1
|
Bante A, Ayele G, Alamirew B, Ahmed M. Regulatory problems and associated factors among infants in Arba Minch health and demographic surveillance system sites, southern Ethiopia. PLoS One 2024; 19:e0305722. [PMID: 38889163 PMCID: PMC11185483 DOI: 10.1371/journal.pone.0305722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 06/03/2024] [Indexed: 06/20/2024] Open
Abstract
INTRODUCTION Infant regulatory problems are a common source of concern for parents, and they increase the risk of impaired infant-caregiver bonding. Despite their impact, they are often overlooked in Ethiopia. Hence, this study aimed to determine the prevalence and associated factors of infant regulatory problems in Arba Minch Health and Demographic Surveillance System sites in southern Ethiopia. METHODS A community-based cross-sectional study was conducted among 451 mother-infant pairs from February 15 to March 15, 2022. Regulatory problems were assessed using diagnostic interviews for regulatory problems. The data was collected using an open data kit Android application and analyzed with Stata version 17.0. Bivariable and multivariable logistic regression analyses were computed to identify factors associated with each infant regulatory problem. Statistical significance was declared at a p-value < 0.05. RESULTS In this study, four hundred forty-nine mother-infant pairs were involved, with a response rate of 99.5%. The prevalence of excessive crying, feeding problems, and sleeping difficulties was 14.03% [95% CI: 10.95, 17.59], 20.04% [95% CI: 16.44, 24.05], and 13.59% [95% CI: 10.55, 17.11], respectively. Attending primary education (AOR: 2.54, 95% CI: 1.22, 5.32), high perceived social support (AOR: 0.32, 95% CI: 0.12, 0.89), feeding problems (AOR: 5.0, 95% CI: 2.65, 9.45), and depression, anxiety, and stress (DAS) symptoms (AOR: 2.67, 95% CI: 1.19, 5.98) were associated with excessive crying. In addition, a family size of above five (AOR: 1.82, 95% CI: 1.03, 3.22), excessive crying (AOR: 3.76, 95% CI: 1.85, 7.65), sleeping problems (AOR: 2.29, 95% CI: 1.13, 4.65), comorbid DAS symptoms (AOR: 3.42, 95% CI: 1.64, 7.11), alcohol abuse (AOR: 1.89, 95% CI: 1.04, 3.42), and late initiation of complementary feeding (AOR: 2.67, 95% CI: 1.22, 5.88) were associated with feeding problems. Furthermore, attending primary education (AOR: 2.35, 95% CI: 1.16, 4.77), feeding problems (AOR: 3.47, 95% CI: 1.86, 6.48), and comorbid DAS symptoms (AOR: 3.23, 95% CI: 1.53, 6.84) were associated with sleeping problems. CONCLUSIONS Approximately one-third of infants encountered at least one regulatory problem. Level of education, perceived social support, feeding problems, and DAS symptoms were associated with excessive crying. Large family sizes, excessive crying, sleeping problems, comorbid DAS symptoms, alcohol abuse and, late initiation of complementary feeding increase the likelihood of feeding problems. Moreover, attending primary education, feeding problems, and comorbid DAS symptoms increase the odds of sleeping problems. Continuous guidance and support on infant soothing techniques, cognitive and behavioral therapy, and counselling on appropriate coping strategies for postpartum women are imperative to reduce the burden of infant regulatory problems.
Collapse
Affiliation(s)
- Agegnehu Bante
- School of Nursing, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Gistane Ayele
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Birhanu Alamirew
- School of Nursing, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Muluken Ahmed
- School of Medicine, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| |
Collapse
|
2
|
van Dokkum NH, Bos AF, Kraft KE, Bouma HA, Reijneveld SA, Krabbe PFM, de Kroon MLA. Early stress during NICU stay and parent-reported health-related quality of life after extremely preterm birth: an exploratory study with possible targets for early intervention. Front Pediatr 2024; 12:1381008. [PMID: 38650996 PMCID: PMC11033392 DOI: 10.3389/fped.2024.1381008] [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: 02/02/2024] [Accepted: 03/27/2024] [Indexed: 04/25/2024] Open
Abstract
Introduction The association between neonatal intensive care unit (NICU) related stress in preterm infants and their health-related quality of life (HRQoL) in the first year following preterm birth remains unexplored. Understanding this association is crucial for enhancing preventive and supportive measures for infants and parents within and beyond the NICU. Methods From a single center observational cohort study, we included infants with gestational ages below 30 weeks and/or birth weights under 1,000 grams. HRQoL was quantified using the Infant Quality of Life Instrument (IQI) at 3-, 6-, 9- and 12-months corrected age, covering seven domains. NICU stress was quantified using the Neonatal Infant Stressor Scale (NISS) for the first week of life. We performed Spearman's correlation analyses to test this association. Results Of the 45 included infants, the IQI was completed for 27 (60%) at 3, 15 (33%) at 6, 14 (31%) at 9 and 15 (33%) at 12 months. The HRQoL sum scores were related to neonatal stress at 9 and 12 months (ρ = 0.643 and 0.591, p = 0.013 and p = 0.019, respectively) but not at 3 and 6 months (ρ = -0.001 and -0.077 respectively, p > 0.05). Higher NICU stress tended to be associated with more respiratory and mood problems throughout the first year. Discussion From a parental perspective on infant HRQoL, extremely preterm infants with higher stress exposure show more problems in the second half-year of life, mainly breathing and possibly mood-related problems. This knowledge may help improve our neonatal care, both during NICU stay and in follow-up clinics, by implementing targeted interventions.
Collapse
Affiliation(s)
- Nienke H. van Dokkum
- Divison of Neonatology, Department of Pediatrics, Beatrix Children’s Hospital, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Arend F. Bos
- Divison of Neonatology, Department of Pediatrics, Beatrix Children’s Hospital, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Karianne E. Kraft
- Divison of Neonatology, Department of Pediatrics, Beatrix Children’s Hospital, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Helene A. Bouma
- Divison of Neonatology, Department of Pediatrics, Beatrix Children’s Hospital, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Sijmen A. Reijneveld
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Paul F. M. Krabbe
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Marlou L. A. de Kroon
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
- Environment and Health, Youth Health Care, University of Leuven, KU Leuven, Leuven, Belgium
| |
Collapse
|
3
|
Ibrahim C, Grabill M, Smith J, Pineda R. Relationships between preterm medical factors and feeding behaviors at term-equivalent age. Early Hum Dev 2024; 191:105975. [PMID: 38492414 PMCID: PMC11019834 DOI: 10.1016/j.earlhumdev.2024.105975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 02/23/2024] [Accepted: 02/24/2024] [Indexed: 03/18/2024]
Abstract
AIM To identify relationships between early medical factors and preterm infant feeding behaviors at term-equivalent age. METHODS Forty-three very preterm infants born ≤32 weeks gestation had standardized feeding assessments using the Neonatal Eating Outcome Assessment at term-equivalent age (36-42 weeks postmenstrual age). Medical factors were collected and analyses were run to determine if associations between different medical factors and feeding performance exist. RESULTS Lower Neonatal Eating Outcome Assessment scores at term-equivalent age were associated with lower estimated gestational age (p < .01), lower birthweight (p < .01), older postmenstrual age at discharge (p < .01), longer length of stay in the neonatal intensive care unit (p < .01), chronic lung disease (p = .03), as well as more days on total parenteral nutrition (p = .03), endotracheal intubation (p < .01), and noninvasive mechanical ventilation (p < .01). CONCLUSION More feeding problems are observed in infants born earlier, with longer hospital stays, and with complex medical courses. Knowledge of the association between these medical factors and feeding difficulties allows for identification of infants who may benefit from early, targeted interventions to optimize the feeding process.
Collapse
Affiliation(s)
- Carolyn Ibrahim
- College of Health Sciences, Rush University, Chicago, IL, United States of America
| | - Molly Grabill
- Washington University Program in Occupational Therapy, St. Louis, MO, United States of America
| | - Joan Smith
- Saint Louis Children's Hospital Department of Quality, Safety & Practice Excellence, St. Louis, MO, United States of America
| | - Roberta Pineda
- Washington University Program in Occupational Therapy, St. Louis, MO, United States of America; Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, United States of America.
| |
Collapse
|
4
|
Buechel C, Friedmann A, Eber S, Behrends U, Mall V, Nehring I. The change of psychosocial stress factors in families with infants and toddlers during the COVID-19 pandemic. A longitudinal perspective on the CoronabaBY study from Germany. Front Pediatr 2024; 12:1354089. [PMID: 38562139 PMCID: PMC10982396 DOI: 10.3389/fped.2024.1354089] [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: 12/11/2023] [Accepted: 03/01/2024] [Indexed: 04/04/2024] Open
Abstract
Background Over nearly three years, the COVID-19 pandemic has had a lasting impact on people's lives and mental health worldwide with its far-reaching restrictions and concerns about infections and other personal consequences. Families were particularly affected and showed increased stress and psychological problems. Long-term effects cannot be ruled out. So far, data on young families are sparse. The present longitudinal analysis (n = 932) of the CoronabaBY study investigated the development of parenting stress, parental affective symptoms, and child's mental health in young families with children aged 0-3 years in Germany as well as potential influencing factors. Methods The observational study includes two measurement points over the course of the pandemic (baseline and follow-up). Data was collected by app using standardized questionnaires. Results N = 932 participants, mainly mothers (94.7%) born in Germany (93.1%) with higher education (61.3% with at least high school diploma) and a comfortable financial situation participated in the longitudinal study. Children were on average 14.7 months old at baseline (SD: 12, range: 1-39 months). While the proportion of parents who perceived the pandemic as stressful decreased significantly from baseline (60%) to follow-up (52.3%), the proportion with parenting stress increased significantly (from 40.1% to 45.4%). Both parental and child mental health problems remained constant over time, with infants crying/feeding/sleeping problems ranging above pre-pandemic comparative data. Most predictive for high parenting stress at follow-up was high parenting stress at baseline. This was also true for parental affective symptoms (depression/anxiety) and child mental health problems. Conclusions Despite faded pandemic restrictions, parents remained burdened. Support services do not appear to have been sufficient to help families out of their stressful situation. Our results indicate a need for action regarding low-threshold services that effectively reach affected families. Trial registration The study was pre-registered in OSF (https://osf.io/search/?q=tksh5&page=1).
Collapse
Affiliation(s)
- Catherine Buechel
- Chair of Social Pediatrics, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Anna Friedmann
- Chair of Social Pediatrics, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Stefan Eber
- Professional Association of Pediatricians in Bavaria (BVKJ) and PaedNetz Bayern, Munich, Germany
| | - Uta Behrends
- Children’s Hospital, School of Medicine, Technical University Munich, Munich, Germany
| | - Volker Mall
- Chair of Social Pediatrics, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Ina Nehring
- Chair of Social Pediatrics, TUM School of Medicine, Technical University of Munich, Munich, Germany
| |
Collapse
|
5
|
Msall ME, Lagatta JM, Bora S. Optimizing trajectories of social adaptive competencies after extreme prematurity during the first 1000 days. Semin Fetal Neonatal Med 2024; 29:101531. [PMID: 38632009 PMCID: PMC11156543 DOI: 10.1016/j.siny.2024.101531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
Over 75% of surviving extremely preterm infants do not have major neurodevelopmental disabilities; however, more than half face difficulties with communication, coordination, attention, learning, social, and executive function abilities. These "minor" challenges can have a negative impact on educational and social outcomes, resulting in physical, behavioral, and social health problems in adulthood. We will review assessment tools for social-emotional and adaptive functional skills in early childhood as these determine family and early childhood supports. We highlight bronchopulmonary dysplasia as an example of the critical intersections of parental wellbeing, medical and developmental adaptive trajectories in infancy and early childhood, and partnerships between child neurologists and community medical and developmental professionals. We examine studies of engaging parents to promote developmental trajectories, with a focus on supporting parent-child interactions that underlie communication, social-adaptive behaviors, and learning in the first 1000 days of life. Recommendations for neurodevelopmental surveillance and screening of extremely preterm infants can also be applied to infants with other risk factors for altered neurodevelopment.
