Challenges and Opportunities. Front Psychol 2021; 12:630594. [PMID: 33716895 PMCID: PMC7943863 DOI: 10.3389/fpsyg.2021.630594] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 01/25/2021] [Indexed: 12/28/2022] Open
Abstract
The ongoing Coronavirus disease 2019 (COVID-19) pandemic is disrupting most specialized healthcare services worldwide, including those for high-risk newborns and their families. Due to the risk of contagion, critically ill infants, relatives and professionals attending neonatal intensive care units (NICUs) are undergoing a profound remodeling of the organization and quality of care. In particular, mitigation strategies adopted to combat the COVID-19 pandemic may hinder the implementation of family-centered care within the NICU. This may put newborns at risk for several adverse effects, e.g., less weight gain, more nosocomial infections, increased length of NICU stay as well as long-term worse cognitive, emotional, and social development. This article aims to contribute to deepening the knowledge on the psychological impact of COVID-19 on parents and NICU staff members based on empirical data from the literature. We also provided evidence-based indications on how to safely empower families and support NICU staff facing such a threatening emergency, while preserving the crucial role of family-centered developmental care practices.
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Affiliation(s)
- Loredana Cena
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Paolo Biban
- Department of Neonatal and Pediatric Critical Care, Verona University Hospital, Verona, Italy
| | - Jessica Janos
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Manuela Lavelli
- Department of Human Sciences, University of Verona, Verona, Italy
| | - Joshua Langfus
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Angelina Tsai
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Eric A. Youngstrom
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Alberto Stefana
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
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21
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Martins CBS, Cassiano RGM, Linhares MBM. Negative affectivity moderated by preterm birth predicted toddlers' behavior problems. Infant Behav Dev 2021; 63:101544. [PMID: 33618212 DOI: 10.1016/j.infbeh.2021.101544] [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] [Received: 05/13/2020] [Revised: 02/13/2021] [Accepted: 02/13/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The present study aimed to examine the predictive effect of temperament moderated by preterm childbirth on behavioral problems in toddlerhood. METHOD The sample comprised 100 toddlers of 18-36 months of chronological age and their mothers. They were divided into two groups: 50 toddlers born preterm and admitted to the Neonatal Intensive Care Unit (PT group), and 50 toddlers born full-term (FT group) and recruited from day-care centers. Mothers completed questionnaires about toddlers' temperament and behavior. The Early Childhood Behavior Questionnaire was used to assess temperament, and the Child Behavior Checklist (CBCL 1¹/²-5) to evaluate the total, internalizing, and externalizing behavior problems. Multiple regression analysis was performed to examine the moderation effects of preterm childbirth and temperament factors after controlling for toddlers' age and socioeconomic level. RESULTS There was a moderation effect between preterm childbirth and temperament. Temperament with more Negative Affectivity, moderated by preterm birth, and less Effortful Control explained the total, internalizing, and externalizing behavior problems. CONCLUSION The findings contribute to a better understanding of the impact of preterm childbirth and the dispositional traits of temperament on behavioral problems of toddlers born preterm.
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22
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Posttraumatic Stress Symptoms in Mothers and Fathers of Very Preterm Infants Over the First 2 Years. J Dev Behav Pediatr 2020; 41:612-618. [PMID: 32576786 DOI: 10.1097/dbp.0000000000000828] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Mothers and fathers of infants born very preterm (VPT) are at increased risk for posttraumatic stress symptoms (PTSSs), such as reexperiencing the event, persistent avoidance, or increased reactivity within the early months, compared with parents of term-born infants. This study aimed to assess PTSSs in mothers and fathers of VPT infants over the first 2 years of life, including changes over time and relationship with medical and social risk. METHOD A longitudinal, prospective, cohort study of PTSSs in parents of VPT infants. PTSS was assessed at term equivalent age (TEA) and 12 and 24 months using the Posttraumatic Stress Disorder Checklist Specific Version. Participants were 105 parents of 131 infants born at <30 weeks' gestational age with PTSS data at least once (92 mothers and/or 75 fathers). RESULTS At TEA and 12 and 24 months, elevated PTSSs were reported by 36%, 22%, and 18% of mothers and 35%, 25%, and 19% of fathers, respectively. The mean symptom scores and rates of elevated PTSSs declined over time: mean (95% confidence interval) change in PTSS score per year = -1.52 (-2.33 to -0.72, p < 0.001). There was little evidence for difference in these patterns for mothers or fathers (interaction p = 0.46 [total score] and 0.71 [elevated category]) or that medical and social risk were associated with PTSSs over time. CONCLUSION Although the rates of parents experiencing clinically elevated symptoms declined over time, it is concerning that one-fifth of mothers and fathers reported elevated PTSSs at 24 months. Further research is needed to identify factors associated with increased risk and resilience for PTSSs after VPT birth in mothers and fathers to provide effective and appropriate support.