Collapse
Affiliation(s)
- Michael E Msall
- Department of Pediatrics, Section of Developmental and Behavioral Pediatrics and Kennedy Research Center on Intellectual and Developmental Disabilities, University of Chicago Medicine, Chicago, IL, USA.
| | - Joanne M Lagatta
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - Samudragupta Bora
- Department of Pediatrics, University Hospitals Rainbow Babies & Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
| |
Collapse
|
6
|
Harskamp-van Ginkel MW, Imkamp NLE, van Houtum L, Vrijkotte TGM, Ben Haddi-Toutouh Y, Chinapaw MJM. Parental Discontent with Infant Sleep During the First Two Years of Life. Behav Sleep Med 2023; 21:727-740. [PMID: 36625550 DOI: 10.1080/15402002.2022.2156867] [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] [Indexed: 01/11/2023]
Abstract
BACKGROUND Problematic sleep in infants can have a high impact on families. We examined parental discontent with infant sleep in the first six months of life and parent-perceived problematic sleep during the second year of life. METHODS We used Sarphati Cohort data of 1471 children. During periodic youth health care visits in the first six months of life, professionals registered parental discontent with infant sleep. In the second year of life, parents filled out the Brief Infant Sleep Questionnaire (BISQ), from which we defined parent-perceived problematic sleep and BISQ-defined problematic sleep. We examined the association of parental discontent with infant sleep during the first six months with both BISQ-derived outcomes up to age two, using multivariable logistic regression analysis. RESULTS 26% of parents were discontented with infant sleep during the first six months of life. During the second year of life, 27% of the parents perceived their child's sleep as problematic, and 9% of the infants had BISQ-defined problematic sleep. Early parental discontent with infant sleep was associated with parent-perceived problematic sleep [adjusted OR 2.50 (95% CI 1.91-3.28)], and BISQ-defined problematic sleep [adjusted OR 1.88 (1.11-3.17)]. CONCLUSIONS Early registered parental discontent with infant sleep was a predictor of parent-perceived problematic sleep in early toddlerhood. Registering parental discontent during infancy might enable professionals to identify a group of infants at risk for later problematic sleep. We recommend screening and parental support for sleep difficulties in an early stage.
Collapse
Affiliation(s)
- Margreet W Harskamp-van Ginkel
- Amsterdam UMC, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, The Netherlands
| | - Nicola L E Imkamp
- Amsterdam UMC, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, The Netherlands
| | - Lieke van Houtum
- Sarphati Amsterdam, Public Health Service (GGD), Amsterdam, The Netherlands
| | - Tanja G M Vrijkotte
- Amsterdam UMC, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Mai J M Chinapaw
- Amsterdam Public Health Research Institute, Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan The Netherlands
| |
Collapse
|
7
|
Robinson R, Girchenko P, Pulakka A, Heinonen K, Lähdepuro A, Lahti-Pulkkinen M, Hovi P, Tikanmäki M, Bartmann P, Lano A, Doyle LW, Anderson PJ, Cheong JLY, Darlow BA, Woodward LJ, Horwood LJ, Indredavik MS, Evensen KAI, Marlow N, Johnson S, de Mendonca MG, Kajantie E, Wolke D, Räikkönen K. ADHD symptoms and diagnosis in adult preterms: systematic review, IPD meta-analysis, and register-linkage study. Pediatr Res 2023; 93:1399-1409. [PMID: 34997222 PMCID: PMC10132969 DOI: 10.1038/s41390-021-01929-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 12/07/2021] [Accepted: 12/14/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND This study examined differences in ADHD symptoms and diagnosis between preterm and term-born adults (≥18 years), and tested if ADHD is related to gestational age, birth weight, multiple births, or neonatal complications in preterm borns. METHODS (1) A systematic review compared ADHD symptom self-reports and diagnosis between preterm and term-born adults published in PubMed, Web of Science, and PROQUEST until April 2021; (2) a one-stage Individual Participant Data(IPD) meta-analysis (n = 1385 preterm, n = 1633 term; born 1978-1995) examined differences in self-reported ADHD symptoms[age 18-36 years]; and (3) a population-based register-linkage study of all live births in Finland (01/01/1987-31/12/1998; n = 37538 preterm, n = 691,616 term) examined ADHD diagnosis risk in adulthood (≥18 years) until 31/12/2016. RESULTS Systematic review results were conflicting. In the IPD meta-analysis, ADHD symptoms levels were similar across groups (mean z-score difference 0.00;95% confidence interval [95% CI] -0.07, 0.07). Whereas in the register-linkage study, adults born preterm had a higher relative risk (RR) for ADHD diagnosis compared to term controls (RR = 1.26, 95% CI 1.12, 1.41, p < 0.001). Among preterms, as gestation length (RR = 0.93, 95% CI 0.89, 0.97, p < 0.001) and SD birth weight z-score (RR = 0.88, 95% CI 0.80, 0.97, p < 0.001) increased, ADHD risk decreased. CONCLUSIONS While preterm adults may not report higher levels of ADHD symptoms, their risk of ADHD diagnosis in adulthood is higher. IMPACT Preterm-born adults do not self-report higher levels of ADHD symptoms, yet are more likely to receive an ADHD diagnosis in adulthood compared to term-borns. Previous evidence has consisted of limited sample sizes of adults and used different methods with inconsistent findings. This study assessed adult self-reported symptoms across 8 harmonized cohorts and contrasted the findings with diagnosed ADHD in a population-based register-linkage study. Preterm-born adults may not self-report increased ADHD symptoms. However, they have a higher risk of ADHD diagnosis, warranting preventive strategies and interventions to reduce the presentation of more severe ADHD symptomatology in adulthood.
Collapse
Affiliation(s)
| | | | - Anna Pulakka
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Kati Heinonen
- University of Helsinki, Helsinki, Finland
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | | | - Marius Lahti-Pulkkinen
- University of Helsinki, Helsinki, Finland
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Petteri Hovi
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | | | - Peter Bartmann
- Department of Neonatology, University of Bonn, Bonn, Germany
| | - Aulikki Lano
- University of Helsinki, Helsinki, Finland
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Lex W Doyle
- Royal Women's Hospital, Melbourne, VIC, Australia
- University of Melbourne, Melbourne, VIC, Australia
- Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Peter J Anderson
- Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
- Department of Paediatrics, University of Otago, Christchurch, New Zealand
| | - Jeanie L Y Cheong
- Royal Women's Hospital, Melbourne, VIC, Australia
- University of Melbourne, Melbourne, VIC, Australia
- Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Brian A Darlow
- Department of Paediatrics, University of Otago, Christchurch, New Zealand
| | | | - L John Horwood
- Department of Paediatrics, University of Otago, Christchurch, New Zealand
| | - Marit S Indredavik
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kari Anne I Evensen
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
| | | | | | - Marina Goulart de Mendonca
- University of Warwick, Coventry, UK
- Department of Neuroscience, Psychology and Behaviour, School of Psychology, University of Leicester, Leicester, UK
| | - Eero Kajantie
- University of Helsinki, Helsinki, Finland
- Finnish Institute for Health and Welfare, Helsinki, Finland
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | | | | |
Collapse
|
8
|
Kersten JM, van Veen M, van Houten MA, Wieringa J, Noordzij JG, Bekhof J, Tramper-Stranders GA, Visser-Trip H, Vet NJ, Kruizinga MD. Adverse effect of lockdowns during the COVID-19 pandemic: increased incidence of pediatric crisis admissions due to eating disorders and adolescent intoxications. Eur J Pediatr 2023; 182:1137-1142. [PMID: 36598566 PMCID: PMC9811038 DOI: 10.1007/s00431-022-04773-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 12/12/2022] [Accepted: 12/19/2022] [Indexed: 01/05/2023]
Abstract
During the COVID-19 pandemic, countries imposed (partial) lockdowns that reduced viral transmission. However, these interventions may have unfavorable effects on emotional and psychological well-being. The aim of this study was to quantify possible adverse effects of the COVID-19 pandemic on psychological wellbeing in children and adolescents. Hospital admission data between January 2017 and September 2021 from eight general hospitals in the Netherlands was collected, comparing the incidences of sub-categorized psychological diagnoses, more specifically eating disorders, intentional intoxications, accidental intoxications, and excessive crying, before (2017-2019) and during the pandemic (2020-2021). Data was summarized per month and per year, and the years 2020 and 2021 were compared to 2017-2019. The relative increase or decrease in diagnoses since the start of the pandemic was calculated. Overall pediatric hospital admissions decreased with 28% since the start of the pandemic. Non-infectious diagnoses showed a decrease of 8%. Of these non-infectious diagnoses, overall psychosocial admissions were increased (+ 9%), mostly caused by an increase in admissions for eating disorders (+ 64%) and intoxications in adolescents (+ 24%). In addition, the proportion of admissions due to psychosocial diagnoses increased post-pandemic (6% vs 4%, p < 0.001). Overall admissions for intoxications in children (- 3%) and excessive crying (- 1%) did not increase, although peaks in incidence were found at the start of the second lockdown. CONCLUSION During the COVID-19 pandemic, admission rates for eating disorders and intentional intoxications showed a substantial increase, indicating a high burden of pediatric psychiatric diseases. WHAT IS KNOWN • The COVID-19 pandemic has had an impact on psychosocial wellbeing in children and adolescents. WHAT IS NEW • There was an increase in admissions due to psychosocial problems in the Netherlands in the period after the pandemic. • This was mainly caused by an increase in crisis admissions due to eating disorders and intoxications in adolescents.
Collapse
Affiliation(s)
- Juliette M Kersten
- Juliana Children's Hospital (Haga Teaching Hospital), Els Borst-Eilersplein 275, 2545 AA, The Hague, The Netherlands
| | - Mirjam van Veen
- Juliana Children's Hospital (Haga Teaching Hospital), Els Borst-Eilersplein 275, 2545 AA, The Hague, The Netherlands
| | | | - Jantien Wieringa
- Department of Pediatrics, Haaglanden Medical Centre, The Hague, The Netherlands
| | - Jeroen G Noordzij
- Department of Pediatrics, Reinier de Graaf Ziekenhuis, Delft, The Netherlands
| | - Jolita Bekhof
- Department of Pediatrics, Isala, Zwolle, the Netherlands
| | | | - Héléne Visser-Trip
- Department of Pediatrics, Groene Hart Ziekenhuis, Gouda, The Netherlands
| | - Nienke J Vet
- Department of Pediatrics, St Antonius Ziekenhuis, Nieuwegein, The Netherlands
| | - Matthijs D Kruizinga
- Juliana Children's Hospital (Haga Teaching Hospital), Els Borst-Eilersplein 275, 2545 AA, The Hague, The Netherlands.
| |
Collapse
|
9
|
Perrella SL, Dix-Matthews A, Williams J, Rea A, Geddes DT. Breastfeeding and Maternal Perceptions of Infant Sleep, Settle and Cry Patterns in the First 9 Months. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13098. [PMID: 36293676 PMCID: PMC9602824 DOI: 10.3390/ijerph192013098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/03/2022] [Accepted: 10/06/2022] [Indexed: 06/16/2023]
Abstract
This study evaluated relationships between maternal perceptions of infant sleep, settling and crying patterns and breastfeeding. A prospective observational study of 91 mothers of healthy, term infants was conducted with follow ups over 9 months after discharge from a Western Australian maternity hospital. Feeding information, sleep, settle and cry behaviours, maternal bother at infant behaviours and confidence were measured using the Sleep and Settle Questionnaire. Breastfeeding confidence was measured using the Breastfeeding Self-Efficacy Scale-Short Form. Questionnaires were administered at 2 and 6 weeks, 3, 6 and 9 months. Linear mixed models were used to assess associations between maternal bother, feeding method and infant characteristics. The feeding method was not associated with maternal bother, and cessation of breastfeeding did not result in a change in bother scores (p = 0.34). Duration of infant crying in the day, evening and night, frequency of night waking and duration of settling to sleep in the day were associated with increased bother scores. Higher breastfeeding self-efficacy and maternal confidence were associated with lower bother scores (both p < 0.01). Maternal bother is associated with infant behaviours that require parental input, but not breastfeeding status. Resources that address parental expectations regarding infant sleep while providing strategies to support maternal wellbeing and breastfeeding are needed.
Collapse
Affiliation(s)
- Sharon Lisa Perrella
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia
| | - Alice Dix-Matthews
- School of Medicine, The University of Western Australia, Crawley, WA 6009, Australia
| | - Julie Williams
- Neonatology Clinical Care Unit, King Edward Memorial Hospital, Subiaco, WA 6008, Australia
| | - Alethea Rea
- Mathematics and Statistics, Murdoch University, Murdoch, WA 6150, Australia
| | - Donna Tracy Geddes
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia
| |
Collapse
|
10
|
Léniz-Maturana L, Vilaseca R, Leiva D. Maternal self-efficacy and emotional well-being in Chilean adolescent mothers: the relationship with their children's social-emotional development. PeerJ 2022; 10:e13162. [PMID: 35433128 PMCID: PMC9012175 DOI: 10.7717/peerj.13162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 03/03/2022] [Indexed: 01/12/2023] Open
Abstract
Background Low maternal self-efficacy and high levels of anxiety, depression, and stress can be triggered in adolescent mothers due to an incomplete development process that makes them physically or psychologically unprepared for the responsibilities of motherhood and parenting. These factors may be linked to difficulties with their children's social-emotional development. The present study aims to: (a) analyze the relationship between maternal self-efficacy and stress, depression, and anxiety levels in low-income adolescent mothers; (b) examine the relationship between maternal self-efficacy and well-being with children's social-emotional development; and (c) describe the effects of maternal self-efficacy on children's social-emotional development, mediated by maternal well-being. Methods A sample of 79 dyads comprising low-income Chilean adolescent mothers aged from 15 to 21 years old (M = 19.1, SD = 1.66) and their children aged 10 to 24 months (M = 15.5, SD = 4.2) participated in this research. A set of psychometric scales was used to measure maternal self-efficacy (Parental Evaluation Scale, EEP), the mothers' anxiety and depression (Hospital Anxiety and Depression Scale, HADS), maternal stress (Parental Stress Scale, PSS), and the children's social-emotional development (Ages and Stages Questionnaire Socio-emotional, ASQ-SE). Bivariate analyses and mediation models were employed to estimate and test the relevant relationships. Results A bivariate analysis showed that maternal self-efficacy was negatively related to the mother's anxiety, depression, and stress. Moreover, there was a significant relationship between maternal self-efficacy and maternal stress, and children's self-regulation and social-emotional development. Maternal self-efficacy, mediated by maternal anxiety, depression, and stress scores, had a significant effect on the development of children's self-regulation. Conclusions The results confirm the importance of adolescent mothers' emotional well-being and maternal self- efficacy with respect to their children's social-emotional development. This makes it necessary to have detailed information about how emotional and self-perception status influences a mother's role in the development of her children.
Collapse
Affiliation(s)
- Laura Léniz-Maturana
- Department of Cognition, Development and Educational Psychology, Universitat de Barcelona, Barcelona, Spain
| | - Rosa Vilaseca
- Department of Cognition, Development and Educational Psychology, Universitat de Barcelona, Barcelona, Spain
| | - David Leiva
- Department of Social Psychology and Quantitative Psychology, Universitat de Barcelona, Barcelona, Spain
| |
Collapse
|
11
|
Tettenborn AV, Popp L, Zietlow AL, Woll CFJ, Marx AKG, Nonnenmacher N, Kretz-Bünese T, Hagl M, Müller M, Reck C. Kindliche Verhaltensauffälligkeiten im ersten Lebensjahr und mütterliche Belastung in der Zeit der COVID-19-Pandemie. KINDHEIT UND ENTWICKLUNG 2022. [DOI: 10.1026/0942-5403/a000373] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Theoretischer Hintergrund: Die COVID-19-Pandemie stellte in vielen Bereichen eine Belastung für Familien dar, insbesondere durch die einschneidenden Beschränkungen zu Beginn. Fragestellung: Wie wirkte sich dies auf die Belastung von Müttern mit Kindern im ersten Lebensjahr und auf die kindliche Verhaltensregulation aus? Methode: In einer Online-Befragung schätzten 577 Mütter das Schrei-, Schlaf- und Fütter-/Essverhalten ihrer Kinder ( M = 7.3; 0 – 12 Mon., SD = 3.25) und ihre eigene Belastung ein, zudem Stresserleben, depressive Symptomatik, Partnerschaftszufriedenheit und Bonding. Ergebnisse: Schlafprobleme traten bei 21.7 %, schwer tröstbares und häufiges Schreien bei 12.3 % und exzessives Schreien bei 1.6 % der Kinder auf. Mindestens jede fünfte Mutter fühlte sich durch Schreien oder Schlafprobleme belastet. Mehr Stress, beeinträchtigtes Bonding und weniger Partnerschaftszufriedenheit erklärten 17 – 21 % der Varianz der mütterlichen Belastung durch Schrei- und Schlafverhalten. In der Zeit der stärksten Beschränkungen zeigte sich signifikant mehr Belastung in der Gruppe von Müttern, die von vermehrtem Schreien und verlängerter Einschlaflatenz berichteten, sowie mit mindestens einem weiteren Kind im Haushalt (MANOVA). Diskussion und Schlussfolgerung: Pandemiebedingt belastend für Mütter im ersten Jahr scheinen eingeschränkter Zugang zum Versorgungssystem, die Betreuung von mehr als einem Kind sowie das Alter des Kindes zu sein, während eine gute Beziehung zum Kind (Bonding) und/oder zum Partner (Partnerschaftszufriedenheit) abmildernd wirken.
Collapse
Affiliation(s)
| | - Lukka Popp
- Department Psychologie, Ludwig-Maximilians-Universität München, Deutschland
| | - Anna-Lena Zietlow
- Fakultät für Sozialwissenschaften, Universität Mannheim, Deutschland
| | | | - Anton K. G. Marx
- Department Psychologie, Ludwig-Maximilians-Universität München, Deutschland
| | - Nora Nonnenmacher
- Department Psychologie, Ludwig-Maximilians-Universität München, Deutschland
| | - Tanja Kretz-Bünese
- Department Psychologie, Ludwig-Maximilians-Universität München, Deutschland
| | - Maria Hagl
- freiberufliche Wissenschaftlerin, München, Deutschland
| | - Mitho Müller
- Department Psychologie, Ludwig-Maximilians-Universität München, Deutschland
| | - Corinna Reck
- Department Psychologie, Ludwig-Maximilians-Universität München, Deutschland
| |
Collapse
|
12
|
Asmussen J, Skovgaard AM, Bilenberg N. Trajectories of dysregulation in preschool age. Eur Child Adolesc Psychiatry 2022; 31:313-324. [PMID: 33386524 DOI: 10.1007/s00787-020-01689-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 11/18/2020] [Indexed: 02/06/2023]
Abstract
Dysregulation of emotions, behaviour and attention is involved in several areas of childhood psychopathology, but knowledge about early developmental trajectories remains scarce. This study aims to explore continuity and associations of dysregulation in preschool age. Dysregulation was measured at age 2½ years and again at 5 years in a community-based birth cohort of 1099 children using the Child Behavior Checklist, preschool version (CBCL1½-5), answered by mothers. Based on the Dysregulation Profile (CBCL-DP) score, we defined four trajectory groups, using the 75th percentile from the Danish norm material as a cut-off. Associations between the four CBCL-DP trajectory groups and potential covariates, including child, parental and family factors, were analysed using univariate and multiple multinomial logistic regression. Nearly half (54%) of the children showed persistent low scores of CBCL-DP, 17% displayed continuing dysregulation problems, 13% had problems that increased from 2½ years to 5 years, whereas 16% of the children showed reduced problems across preschool age. Persistent dysregulation was associated with maternal postpartum depressive symptoms RRR = 2.20 (95% CI 1.29-3.75), low maternal educational level RRR = 1.69 (95% CI 1.08-2.66), and mothers' smoking during pregnancy RRR = 2.87 (95% CI 1.09-7.55). Persistent problems of emotional, behavioural and attention regulation in children aged 2½ years to 5 years is influenced by maternal educational level and post-partum depression symptoms. The study draws clinical attention to early symptoms of dysregulation and to the importance of addressing the specific needs of mentally vulnerable parents in intervention planning.
Collapse
Affiliation(s)
- Jette Asmussen
- Research Unit of Child and Adolescent Mental Health, Department of Clinical Research, University of Southern Denmark, J.B Winsløws Vej 16, indgang 228, 5000, Odense C, Denmark.
| | - Anne Mette Skovgaard
- Faculty of Health Sciences, National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Niels Bilenberg
- Research Unit of Child and Adolescent Psychiatry Odense, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| |
Collapse
|
13
|
Perez A, Göbel A, Stuhrmann LY, Schepanski S, Singer D, Bindt C, Mudra S. Born Under COVID-19 Pandemic Conditions: Infant Regulatory Problems and Maternal Mental Health at 7 Months Postpartum. Front Psychol 2022; 12:805543. [PMID: 35153928 PMCID: PMC8826543 DOI: 10.3389/fpsyg.2021.805543] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 12/09/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The SARS-COVID-19 pandemic and its associated disease control restrictions have in multiple ways affected families with young children, who may be especially vulnerable to mental health problems. Studies report an increase in perinatal parental distress as well as symptoms of anxiety or depression in children during the pandemic. Currently, little is known about the impact of the pandemic on infants and their development. Infant regulatory problems (RPs) have been identified as early indicators of child socio-emotional development, strongly associated with maternal mental health and the early parent-infant interaction. Our study investigates whether early parenthood under COVID-19 is associated with more maternal depressive symptoms and with a perception of their infants as having more RPs regarding crying/fussing, sleeping, or eating, compared to mothers assessed before the pandemic. METHODS As part of a longitudinal study, 65 women who had given birth during the first nationwide disease control restrictions in Northern Germany, were surveyed at 7 months postpartum and compared to 97 women assessed before the pandemic. RPs and on maternal depressive symptoms were assessed by maternal report. Number of previous children, infant negative emotionality, and perceived social support were assessed as control variables. RESULTS Compared to the control cohort, infants born during the COVID-19 pandemic and those of mothers with higher depressive symptoms were perceived as having more sleeping and crying, but not more eating problems. Regression-based analyses showed no additional moderating effect of parenthood under COVID-19 on the association of depressive symptoms with RPs. Infant negative emotionality was positively, and number of previous children was negatively associated with RPs. LIMITATIONS Due to the small sample size and cross-sectional assessment, the possibility for more complex multivariate analysis was limited. The use of parent-report questionnaires to assess infant RPs can support but not replace clinical diagnosis. CONCLUSIONS The pandemic conditions affecting everyday life may have a long-term influence on impaired infant self- and maternal co-regulation and on maternal mental health. This should be addressed in peripartum and pediatric care. Qualitative and longitudinal studies focusing on long-term parental and infant outcomes under ongoing pandemic conditions are encouraged.
Collapse
Affiliation(s)
- Anna Perez
- Division of Neonatology and Pediatric Intensive Care, Center for Obstetrics and Pediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ariane Göbel
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lydia Yao Stuhrmann
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Steven Schepanski
- Division of Experimental Feto-Maternal Medicine, Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Institute of Developmental Neurophysiology, Center for Molecular Neurobiology Hamburg (ZMNH), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Dominique Singer
- Division of Neonatology and Pediatric Intensive Care, Center for Obstetrics and Pediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Carola Bindt
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Susanne Mudra
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| |
Collapse
|
14
|
Ksinan Jiskrova G, Pikhart H, Bobák M, Klanova J, Stepanikova I. Prenatal psychosocial stress and children's sleep problems: Evidence from the ELSPAC-CZ study. J Sleep Res 2021; 31:e13531. [PMID: 34879444 DOI: 10.1111/jsr.13531] [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: 07/13/2021] [Revised: 10/24/2021] [Accepted: 11/23/2021] [Indexed: 11/28/2022]
Abstract
Prenatal exposure to maternal stress may increase the risk of developing sleep problems in childhood. This study examined the association between prenatal stressful life events (PSLE) and children's sleep problems, taking into consideration their trajectory over time. Data were obtained from the Czech portion of the European Longitudinal Cohort Study of Pregnancy and Childhood (ELSPAC-CZ; N = 4,371 children). Mothers reported PSLE using an inventory of 42 life events and child sleep problems at five time-points (child age of 1.5, 3, 5, 7, and 11 years). The association was tested by a Poisson latent growth model, controlling for maternal and family demographics, birth characteristics, maternal depression, and alcohol use in pregnancy. The average rate of sleep problems was 2.06 (p < 0.001) at the age of 1.5 years and the rate of sleep problems decreased in a linear fashion over time (estimate = -0.118; p < 0.001). A higher number of PSLE was associated with a higher rate of sleep problems at the age of 1.5 years (incidence rate ratio [IRR] per interquartile range = 1.08, 95% confidence interval [CI] 1.05-1.12, p < 0.001) and with a reduced rate of decrease in sleep problems between the ages of 1.5 and 11 years (p < 0.001). Thus, PSLE were associated with chronicity of sleep problems in addition to their amount during early childhood. Prenatal exposure to stress may predispose individuals to the development of sleep problems in later life.