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23
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Maitre NL, Key AP, Slaughter JC, Yoder PJ, Neel ML, Richard C, Wallace MT, Murray MM. Neonatal Multisensory Processing in Preterm and Term Infants Predicts Sensory Reactivity and Internalizing Tendencies in Early Childhood. Brain Topogr 2020; 33:586-599. [PMID: 32785800 PMCID: PMC7429553 DOI: 10.1007/s10548-020-00791-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 07/13/2020] [Indexed: 12/22/2022]
Abstract
Multisensory processes include the capacity to combine information from the different senses, often improving stimulus representations and behavior. The extent to which multisensory processes are an innate capacity or instead require experience with environmental stimuli remains debated. We addressed this knowledge gap by studying multisensory processes in prematurely born and full-term infants. We recorded 128-channel event-related potentials (ERPs) from a cohort of 55 full-term and 61 preterm neonates (at an equivalent gestational age) in response to auditory, somatosensory, and combined auditory-somatosensory multisensory stimuli. Data were analyzed within an electrical neuroimaging framework, involving unsupervised topographic clustering of the ERP data. Multisensory processing in full-term infants was characterized by a simple linear summation of responses to auditory and somatosensory stimuli alone, which furthermore shared common ERP topographic features. We refer to the ERP topography observed in full-term infants as "typical infantile processing" (TIP). In stark contrast, preterm infants exhibited non-linear responses and topographies less-often characterized by TIP; there were distinct patterns of ERP topographies to multisensory and summed unisensory conditions. We further observed that the better TIP characterized an infant's ERPs, independently of prematurity, the more typical was the score on the Infant/Toddler Sensory Profile (ITSP) at 12 months of age and the less likely was the child to the show internalizing tendencies at 24 months of age. Collectively, these results highlight striking differences in the brain's responses to multisensory stimuli in children born prematurely; differences that relate to later sensory and internalizing functions.
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Affiliation(s)
- Nathalie L Maitre
- Center for Perinatal Research at the Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA.
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.
- Department of Pediatrics, Nationwide Children's Hospital, 700 Children's Way, Columbus, OH, 43205, USA.
| | - Alexandra P Key
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - James C Slaughter
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Paul J Yoder
- Department of Special Education, Peabody College of Education and Human Development, Vanderbilt University, Nashville, TN, USA
| | - Mary Lauren Neel
- Center for Perinatal Research at the Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
| | - Céline Richard
- Center for Perinatal Research at the Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
| | - Mark T Wallace
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA
- Departments of Psychology and Pharmacology, Vanderbilt University, Nashville, TN, USA
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
| | - Micah M Murray
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.
- The Laboratory for Investigative Neurophysiology (The LINE), Department of Radiology, University Hospital Center and University of Lausanne, Lausanne, Switzerland.
- Sensory, Perceptual, and Cognitive Neuroscience Section, Center for Biomedical Imaging (CIBM) of Lausanne, Lausanne, Switzerland.
- Department of Ophthalmology, Fondation Asile des aveugles and University of Lausanne, Lausanne, Switzerland.
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24
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Lower estimated intelligence quotient is associated with suicide attempts in pediatric bipolar disorder. J Affect Disord 2020; 261:103-109. [PMID: 31610309 DOI: 10.1016/j.jad.2019.09.083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Revised: 08/28/2019] [Accepted: 09/30/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Approximately 20% of individual with pediatric bipolar disorder (PBD) have a lifetime history of suicide attempt. Some cognitive measures were associated with a suicide attempt, but no study has assessed the association of this event with the estimated intelligence quotient (IQ) in PBI. In adult Bipolar Disorder no association between IQ and suicidality was found, with different correlations between cognitive measures. There are studies in general population showing a negative correlation and others did not find any association. In Schizophrenia, IQ had a positive correlation with suicide attempt. So, the correlation between IQ and suicidality still controversial. METHODS We recruited 63 children and adolescents younger than 18 years of age with PBD based on DSM-IV criteria from an outpatient clinic in Brazil. Manic and depressive symptoms were assessed with the YMRS and CDRS, respectively. Estimated IQ was assessed with the WISC-III. The presence or absense of suicidal attempt, clinical and demographic variables were assessed with the K-SADS-PL-W. RESULTS Patients who attempted suicide had lower estimated IQ compared to patients who did not attempt suicide (82.72 ± 18.70 vs. 101.0 ± 14.36; p = 0.009). This finding remained after correction for depressive symptoms and family income (OR = 0.94; 95% CI = 0.89 - 0.99; p = 0.029). LIMITATIONS Small sample, reverse causality could not be discarded, we only used two subscales of the WISC-III to estimate intelligence. CONCLUSION Estimated IQ and suicide attempts were negative correlated in PBD. Future longitudinal and larger studies may confirm our findings.
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25
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Murray PD, Swanson JR. Visitation restrictions: is it right and how do we support families in the NICU during COVID-19? J Perinatol 2020; 40:1576-1581. [PMID: 32772051 PMCID: PMC7414900 DOI: 10.1038/s41372-020-00781-1] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 07/27/2020] [Accepted: 08/03/2020] [Indexed: 11/09/2022]
Abstract
Although the COVID-19 pandemic has largely not clinically affected infants in neonatal intensive care units around the globe, it has affected how care is provided. Most hospitals, including their NICUs, have significantly reduced parental and family visitation privileges. From an ethical perspective, this restriction of parental visitation in settings where infectious risk is difficult to understand. No matter what the right thing to do is, NICUs are currently having to support families of their patients via different mechanisms. In this perspective, we discuss ways NICUs can support parents and families when they are home and when they are in the NICU as well as provide infants the support needed when family members are not able to visit.
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Affiliation(s)
- Peter D. Murray
- grid.412998.f0000 0004 0434 0379Department of Pediatrics, Division of Neonatology, University of Virginia Children’s Hospital, Charlottesville, VA USA
| | - Jonathan R. Swanson
- grid.412998.f0000 0004 0434 0379Department of Pediatrics, Division of Neonatology, University of Virginia Children’s Hospital, Charlottesville, VA USA
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