Collapse
Affiliation(s)
| | - Hynek Pikhart
- RECETOX, Faculty of Science, Masaryk University, Brno, Czech Republic.,Department of Epidemiology & Public Health, University College London, London, UK
| | - Martin Bobák
- RECETOX, Faculty of Science, Masaryk University, Brno, Czech Republic.,Department of Epidemiology & Public Health, University College London, London, UK
| | - Jana Klanova
- RECETOX, Faculty of Science, Masaryk University, Brno, Czech Republic
| | - Irena Stepanikova
- RECETOX, Faculty of Science, Masaryk University, Brno, Czech Republic.,Department of Sociology, University of Alabama at Birmingham, Birmingham, AL, USA
| |
Collapse
|
15
|
Eskola E, Kataja EL, Hyönä J, Häikiö T, Pelto J, Karlsson H, Karlsson L, Korja R. Behavioral Regulatory Problems Are Associated With a Lower Attentional Bias to Fearful Faces During Infancy. Child Dev 2021; 92:1539-1553. [PMID: 33474751 DOI: 10.1111/cdev.13516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
To investigate the role of early regulatory problems (RP), such as problems in feeding, sleeping, and calming down during later development, the association between parent-reported RP at 3 months (no-RP, n = 110; RP, n = 66) and attention to emotional faces at 8 months was studied. Eight-month-old infants had a strong tendency to look at faces and to specifically fearful faces, and the individual variance in this tendency was assessed with eye tracking using a face-distractor paradigm. The early RPs were related to a lower attention bias to fearful faces compared to happy and neutral faces after controlling for temperamental negative affectivity. This suggests that early RPs are related to the processing of emotional information later during infancy.
Collapse
Affiliation(s)
- Eeva Eskola
- University of Turku.,Turku University Hospital
| | | | | | | | | | | | | | | |
Collapse
|
16
|
Georg AK, Schröder-Pfeifer P, Cierpka M, Taubner S. Maternal Parenting Stress in the Face of Early Regulatory Disorders in Infancy: A Machine Learning Approach to Identify What Matters Most. Front Psychiatry 2021; 12:663285. [PMID: 34408674 PMCID: PMC8365191 DOI: 10.3389/fpsyt.2021.663285] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 06/08/2021] [Indexed: 11/25/2022] Open
Abstract
Objective: Early regulatory disorders (ERD) in infancy are typically associated with high parenting stress (PS). Theoretical and empirical literature suggests a wide range of factors that may contribute to PS related to ERD. The aim of this study was to identify key predictors of maternal PS within a large predictor data set in a sample of N = 135 mothers of infants diagnosed with ERD. Methods: We used machine learning to identify relevant predictors. Maternal PS was assessed with the Parenting Stress Index. The multivariate dataset assessed cross-sectionally consisted of 464 self-reported and clinically rated variables covering mother-reported psychological distress, maternal self-efficacy, parental reflective functioning, socio-demographics, each parent's history of illness, recent significant life events, former miscarriage/abortion, pregnancy, obstetric history, infants' medical history, development, and social environment. Variables were drawn from behavioral diaries on regulatory symptoms and parental co-regulative behavior as well as a clinical interview which was utilized to diagnose ERD and to assess clinically rated regulatory symptoms, quality of parent-infant relationship, organic/biological and psychosocial risks, and social-emotional functioning. Results: The final prediction model identified 11 important variables summing up to the areas maternal self-efficacy, psychological distress (particularly depression and anger-hostility), infant regulatory symptoms (particularly duration of fussing/crying), and age-appropriate physical development. The RMSE (i.e., prediction accuracy) of the final model applied to the test set was 21.72 (R 2 = 0.58). Conclusions: This study suggests that among behavioral, environmental, developmental, parent-infant relationship, and mental health variables, a mother's higher self-efficacy, psychological distress symptoms particularly depression and anger symptoms, symptoms in the child particularly fussing/crying symptoms, and age-inappropriate physical development are associated with higher maternal PS. With these factors identified, clinicians may more efficiently assess a mother's PS related to ERD in a low-risk help-seeking sample.
Collapse
Affiliation(s)
- Anna K Georg
- Institute for Psychosocial Prevention, Centre for Psychosocial Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Paul Schröder-Pfeifer
- Institute for Psychosocial Prevention, Centre for Psychosocial Medicine, Heidelberg University Hospital, Heidelberg, Germany.,Psychological Institute, University Heidelberg, Heidelberg, Germany
| | - Manfred Cierpka
- Institute for Psychosocial Prevention, Centre for Psychosocial Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Svenja Taubner
- Institute for Psychosocial Prevention, Centre for Psychosocial Medicine, Heidelberg University Hospital, Heidelberg, Germany
| |
Collapse
|
17
|
Jeukens-Visser M, Koldewijn K, van Wassenaer-Leemhuis AG, Flierman M, Nollet F, Wolf MJ. Development and nationwide implementation of a postdischarge responsive parenting intervention program for very preterm born children: The TOP program. Infant Ment Health J 2020; 42:423-437. [PMID: 33336859 PMCID: PMC8247046 DOI: 10.1002/imhj.21902] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
A previous randomized controlled trial has suggested the effectiveness of a Dutch postdischarge responsive parenting program for very preterm (VPT) infants, indicating that nationwide implementation was justified. This paper describes the development and nationwide implementation of the intervention, known as the TOP program, which consisted of three phases. In the preparation phase (2006-2010), a theory of change and the structure of the TOP program were developed, and funding for phase two, based on a positive Business Case, was obtained. In the pilot implementation phase (2010-2014), intervention strategies were developed for a real-world setting, capacity and adoption were increased, systematic evaluations were incorporated, and sustained funding was obtained. In the full-implementation phase (2014-2019), all Dutch Healthcare Insurers reimbursed the TOP program, enabling VPT infants to participate in the program without charge. By 2018, the number of interventionists that provided the TOP program had increased from 37 to 91, and all level III hospitals and 65% of regional hospitals in the Netherlands referred VPT infants. Currently, the program reaches 70% of the Dutch target population and parental satisfaction with the TOP program is high. After a 12-year implementation period, the TOP program forms part of routine care in the Netherlands.
Collapse
Affiliation(s)
- Martine Jeukens-Visser
- Amsterdam UMC, Department of Rehabilitation, Amsterdam Reproduction and Development, University of Amsterdam, Amsterdam, The Netherlands
| | - Karen Koldewijn
- Amsterdam UMC, Department of Rehabilitation, Amsterdam Reproduction and Development, University of Amsterdam, Amsterdam, The Netherlands
| | - Aleid G van Wassenaer-Leemhuis
- Emma Children's Hospital, Amsterdam UMC, Department of Neonatology, Amsterdam Reproduction and Development, University of Amsterdam, Amsterdam, The Netherlands
| | - Monique Flierman
- Amsterdam UMC, Department of Rehabilitation, Amsterdam Reproduction and Development, University of Amsterdam, Amsterdam, The Netherlands
| | - Frans Nollet
- Amsterdam UMC, Department of Rehabilitation, Amsterdam Movement Sciences, University of Amsterdam, Amsterdam, The Netherlands
| | - Marie-Jeanne Wolf
- Amsterdam UMC, Department of Rehabilitation, Amsterdam Reproduction and Development, University of Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
18
|
Baumann N, Jaekel J, Breeman L, Bartmann P, Bäuml JG, Avram M, Sorg C, Wolke D. The association of infant crying, feeding, and sleeping problems and inhibitory control with attention regulation at school age. INFANCY 2020; 24:768-786. [PMID: 32677276 DOI: 10.1111/infa.12305] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 04/08/2019] [Accepted: 05/18/2019] [Indexed: 12/24/2022]
Abstract
Regulatory problems in infancy and toddlerhood have previously been associated with an increased risk of developing attention problems in childhood. We hypothesized that early regulatory problems are associated with attention problems via reduced inhibitory control. This prospective study assessed 1,459 children from birth to 8 years. Crying, feeding, and sleeping problems were assessed at 5 and 20 months via parent interviews and neurological examinations. At 20 months, inhibitory control was tested with a behavioral (snack delay) task. Attention regulation was assessed at 6 and 8 years using multiple instruments and informants. Detrimental effects of crying, feeding, and sleeping problems on attention regulation were partly mediated by children's ability to inhibit unwanted behaviors (β = -0.04, p = 0.013). Accounting for cognition diminished this indirect effect (β = -0.01, p = 0.209). Instead, the effects of crying, feeding, and sleeping problems on attention regulation were fully mediated by children's cognitive functioning (β = -0.10, p < 0.001). These results support that inhibitory control abilities partly mediate effects of crying, feeding, and sleeping problems. However, these effects may be accounted for by children's general cognitive abilities. Early regulatory problems may set infants on a course of under control of behavior into school age, and such trajectories are highly associated with general cognitive development.
Collapse
Affiliation(s)
- Nicole Baumann
- Department of Psychology, University of Warwick, Coventry, UK
| | - Julia Jaekel
- Department of Psychology, University of Warwick, Coventry, UK.,Department of Child and Family Studies, University of Tennessee, Knoxville, Tennessee
| | - Linda Breeman
- Department of Psychology, University of Warwick, Coventry, UK.,Department of Youth and Family, Utrecht University, Utrecht, The Netherlands.,Department of Neuroradiology, Technische Universität München, München, Germany
| | - Peter Bartmann
- Department of Neonatology, University Hospital Bonn, Bonn, Germany
| | - Josef G Bäuml
- Department of Neuroradiology, Technische Universität München, München, Germany.,TUM-NIC Neuroimaging Center, Technische Universität München, München, Germany
| | - Mihai Avram
- Department of Neuroradiology, Technische Universität München, München, Germany.,TUM-NIC Neuroimaging Center, Technische Universität München, München, Germany
| | - Christian Sorg
- Department of Neuroradiology, Technische Universität München, München, Germany.,TUM-NIC Neuroimaging Center, Technische Universität München, München, Germany.,Department of Psychiatry, Klinikum rechts der Isar, Technische Universität München, München, Germany
| | - Dieter Wolke
- Department of Psychology, University of Warwick, Coventry, UK.,Warwick Medical School, University of Warwick, Coventry, UK
| |
Collapse
|
19
|
Norlyk A, Larsen JS, Kronborg H. Infants' transition from milk to solid foods - the lived experiences of first-time parents. Int J Qual Stud Health Well-being 2019; 14:1693483. [PMID: 31746275 PMCID: PMC6882487 DOI: 10.1080/17482631.2019.1693483] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Purpose: During the transition from ingesting milk to ingesting solid food, infants substantiate their eating habits. The present study focuses on this transition. Specifically, it aimed to explore first-time parents’ lived experiences of their infants’ transition from milk to solid foods. Method: The study is based on the descriptive phenomenological approach Reflective Lifeworld Research (RLR). Ten mothers and ten fathers were interviewed twice; when the infants were aged four to five months and again at seven to eight months of age. Data were analysed according to RLR principles. Results: The findings show that the transition from milk to solid food is a demanding in-between phase. The physically intimate feeding situation is replaced by unfamiliar situations in which parents and infant are physically separated and new types of food are introduced. The process of feeding requires parents’ full attention and sensitivity towards the infant’s reactions. Conclusion: The study highlights how shared parental experiences were reflected in frames for how a meal should normally proceed, including parents’ desire to create healthy eating habits and uphold harmony duringfamily meals We suggest for health professionals to present parents with a wider frame of normality, especially as concerns the concept of what constitutes “normal” eating patterns.
Collapse
Affiliation(s)
- Annelise Norlyk
- Research Unit for Nursing and Health Care, Department of Public Health, Aarhus University, Aarhus C, Denmark
| | | | - Hanne Kronborg
- Research Unit for Nursing and Health Care, Department of Public Health, Aarhus University, Aarhus C, Denmark
| |
Collapse
|
20
|
Reyes LM, Jaekel J, Heuser KM, Wolke D. Developmental cascades of social inhibition and friendships in preterm and full‐term children. INFANT AND CHILD DEVELOPMENT 2019. [DOI: 10.1002/icd.2165] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Lucia M. Reyes
- Department of Child & Family StudiesUniversity of Tennessee Knoxville Knoxville Tennessee
| | - Julia Jaekel
- Department of Child & Family StudiesUniversity of Tennessee Knoxville Knoxville Tennessee
- Department of PsychologyUniversity of Warwick Coventry UK
| | | | - Dieter Wolke
- Department of PsychologyUniversity of Warwick Coventry UK
| |
Collapse
|
21
|
Olsen AL, Ammitzbøll J, Olsen EM, Skovgaard AM. Problems of feeding, sleeping and excessive crying in infancy: a general population study. Arch Dis Child 2019; 104:1034-1041. [PMID: 31270094 DOI: 10.1136/archdischild-2019-316851] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 04/26/2019] [Accepted: 05/20/2019] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To study regulatory problems (RPs) of feeding, sleeping and excessive crying in infancy, and explore the influence of maternal mental health problems and parent-child relationship problems. DESIGN AND SETTING Data were collected in the general child health surveillance delivered to infant families by community health nurses (CHNs). Information on CHNs' assessments and conclusions were obtained on 2598 infants and merged with data from national registers. Descriptive statistics and logistic regression models were used to study RPs in early and late infancy, and the influences due to child, family and parent-child relationship problems. RESULTS Combined RPs (C-RPs), defined as two or more simultaneous problems of feeding, sleeping or excessive crying, was identified in 2.9% and 8.6% of the population between age 2-6 and 8-11 months, respectively. Low maternal schooling and immigrant parents were associated with an increased risk of late C-RPs, but RPs in early infancy stand out as the main predictor of late C-RPs OR 3.4 (95% CI 1.8 to 6.6), and the effect of early maternal mental health problems and parent-child relationship problems seem to be mediated by early C-RPs. CONCLUSIONS Combined problems of feeding, sleeping or excessive crying may exist throughout infancy independently of exposures to maternal mental health problems and parent-child relationship problems. The results indicate that infants with RPs exceeding age 2 months need special attention, in clinical as well as community settings. Suggested intervention includes specific guidance to the parents to help them understand and regulate their infant's sensitivity and reactions.
Collapse
Affiliation(s)
- Anne Lise Olsen
- Infant and Toddler Psychiatric Department, Child and Adolescent Centre, University Hospital of Copenhagen, Glostrup, Denmark
| | - Janni Ammitzbøll
- Faculty of Health Sciences, National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Else Marie Olsen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Medicine, Research Centre for Prevention and Health, Healthcare Services, Capital Region, Copenhagen, Denmark
| | - Anne Mette Skovgaard
- Faculty of Health Sciences, National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| |
Collapse
|
22
|
Rea-Sandin G, Clifford S, Valiente C, Lemery-Chalfant K. Toddler risk and protective characteristics: Common and unique genetic and environmental influences. SOCIAL DEVELOPMENT 2019; 28:482-498. [PMID: 31543571 DOI: 10.1111/sode.12347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The goal of this study was to disentangle the common and unique genetic and environmental influences on social-emotional competence, problem behavior, physiological dysregulation, and negative emotionality (NE) in toddlers. The sample consisted of 243 twin pairs (mean age = 31.94 months) rated by primary caregivers (>95% mothers) on the Children's Behavior Questionnaire and the Infant-Toddler Social and Emotional Assessment. A multivariate Cholesky Decomposition revealed three shared environmental factors, with one set of environmental influences common to competence, problem behavior, and physiological dysregulation, a second common to problem behavior and physiological dysregulation, and a third common to physiological dysregulation and NE. Also, there were two additive genetic factors, with one explaining variance in competence, NE, and a small amount of variance in problem behavior, and a second explaining variance in problem behavior and NE. Given the common shared environmental factors across outcomes, these results suggest that toddlerhood could be a particularly important time to intervene, as interventions could simultaneously improve competencies and reduce problem behaviors. This study also highlights the need for genetically informed research to examine the etiology of multiple outcomes and address overlap.
Collapse
Affiliation(s)
| | | | - Carlos Valiente
- T. Denny Sanford School of Social and Family Dynamics, Arizona State University
| | | |
Collapse
|
23
|
Bilgin A, Wolke D. Infant crying problems and symptoms of sleeping problems predict attachment disorganization at 18 months. Attach Hum Dev 2019; 22:367-391. [PMID: 31132936 DOI: 10.1080/14616734.2019.1618882] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This longitudinal study examined the associations among infant crying, symptoms of sleeping problems, and attachment while considering the influence of maternal sensitivity and depressive symptoms. One hundred and five healthy full-term infants (42.9% female) were assessed for crying and symptoms of sleeping problems at 3 and 18 months via parental interview. Maternal sensitivity was measured through researcher observation, and attachment was measured at 18 months using the Strange Situation procedure. It was found that infant crying and symptoms of sleeping problems were not linked to the organized patterns of secure or insecure (avoidant versus resistant) attachment. However, when the disorganized attachment was considered, there were direct links found from infant crying and symptoms of sleeping problems at 3 months (β= .22, p< .05) and 18 months (β= .21, p< .05). Thus, crying and symptoms of sleeping problems as early as 3 months may indicate a disruption in the coherence of infants' relationship to their caretakers.
Collapse
Affiliation(s)
- Ayten Bilgin
- Department of Psychology, University of Warwick , Coventry, UK.,Psychologische Hochschule Berlin , Berlin, Germany
| | - Dieter Wolke
- Department of Psychology, University of Warwick , Coventry, UK.,Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick , Coventry, UK
| |
Collapse
|
24
|
Neonatal regulatory behavior problems are predicted by maternal early pregnancy overweight and obesity: findings from the prospective PREDO Study. Pediatr Res 2018; 84:875-881. [PMID: 30305694 DOI: 10.1038/s41390-018-0199-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 06/21/2018] [Accepted: 08/31/2018] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Maternal overweight/obesity and comorbid hypertensive disorders and gestational diabetes associate with neurodevelopmental delay in the offspring in childhood. We hypothesize that these maternal conditions associate also with the offspring regulatory behavior problems and impact on neurodevelopment via the offspring regulatory behavior. METHODS A number of 3117 women of the PREDO Study filled in a questionnaire on regulatory behavior problems at the child's mean age of 16.9 days and 2116 of them a questionnaire on developmental milestones at the child's mean age of 42.2 months. Data on maternal BMI and comorbid disorders come from the Finnish Medical Birth Register. RESULTS Offspring of overweight/obese mothers in comparison to normal weight mothers had higher levels of regulatory behavior problems and 22% (95% confidence interval 5-42%) higher odds of having problems on multiple domains of behavioral regulation at the mean age of 16.9 days. Offspring regulatory behavior problems partially mediated the association between maternal overweight/obesity and developmental milestones comprising communication, gross motor, fine motor, problem solving, and personal/social domains of development. Comorbid disorders did not associate with offspring regulatory behavior problems. CONCLUSION Regulatory behavior problems of the offspring have prenatal origins and partially mediate the effects of maternal overweight/obesity on offspring neurodevelopment.
Collapse
|
25
|
Webb HJ. Maternal self-rated health and psychological distress predict early feeding difficulties: Results from the longitudinal study of Australian children. Int J Eat Disord 2018; 51:1312-1321. [PMID: 30488588 DOI: 10.1002/eat.22971] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 09/24/2018] [Accepted: 09/26/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND Drawing from the extended UNICEF model of children's eating and weight problems and growing empirical evidence, exposure to adversity may place mothers at increased risk for child feeding difficulties. AIM The aim of the present study of a community sample of mothers was to examine whether maternal psychological distress, exposure to stressful events, and poor self-rated health in their child's first year of life were associated with breastfeeding duration, as well as concurrent and prospective feeding problems. MATERIALS & METHODS Participants were 5107 Australian mother-child dyads from the infant cohort of the Longitudinal Study of Australian Children (LSAC). Data for the present study was drawn from questionnaires completed by the mother at Wave 1 and Wave 2 (conducted 2 years apart). On average, at Wave 1, mothers and children (51% male) were aged 31 years and 9 months, respectively; while at Wave 2 their ages were 33 years and 34 months, respectively. RESULTS Maternal psychological distress and poorer self-rated health were uniquely predictive of concurrent and prospective child feeding difficulties, while poorer self-rated health was also concurrently associated with a shorter duration of breastfeeding. DISCUSSION These findings suggest that poorer maternal functioning poses a significant risk for early child feeding difficulties, and highlights the potential benefit of screening and early intervention for mothers experiencing emotional and physical health problems. CONCLUSION Further research is needed that takes a broad view of maternal functioning, and examines reciprocal interactions between maternal and child characteristics in understanding the development of child feeding problems.
Collapse
Affiliation(s)
- Haley J Webb
- School of Applied Psychology & Menzies Health Institute of Queensland, Griffith University, Gold Coast, Australia
| |
Collapse
|
26
|
Breeman LD, Jaekel J, Baumann N, Bartmann P, Bäuml JG, Avram M, Sorg C, Wolke D. Infant regulatory problems, parenting quality and childhood attention problems. Early Hum Dev 2018; 124:11-16. [PMID: 30077865 DOI: 10.1016/j.earlhumdev.2018.07.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 07/23/2018] [Accepted: 07/23/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND AND AIMS To determine the combined impact of infant multiple/persistent regulatory problems (RPs), parenting quality and maternal mental health on childhood attention problems. STUDY DESIGN A prospective, population-based cohort study including 16 paediatric hospitals in Southern Bavaria (Germany). SUBJECTS 1459 infants were followed from birth to 8 years of age. OUTCOME MEASURES RPs were assessed at 5 and 20 months using interviews by trained paediatricians; parenting quality was assessed between birth and 5 months using parent interviews and nurses' observations; maternal mental health was assessed at birth and 5 months using standardized parents' interviews; childhood data on attention problems were collected at 8 years, using parent reports and expert behaviour observation ratings. RESULTS After correction for gestational age, sex, and socioeconomic status, early RPs (β = 0.079) and low parenting quality (β = 0.175) predicted later attention problems (R2 = 0.272). Their impact was additive, such that infants with both multiple/persistent RPs and poor parenting quality showed the highest attention problems 8 years later. However, the impact of RPs on attention was strongest for preterm children. Maternal mental health was a significant moderator of the relationship between parenting quality and attention problems. With adequate maternal mental health, good parenting quality was related to lower attention problems, yet with mental health problems present, the effect of good parenting on attention problems diminished. CONCLUSIONS Guidance and support for parents of infants with multiple/persistent crying, sleeping or feeding problems may be essential to prevent the development of childhood attention problems, especially when maternal mental health problems are present.
Collapse
Affiliation(s)
- Linda D Breeman
- Department of Youth and Family, Utrecht University, PO Box 80140, 3508, TC, Utrecht, the Netherlands.
| | - Julia Jaekel
- Department of Child and Family Studies, University of Tennessee Knoxville, 1215 W. Cumberland Ave., Knoxville, TN 37996, USA.
| | - Nicole Baumann
- Department of Psychology, University of Warwick, Coventry CV4 7AL, United Kingdom.
| | - Peter Bartmann
- Department of Neonatology, University Hospital Bonn, Children's Hospital, Research Group Longitudinal Studies, Adenauerallee 119, 53113 Bonn, Germany.
| | - Josef G Bäuml
- Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675 München, Germany.
| | - Mihai Avram
- Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675 München, Germany.
| | - Christian Sorg
- Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675 München, Germany.
| | - Dieter Wolke
- Department of Child and Family Studies, University of Tennessee Knoxville, 1215 W. Cumberland Ave., Knoxville, TN 37996, USA.
| |
Collapse
|
27
|
Oh DL, Jerman P, Silvério Marques S, Koita K, Purewal Boparai SK, Burke Harris N, Bucci M. Systematic review of pediatric health outcomes associated with childhood adversity. BMC Pediatr 2018; 18:83. [PMID: 29475430 PMCID: PMC5824569 DOI: 10.1186/s12887-018-1037-7] [Citation(s) in RCA: 206] [Impact Index Per Article: 34.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 01/30/2018] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Early detection of and intervention in childhood adversity has powerful potential to improve the health and well-being of children. A systematic review was conducted to better understand the pediatric health outcomes associated with childhood adversity. METHODS PubMed, PsycArticles, and CINAHL were searched for relevant articles. Longitudinal studies examining various adverse childhood experiences and biological health outcomes occurring prior to age 20 were selected. Mental and behavioral health outcomes were excluded, as were physical health outcomes that were a direct result of adversity (i.e. abusive head trauma). Data were extracted and risk of bias was assessed by 2 independent reviewers. RESULTS After identifying 15940 records, 35 studies were included in this review. Selected studies indicated that exposure to childhood adversity was associated with delays in cognitive development, asthma, infection, somatic complaints, and sleep disruption. Studies on household dysfunction reported an effect on weight during early childhood, and studies on maltreatment reported an effect on weight during adolescence. Maternal mental health issues were associated with elevated cortisol levels, and maltreatment was associated with blunted cortisol levels in childhood. Furthermore, exposure to childhood adversity was associated with alterations of immune and inflammatory response and stress-related accelerated telomere erosion. CONCLUSION Childhood adversity affects brain development and multiple body systems, and the physiologic manifestations can be detectable in childhood. A history of childhood adversity should be considered in the differential diagnosis of developmental delay, asthma, recurrent infections requiring hospitalization, somatic complaints, and sleep disruption. The variability in children's response to adversity suggests complex underlying mechanisms and poses a challenge in the development of uniform diagnostic guidelines. More large longitudinal studies are needed to better understand how adversity, its timing and severity, and the presence of individual genetic, epigenetic, and protective factors affects children's health and development.
Collapse
Affiliation(s)
- Debora Lee Oh
- Center for Youth Wellness, 3450 Third Street, Bldg 2, Ste 201, San Francisco, CA 94124 USA
| | - Petra Jerman
- Center for Youth Wellness, 3450 Third Street, Bldg 2, Ste 201, San Francisco, CA 94124 USA
| | - Sara Silvério Marques
- Center for Youth Wellness, 3450 Third Street, Bldg 2, Ste 201, San Francisco, CA 94124 USA
| | - Kadiatou Koita
- Center for Youth Wellness, 3450 Third Street, Bldg 2, Ste 201, San Francisco, CA 94124 USA
| | - Sukhdip Kaur Purewal Boparai
- Center for Youth Wellness, 3450 Third Street, Bldg 2, Ste 201, San Francisco, CA 94124 USA
- Human Impact Partners, Oakland, California, USA
| | - Nadine Burke Harris
- Center for Youth Wellness, 3450 Third Street, Bldg 2, Ste 201, San Francisco, CA 94124 USA
| | - Monica Bucci
- Center for Youth Wellness, 3450 Third Street, Bldg 2, Ste 201, San Francisco, CA 94124 USA
| |
Collapse
|
28
|
Martini J, Petzoldt J, Knappe S, Garthus-Niegel S, Asselmann E, Wittchen HU. Infant, maternal, and familial predictors and correlates of regulatory problems in early infancy: The differential role of infant temperament and maternal anxiety and depression. Early Hum Dev 2017; 115:23-31. [PMID: 28869923 DOI: 10.1016/j.earlhumdev.2017.08.005] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 08/09/2017] [Accepted: 08/17/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND Excessive infant crying, feeding and sleeping problems are likely to emerge from the complex interplay of various factors. AIMS To investigate the role of infant (e.g., temperament), maternal (e.g., anxiety and depressive disorders), and familial (e.g., social support) factors as potential precursors of infant regulatory problems. STUDY DESIGN Prospective-longitudinal study. SUBJECTS 286 mother-infant dyads were investigated from early pregnancy until 16 months postpartum via questionnaires and interviews. OUTCOME MEASURES Regulatory problems at 2, 4 and 16 months postpartum assessed by standardized diagnostic interviews. RESULTS Fussy infant temperament and maternal anxiety disorders were associated with excessive infant crying (OR=1.16, 95%CI:1.05-1.29, OR=3.28, 95%CI:1.16-9.26) and feeding problems (OR=1.05, 95%CI:1.01-1.11, OR=2.27, 95%CI:1.36-3.80) whereas maternal depressive disorders were associated with infant sleeping problems (OR=2.55, 95%CI:1.06-6.11). Moreover, high maternal age (OR=0.86, 95%CI:0.75-0.98) was associated with a lower risk for excessive crying and being a single mother (OR=0.16, 95%CI:0.03-0.73) and cognitive reappraisal to regulate emotions (OR: 0.59, 95%CI:0.36-0.96) was associated with a lower risk for sleeping problems. CONCLUSION Excessive infant crying and feeding problems may be related to interactional deficits of anxious mothers who perceive their infants as "difficult" during soothing or feeding situations. Sleeping problems may be transmitted already during pregnancy by an altered sleep-wake-rhythm of mothers with a history of depression or by a genetic predisposition. Therapeutic interventions should focus on maternal anxiety and depression, behavior management techniques to cope with difficult situations with "fussy" infants and potential protective factors (e.g. favorable maternal emotion regulation) to address crying, feeding and sleeping problems.
Collapse
Affiliation(s)
- Julia Martini
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany; Department of Child and Adolescent Psychiatry, Faculty of Medicine of the Technische Universität Dresden, Schubertstr. 42, 01307 Dresden, Germany.
| | - Johanna Petzoldt
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany.
| | - Susanne Knappe
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany.
| | - Susan Garthus-Niegel
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany; Department of Child Health, Norwegian Institute of Public Health, PO Box 4404 Nydalen, 0403 Oslo, Norway.
| | - Eva Asselmann
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany; Behavioral Epidemiology, Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany.
| | - Hans-Ulrich Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany; Department of Psychiatry & Psychotherapy, Ludwig Maximilans Universitaet Munich, Germany.
| |
Collapse
|
29
|
Associations Between Feeding Problems and Maternal Sensitivity Across Infancy: Differences in Very Preterm and Full-Term Infants. J Dev Behav Pediatr 2017; 38:538-544. [PMID: 28692577 DOI: 10.1097/dbp.0000000000000466] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To determine the influence of maternal sensitivity on infant feeding problems in very preterm/very low birth weight (VP/VLBW) and full-term (FT) infants. METHODS Longitudinal study of 178 infants (73 VP/VLBW and 105 FT). Feeding problems and maternal sensitivity were assessed at term, 3 and 18 months. A cross-lagged path model was tested to assess the longitudinal associations. RESULTS The direction of the association between maternal sensitivity and feeding problems differed among VP/VLBW and FT infants. In VP/VLBW infants, higher feeding problems at term and 3 months were associated with less maternal sensitivity at 3 months (β = -.27, p < .05) and at 18 months (β = -.36, p < .05), respectively. In FT infants, a reciprocal relationship of feeding problems and maternal sensitivity over time was found. Feeding problems at 3 months were associated with decreased maternal sensitivity at 18 months (β = -.32, p < .05), whereas decreased maternal sensitivity at 3 months was related to increased feeding problems at 18 months (β = -.25, p < .05). CONCLUSION Feeding problems are frequent in VP/VLBW infants and subsequently are associated with poorer maternal sensitivity. In FT infants, poorer levels of maternal sensitivity were both predicted by feeding problems but also were associated with more feeding problems over time.
Collapse
|
30
|
Exclusive breastfeeding at three months and infant sleep-wake behaviors at two weeks, three and six months. Infant Behav Dev 2017; 49:62-69. [PMID: 28735066 DOI: 10.1016/j.infbeh.2017.06.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 06/29/2017] [Accepted: 06/30/2017] [Indexed: 11/22/2022]
Abstract
This study assessed infant sleep-wake behavior at two weeks, three and six months as function of feeding method at three months (exclusively breastfed, partially breastfed, and exclusively formula fed infants). Mothers of 163 first-born, full-term, normal birth weight, healthy infants completed socio-demographic, depression, anxiety, and infant sleep-wake behavior measures. No effects were found for sleep arrangements, depression or anxiety, on feeding methods and sleep-wake behavior at three months. At two weeks exclusively breastfed infants at three months spent more hours sleeping and less hours awake during the 24-h period than partially breastfed infants. At three months, exclusively breastfed infants had a shorter of the longest sleep period at night than exclusively formula fed infants. At six months, exclusively breastfed infants at three months spent more hours awake at night than partially breastfed infants, awake more at night than exclusively formula fed infants, and had a shorter sleep period at night than partially breastfed and exclusively formula fed infants. This study showed differences in sleep-wake behaviors at two weeks, three and six months, when exclusively breastfed infants are compared with partially breastfed and exclusively formula fed infants at three months, while no effects were found for sleep arrangements, depression or anxiety.
Collapse
|
31
|
Wolke D, Bilgin A, Samara M. Systematic Review and Meta-Analysis: Fussing and Crying Durations and Prevalence of Colic in Infants. J Pediatr 2017; 185:55-61.e4. [PMID: 28385295 DOI: 10.1016/j.jpeds.2017.02.020] [Citation(s) in RCA: 120] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 01/06/2017] [Accepted: 02/07/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To determine the mean duration of fussing and crying and prevalence of colic using modified Wessel criteria in infants in the first 3 months of life. STUDY DESIGN A systematic literature search was performed using the databases Medline, PsycINFO, and Embase. The major outcome measure was mean total fuss/cry duration during 24 hours at ages 1-2 weeks (11 samples), 3-4 weeks (6 samples), 5-6 weeks (28 samples), 8-9 weeks (9 samples), and 10-12 weeks (12 samples). RESULTS Of 5687 articles reviewed, 28 diary studies (33 samples) were suitable for inclusion in meta-analysis; these studies included 8690 infants. No statistical evidence for a universal crying peak at 6 weeks of age across studies was found. Rather, the mean fuss/cry duration across studies was stable at 117-133 minutes (SDs: 66-70) in the first 6 weeks and dropped to a mean of 68 minutes (SD: 46.2) by 10-12 weeks of age. Colic was much more frequent in the first 6 weeks (17%-25%) compared with 11% by 8-9 weeks of age and 0.6% by 10-12 weeks of age, according to modified Wessel criteria and lowest in Denmark and Japan. CONCLUSIONS The duration of fussing/crying drops significantly after 8-9 weeks of age, with colic as defined by modified Wessel criteria being rare in infants older than 9 weeks. Colic or excessive fuss/cry may be more accurately identified by defining fuss/cry above the 90th percentile in the chart provided based on the review.
Collapse
Affiliation(s)
- Dieter Wolke
- Department of Psychology, University of Warwick, Coventry, United Kingdom; Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, United Kingdom.
| | - Ayten Bilgin
- Department of Psychology, University of Warwick, Coventry, United Kingdom
| | - Muthanna Samara
- Department of Psychology, Kingston University London, Kingston upon Thames, London, United Kingdom
| |
Collapse
|
32
|
Khanzadeh AAH, Rostampour A, Nedaee N, Khosrojavid M. Effectiveness of cognitive-behavioral education on anxiety during pregnancy and delivery method in primiparous women. J Nurs Educ 2017. [DOI: 10.21859/jne-05064] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
33
|
A new measure for infant mental health screening: development and initial validation. BMC Pediatr 2016; 16:197. [PMID: 27905887 PMCID: PMC5134259 DOI: 10.1186/s12887-016-0744-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 11/29/2016] [Indexed: 11/20/2022] Open
Abstract
Background Mental health problems are a major public health challenges, and strategies of early prevention are needed. Effective prevention depends on feasible and validated measures of screening and intervention. Previous research has demonstrated potentials for infant mental health screening by community health nurses (CHN) in existing service settings in Denmark. This study was conducted to describe the development of a service setting based measure to screen for infant mental health problems, to investigate problems identified by the measure and assess the validity and feasibility in existing public health settings. Methods Experts within the field developed a short, feasible and comprehensive measure. A consecutive sample of 2973 infants from 11 municipalities around the city of Copenhagen was screened at 9–10 months. Face validity and feasibility were evaluated among CHNs. Data on child and family factors and the results of screening were included in descriptive analyses. Exploratory factor analysis (EFA) was used to assess content validity. Results The measure identified problems of communication and interaction in 20.7% of the children, problems of eating in 20.1%, attention problems in 15.9% and problems of emotional regulation in 14.3%. Significant gender differences were seen. EFA demonstrated that among 27 items 11 items were clustering into five areas: Problems of eating, emotions, attention, language and communication and attachment, respectively. High face validity and feasibility was demonstrated, and the participation was 91%. Conclusions The new measure shows potentials for infant mental health screening. However, further exploration of construct validity and reliability is needed.
Collapse
|
34
|
Abstract
OBJECTIVE This study is an investigation of differences in regulatory problems (RPs; crying, sleeping, feeding) expressed by infants born very preterm (VP; <32 wk gestation) or with very low birth weight (VLBW; <1500 g) and infants born at full term (FT) during the first 18 months of life. It investigates the prevalence of single and multiple RPs, their persistence and how early in infancy RPs still found at 18 months of age can be predicted. METHOD This prospective longitudinal study of 73 VP/VLBW and 105 FT infants utilized a standard interview of mothers to assess regulatory problems among the infants at term, 3, 6, and 18 months of age. RESULTS Few differences were found between VP/VLBW and FT infants in the first 6 months. At 18 months, VP/VLBW infants had more single sleeping (RR = 2.2, CI = 1.3-3.7), feeding (RR = 1.4, CI = 1.03-1.8), and multiple RPs (RR = 1.7, CI = 1.02-2.8) than FT infants. In VP/VLBW infants, RPs as early as 3 months and in FT infants RPs as early as 6 months predicted RPs at 18 months. Those infants who had persistent RPs in the first 6 months of life were more likely to still have RPs at 18 months. CONCLUSION VP/VLBW children are at slightly increased risk for RPs at term and in the second year of life. Clinicians should be aware that RPs that persist across the first 6 months point to increased risk of continuing RPs into toddlerhood in both VP/VLBW and FT infants.
Collapse
|
35
|
Petzoldt J, Wittchen HU, Einsle F, Martini J. Maternal anxiety versus depressive disorders: specific relations to infants' crying, feeding and sleeping problems. Child Care Health Dev 2016; 42:231-45. [PMID: 26490836 DOI: 10.1111/cch.12292] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 08/11/2015] [Accepted: 08/30/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND Maternal depression has been associated with excessive infant crying, feeding and sleeping problems, but the specificity of maternal depression, as compared with maternal anxiety remains unclear and manifest disorders prior to pregnancy have been widely neglected. In this prospective longitudinal study, the specific associations of maternal anxiety and depressive disorders prior to, during and after pregnancy and infants' crying, feeding and sleeping problems were investigated in the context of maternal parity. METHODS In the Maternal Anxiety in Relation to Infant Development (MARI) Study, n = 306 primiparous and multiparous women were repeatedly interviewed from early pregnancy until 16 months post partum with the Composite International Diagnostic Interview for Women (CIDI-V) to assess DSM-IV anxiety and depressive disorders. Information on excessive infant crying, feeding and sleeping problems was obtained from n = 286 mothers during postpartum period via questionnaire and interview (Baby-DIPS). RESULTS Findings from this study revealed syndrome-specific risk constellations for maternal anxiety and depressive disorders as early as prior to pregnancy: Excessive infant crying (10.1%) was specifically associated with maternal anxiety disorders, especially in infants of younger and lower educated first-time mothers. Feeding problems (36.4%) were predicted by maternal anxiety (and comorbid depressive) disorders in primiparous mothers and infants with lower birth weight. Infant sleeping problems (12.2%) were related to maternal depressive (and comorbid anxiety) disorders irrespective of maternal parity. CONCLUSIONS Primiparous mothers with anxiety disorders may be more prone to anxious misinterpretations of crying and feeding situations leading to an escalation of mother-infant interactions. The relation between maternal depressive and infant sleeping problems may be better explained by a transmission of unsettled maternal sleep to the fetus during pregnancy or a lack of daily structure and bedtime routine with the infant. Maternal disorders prior to pregnancy require more attention in research and clinical practice.
Collapse
Affiliation(s)
- J Petzoldt
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - H-U Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - F Einsle
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Professorship Clinical Psychology and Psychotherapy, SRH Fachhochschule für Gesundheit Gera, Gera, Germany
| | - J Martini
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| |
Collapse
|
36
|
Gregory AM, Sadeh A. Annual Research Review: Sleep problems in childhood psychiatric disorders--a review of the latest science. J Child Psychol Psychiatry 2016; 57:296-317. [PMID: 26412255 DOI: 10.1111/jcpp.12469] [Citation(s) in RCA: 147] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/13/2015] [Indexed: 12/12/2022]
Abstract
BACKGROUND Hippocrates flagged the value of sleep for good health. Nonetheless, historically, researchers with an interest in developmental psychopathology have largely ignored a possible role for atypical sleep. Recently, however, there has been a surge of interest in this area, perhaps reflecting increased evidence that disturbed or insufficient sleep can result in poor functioning in numerous domains. This review outlines what is known about sleep in the psychiatric diagnoses most relevant to children and for which associations with sleep are beginning to be understood. While based on a comprehensive survey of the literature, the focus of the current review is on the latest science (largely from 2010). There is a description of both concurrent and longitudinal links as well as possible mechanisms underlying associations. Preliminary treatment research is also considered which suggests that treating sleep difficulties may result in improvements in behavioural areas beyond sleep quality. FINDINGS To maximise progress in this field, there now needs to be: (a) greater attention to the assessment of sleep in children; (b) sleep research on a wider range of psychiatric disorders; (c) a greater focus on and examination of mechanisms underlying associations; (d) a clearer consideration of developmental questions and (e) large-scale well-designed treatment studies. CONCLUSIONS While sleep problems may sometimes be missed by parents and healthcare providers; hence constituting a hidden risk for other psychopathologies - knowing about these difficulties creates unique opportunities. The current excitement in this field from experts in diverse areas including developmental psychology, clinical psychology, genetics and neuropsychology should make these opportunities a reality.
Collapse
Affiliation(s)
- Alice M Gregory
- Department of Psychology, Goldsmiths, University of London, New Cross, London, UK
| | - Avi Sadeh
- School of Psychological Sciences, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel
| |
Collapse
|
37
|
Johnson S, Matthews R, Draper ES, Field DJ, Manktelow BN, Marlow N, Smith LK, Boyle EM. Eating difficulties in children born late and moderately preterm at 2 y of age: a prospective population-based cohort study. Am J Clin Nutr 2016; 103:406-14. [PMID: 26718420 DOI: 10.3945/ajcn.115.121061] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 12/04/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Very preterm (<32 wk of gestation) infants are at increased risk of eating difficulties compared with their term-born peers. Little is known about the impact of late and moderately preterm (LMPT; 32-36 wk of gestation) birth on eating difficulties in early childhood. OBJECTIVES The aims were to assess the prevalence of eating difficulties in infants born LMPT at 2 y corrected age and to explore the impact of neonatal and neurodevelopmental factors. DESIGN A geographic population-based cohort of 1130 LMPT and 1255 term-born controls was recruited at birth. The parents of 651 (59%) LMPT and 771 (62%) term-born infants completed questionnaires at 2 y corrected age to assess neurodevelopmental outcomes. Parents also completed a validated questionnaire to assess eating behaviors in 4 domains: refusal/picky eating, oral motor problems, oral hypersensitivity, and eating behavior problems. Infants with scores >90th percentile were classified with eating difficulties in each domain. Neonatal data were collected at discharge, and sociodemographic information was collected via maternal interview. Poisson regression was used to assess between-group differences in eating difficulties and to explore associations with neonatal factors and neurodevelopmental outcomes at 2 y of age. RESULTS In unadjusted analyses, LMPT infants were at increased risk of refusal/picky eating (RR: 1.53; 95% CI: 1.03, 2.25) and oral motor problems (RR: 1.62; 95% CI: 1.06, 2.47). Prolonged nasogastric feeding >2 wk (RR: 1.87; 95% CI: 1.07, 3.25), behavior problems (RR: 2.95; 95% CI: 1.93, 4.52), and delayed social competence (RR: 2.28; 95% CI: 1.49, 3.48) were independently associated with eating difficulties in multivariable analyses. After adjustment for these factors, there was no excess of eating difficulties in LMPT infants. CONCLUSIONS Infants born LMPT are at increased risk of oral motor and picky eating problems at 2 y corrected age. However, these are mediated by other neurobehavioral sequelae in this population. This trial was registered on the UK Clinical Research Network Portfolio at http://public.ukcrn.org.uk/search/ as UKCRN Study ID 7441.
Collapse
Affiliation(s)
- Samantha Johnson
- Department of Health Sciences, University of Leicester, Leicester, United Kingdom; and
| | - Ruth Matthews
- Department of Health Sciences, University of Leicester, Leicester, United Kingdom; and
| | - Elizabeth S Draper
- Department of Health Sciences, University of Leicester, Leicester, United Kingdom; and
| | - David J Field
- Department of Health Sciences, University of Leicester, Leicester, United Kingdom; and
| | - Bradley N Manktelow
- Department of Health Sciences, University of Leicester, Leicester, United Kingdom; and
| | - Neil Marlow
- Department of Academic Neonatology, Institute for Women's Health, University College London, London, United Kingdom
| | - Lucy K Smith
- Department of Health Sciences, University of Leicester, Leicester, United Kingdom; and
| | - Elaine M Boyle
- Department of Health Sciences, University of Leicester, Leicester, United Kingdom; and
| |
Collapse
|
38
|
Breeman LD, Jaekel J, Baumann N, Bartmann P, Wolke D. Attention problems in very preterm children from childhood to adulthood: the Bavarian Longitudinal Study. J Child Psychol Psychiatry 2016; 57:132-40. [PMID: 26287264 DOI: 10.1111/jcpp.12456] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/13/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Very preterm (VP; gestational age <32 weeks) and very low birth weight (VLBW; <1500 grams) is related to attention problems in childhood and adulthood. The stability of these problems into adulthood is not known. METHODS The Bavarian Longitudinal Study is a prospective cohort study that followed 260 VP/VLBW and 229 term-born individuals from birth to adulthood. Data on attention were collected at 6, 8, and 26 years of age, using parent reports, expert behavior observations, and clinical ADHD diagnoses. RESULTS At each assessment, VP/VLBW individuals had significantly more attention problems, shorter attention span, and were more frequently diagnosed with ADHD than term-born comparisons. In both VP/VLBW and term-born individuals, overall, attention span increased and attention problems decreased from childhood to adulthood. Attention problems and attention span were more stable over time for VP/VLBW than term-born individuals. Similarly, ADHD diagnoses showed moderate stability from childhood to adulthood in VP/VLBW, but not in term-born individuals. However, when those with severe disabilities were excluded, differences between VP/VLBW and term-born individuals reduced. CONCLUSIONS Despite improvement in attention regulation from childhood to adulthood, children born very preterm remained at increased risk for attention problems in adulthood. In contrast, term-born children with clinical attention problems outgrew these by adulthood. As inattentive behavior of VP/VLBW children may be overlooked by teachers, it may be necessary to raise awareness for school intervention programs that reduce attention problems in VP/VLBW children.
Collapse
Affiliation(s)
- Linda D Breeman
- Department of Psychology, University of Warwick, Coventry, UK
| | - Julia Jaekel
- Department of Psychology, University of Warwick, Coventry, UK.,Department of Developmental Psychology, Ruhr-University Bochum, Bochum, Germany
| | - Nicole Baumann
- Department of Psychology, University of Warwick, Coventry, UK
| | - Peter Bartmann
- Department of Neonatology, University Hospital Bonn, Bonn, Germany
| | - Dieter Wolke
- Department of Psychology, University of Warwick, Coventry, UK.,Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK
| |
Collapse
|
39
|
Jaekel J, Eryigit-Madzwamuse S, Wolke D. Preterm Toddlers' Inhibitory Control Abilities Predict Attention Regulation and Academic Achievement at Age 8 Years. J Pediatr 2016; 169:87-92.e1. [PMID: 26608089 DOI: 10.1016/j.jpeds.2015.10.029] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Revised: 08/25/2015] [Accepted: 10/08/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To determine if adverse effects of preterm birth on attention and academic abilities at age 8 years are mediated by children's inhibitory control abilities. STUDY DESIGN Five hundred fifty-eight children born at 26-41 weeks gestation were studied as part of a prospective geographically defined longitudinal investigation in Germany. Toddlers' inhibitory control abilities were observed at age 20 months. At 8 years, attention and academic abilities were assessed. RESULTS Preterm birth negatively affected children's inhibitory control abilities (B = .25, 95% CI [.11, .39], P < .001) and directly predicted subsequent low attention regulation (B = .23, 95% CI [.07, .38], P < .001) and academic achievement (B = .10, 95% CI [.03, .17], P < .001), after adjusting for other factors. Higher ability to inhibit unwanted behaviors predicted better later attention regulation (B = .24, 95% CI [.07, .41], P < .001) and academic achievement (B = .10, 95% CI [.03, .17], P < .001). CONCLUSIONS The lower a child's gestational age, the lower the inhibitory control and the more likely that the child had poor attention regulation and low academic achievement. Adverse effects of preterm birth on attention and academic outcomes are partially mediated by toddlers' inhibitory control abilities. These findings provide new information about the mechanisms linking preterm birth with long-term attention difficulties and academic underachievement.
Collapse
Affiliation(s)
- Julia Jaekel
- Department of Child and Family Studies, University of Tennessee, Knoxville, TN; Department of Developmental Psychology, Ruhr-University Bochum, Bochum, Germany; Department of Psychology, University of Warwick, Coventry, United Kingdom
| | | | - Dieter Wolke
- Department of Psychology, University of Warwick, Coventry, United Kingdom; Warwick Medical School, University of Warwick, Coventry, United Kingdom.
| |
Collapse
|
40
|
Daamen M, Bäuml JG, Scheef L, Meng C, Jurcoane A, Jaekel J, Sorg C, Busch B, Baumann N, Bartmann P, Wolke D, Wohlschläger A, Boecker H. Neural correlates of executive attention in adults born very preterm. NEUROIMAGE-CLINICAL 2015; 9:581-91. [PMID: 26640769 PMCID: PMC4633838 DOI: 10.1016/j.nicl.2015.09.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2015] [Revised: 08/31/2015] [Accepted: 09/07/2015] [Indexed: 01/16/2023]
Abstract
Very preterm birth is associated with an increased prevalence of attention problems and may especially impair executive attention, i.e., top-down control of attentional selection in situations where distracting information interferes with the processing of task-relevant stimuli. While there are initial findings linking structural brain alterations in preterm-born individuals with attention problems, the functional basis of these problems are not well understood. The present study used an fMRI adaptation of the Attentional Network Test to examine the neural correlates of executive attention in a large sample of N = 86 adults born very preterm and/or with very low birth weight (VP/VLBW), and N = 100 term-born controls. Executive attention was measured by comparing task behavior and brain activations associated with the processing of incongruent vs. congruent arrow flanker stimuli. Consistent with subtle impairments of executive attention, the VP/VLBW group showed lower accuracy and a tendency for increased response times during the processing of incongruent stimuli. Both groups showed similar activation patters, especially within expected fronto-cingulo-parietal areas, but no significant between-group differences. Our results argue for a maintained attention-relevant network organization in high-functioning preterm born adults in spite of subtle deficits in executive attention. Gestational age and neonatal treatment variables showed associations with task behavior, and brain activation in the dorsal ACC and lateral occipital areas, suggesting that the degree of prematurity (and related neonatal complications) has subtle modulatory influences on executive attention processing. fMRI study examines neural correlates of executive attention in preterm-born adults. Preterm-born adults show subtle behavioral deficits. Preterm-born adults show maintained organization of attention-related networks. Modulatory effects of gestational age and neonatal treatment variables are observed.
Collapse
Key Words
- ACC, anterior cingulate cortex
- ANT, Attentional Network Test
- Anterior cingulate
- Attentional Network Test
- BLS, Bavarian Longitudinal Study
- BW, birth weight
- CSF, cerebrospinal fluid
- DLPFC, dorsolateral prefrontal cortex
- DNTI, duration of neonatal intensive treatment
- EHI, Edinburgh Handedness Inventory
- ELBW, extremely low birth weight
- EP, extremely preterm
- Executive attention
- FWE, familywise error
- GA, gestational age
- GM, gray matter
- Gestational age
- ICV, intracranial volume
- INTI, intensity of neonatal intensive treatment
- IVH, intraventricular hemorrhage
- PFC, prefrontal cortex
- Preterm birth
- VLBW, very low birth weight
- VP, very preterm
- WM, white matter
- fMRI, functional magnetic resonance imaging
Collapse
Affiliation(s)
- Marcel Daamen
- Department of Radiology, University Hospital Bonn, Sigmund Freud-Str. 25, 53105 Bonn, Germany ; Department of Neonatology, University Hospital Bonn, Sigmund Freud-Str. 25, 53105 Bonn, Germany
| | - Josef G Bäuml
- Department of Neuroradiology, Klinikum Rechts der Isar, Technische Universität München, Ismaninger str. 22, 81664 Munich, Germany ; TUM-Neuroimaging Center of Klinikum rechts der Isar, Technische Universität München, Ismaninger str. 22, Munich 81664, Germany
| | - Lukas Scheef
- Department of Radiology, University Hospital Bonn, Sigmund Freud-Str. 25, 53105 Bonn, Germany
| | - Chun Meng
- Department of Neuroradiology, Klinikum Rechts der Isar, Technische Universität München, Ismaninger str. 22, 81664 Munich, Germany ; TUM-Neuroimaging Center of Klinikum rechts der Isar, Technische Universität München, Ismaninger str. 22, Munich 81664, Germany ; Graduate School of Systemic Neurosciences GSN, Ludwig Maximilians Universität, Biocenter, Department Biology II Neurobiology, Großhaderner Str. 2, D-82152 Planegg-Martinsried, Germany
| | - Alina Jurcoane
- Department of Radiology, University Hospital Bonn, Sigmund Freud-Str. 25, 53105 Bonn, Germany ; Department of Neonatology, University Hospital Bonn, Sigmund Freud-Str. 25, 53105 Bonn, Germany
| | - Julia Jaekel
- Department of Developmental Psychology, Ruhr-University Bochum, Universitätsstraße 150, Bochum 44801, Germany ; Department of Psychology, University of Warwick, University Road, Coventry CV4 7AL, UK
| | - Christian Sorg
- Department of Neuroradiology, Klinikum Rechts der Isar, Technische Universität München, Ismaninger str. 22, 81664 Munich, Germany ; Department of Psychiatry, Klinikum Rechts der Isar, Technische Universität München, Ismaninger str. 22, Munich 81664, Germany ; TUM-Neuroimaging Center of Klinikum rechts der Isar, Technische Universität München, Ismaninger str. 22, Munich 81664, Germany
| | - Barbara Busch
- Department of Neonatology, University Hospital Bonn, Sigmund Freud-Str. 25, 53105 Bonn, Germany
| | - Nicole Baumann
- Department of Psychology, University of Warwick, University Road, Coventry CV4 7AL, UK
| | - Peter Bartmann
- Department of Radiology, University Hospital Bonn, Sigmund Freud-Str. 25, 53105 Bonn, Germany
| | - Dieter Wolke
- Department of Psychology, University of Warwick, University Road, Coventry CV4 7AL, UK ; Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
| | - Afra Wohlschläger
- Department of Neuroradiology, Klinikum Rechts der Isar, Technische Universität München, Ismaninger str. 22, 81664 Munich, Germany ; TUM-Neuroimaging Center of Klinikum rechts der Isar, Technische Universität München, Ismaninger str. 22, Munich 81664, Germany ; Graduate School of Systemic Neurosciences GSN, Ludwig Maximilians Universität, Biocenter, Department Biology II Neurobiology, Großhaderner Str. 2, D-82152 Planegg-Martinsried, Germany
| | - Henning Boecker
- Department of Radiology, University Hospital Bonn, Sigmund Freud-Str. 25, 53105 Bonn, Germany
| |
Collapse
|
41
|
Salvatori P, Andrei F, Neri E, Chirico I, Trombini E. Pattern of mother-child feeding interactions in preterm and term dyads at 18 and 24 months. Front Psychol 2015; 6:1245. [PMID: 26347699 PMCID: PMC4541078 DOI: 10.3389/fpsyg.2015.01245] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Accepted: 08/04/2015] [Indexed: 12/11/2022] Open
Abstract
Literature on mother-child feeding interactions during the transition to self-feeding in preterm populations is lacking, particularly through observational methods. The present research study aims to look at the longitudinal patterns of mother-toddler feeding interactions, comparing preterm and full term dyads. To this end, a multi-method approach was used to collect data from 27 preterm to 20 full-term toddlers and their mothers. For each dyad, mother-child interactions were observed during the snack time at 18 and 24 months of age and then assessed through the Italian version of the Feeding Scale. Higher scores on the scale indicate a less healthy pattern of interaction. Additionally, at both points in time, mothers completed the BDI-II questionnaire as a screen for maternal depression and the child's developmental stage was assessed using the Griffiths Scales. A series of repeated measures Analysis of Variances were run to detect differences in feeding interactions between the two groups at the time of assessment. Our results show that preterm dyads report overall higher levels of maternal negative affection, interactional conflicts, and less dyadic reciprocity during the meal compared to full-term dyads. Additionally, longitudinal data show that dyadic conflict decreases in both groups, whereas the child's food refusal behaviors increase in the preterm group from 18 to 24 months. No differences were reported for both the BDI-II and the child's development for the two groups. The results reveal that regardless of maternal depression and the child's developmental stage, the two groups show different trajectories in the pattern of feeding interactions during the transition to self -feeding, at 18 and 24 months, with overall less positive interactions in preterm mother-child dyads.
Collapse
Affiliation(s)
- Paola Salvatori
- Department of Psychology, University of Bologna Bologna, Italy
| | - Federica Andrei
- Department of Psychology, University of Bologna Bologna, Italy
| | - Erica Neri
- Department of Psychology, University of Bologna Bologna, Italy
| | - Ilaria Chirico
- Department of Psychology, University of Bologna Bologna, Italy
| | - Elena Trombini
- Department of Psychology, University of Bologna Bologna, Italy
| |
Collapse
|
42
|
Jaekel J, Strauss VYC, Johnson S, Gilmore C, Wolke D. Delayed school entry and academic performance: a natural experiment. Dev Med Child Neurol 2015; 57:652-659. [PMID: 25692816 DOI: 10.1111/dmcn.12713] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/04/2015] [Indexed: 11/30/2022]
Abstract
AIM Recent reports suggest that delayed school entry (DSE) may be beneficial for children with developmental delays. However, studies of the effects of DSE are inconclusive. This study investigated the effects of DSE versus age-appropriate school entry (ASE) on children's academic achievement and attention in middle childhood. METHOD In total, 999 children (492 females, 507 males; 472 born preterm) were studied as part of a prospective population-based longitudinal study in Germany. Using a natural experimental design, propensity score matching was applied to create two matched groups who differed only in terms of DSE versus ASE. Teacher ratings of achievement in mathematics, reading, writing, and attention were obtained in Year 1, and standardized tests were administered at 8 years of age. RESULTS There was no evidence of a difference in the odds of DSE versus ASE children being rated as above average by teachers in Year 1. In contrast, the standardized mean test scores for DSE children were lower than ASE children's mean scores in all domains (mathematics: B=-0.28 [-0.51 to -0.06)], reading: B=-0.39 [-0.65 to -0.14], writing: B=-0.90 [-1.07 to -0.74], and attention: B=-0.58 [-0.79 to -0.36]). INTERPRETATION DSE did not affect teacher-rated academic performance. However, missing 1 year of learning opportunities was associated with poorer average performance in standardized tests at 8 years of age. Future research is needed to determine the long-term effect of DSE on academic achievement.
Collapse
Affiliation(s)
- Julia Jaekel
- Department of Developmental Psychology, Ruhr-University Bochum, Bochum, Germany
| | | | - Samantha Johnson
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Camilla Gilmore
- Mathematics Education Centre, Loughborough University, Loughborough, UK
| | - Dieter Wolke
- Department of Psychology and Warwick Medical School, University of Warwick, Coventry, UK
| |
Collapse
|
43
|
McGeorge K, Milne L, Cotton L, Whelan T. Effects of infant and maternal sensory processing on infant fussing, crying, and sleep. Infant Ment Health J 2015; 36:275-86. [PMID: 25892527 DOI: 10.1002/imhj.21510] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
This study investigated the effects of infant and maternal sensory processing on sleep, fussing, and crying in a sample of 55 firstborn, 4- to 7-month-old infants and their mothers. Mothers completed self-report questionnaires to assess maternal and infant sensory processing styles and a 4-day diary of infant behavior, including sleep, fussing, and crying. Higher levels of infant Sensation Avoiding were associated with less sleep, more fussing, and more crying whereas higher levels of Sensory Sensitivity were associated with less sleep and more fussing. The positive association between infant Sensation Avoiding and crying was strengthened by lower levels of Low Registration in mothers. The effect of infant Sensory Sensitivity on reducing total sleep also was strengthened by lower levels of maternal Low Registration. Assessment of infant sensory processing as well as the moderating effect of maternal sensory processing on the relationship between infant sensory processing and infant regulatory capacities need to be considered when assessing and designing interventions for families in which infant regulation is problematic.
Collapse
Affiliation(s)
| | - Lisa Milne
- Australian Catholic University, Melbourne
| | | | - Tom Whelan
- Australian Catholic University, Melbourne
| |
Collapse
|
44
|
Douglas PS, Miller Y, Bucetti A, Hill PS, Creedy DK. Preliminary evaluation of a primary care intervention for cry-fuss behaviours in the first 3-4 months of life (‘The Possums Approach’): effects on cry-fuss behaviours and maternal mood. Aust J Prim Health 2015; 21:38-45. [DOI: 10.1071/py13011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Accepted: 07/18/2013] [Indexed: 11/23/2022]
Abstract
Problem crying in the first few months of life is both common and complex, arising out of multiple interacting and co-evolving factors. Parents whose babies cry and fuss a lot receive conflicting advice as they seek help from multiple health providers and emergency departments, and may be admitted into tertiary residential services. Conflicting advice is costly, and arises out of discipline-specific interpretations of evidence. An integrated, interdisciplinary primary care intervention (‘The Possums Approach’) for cry-fuss problems in the first months of life was developed from available peer-reviewed evidence. This study reports on preliminary evaluation of delivery of the intervention. A total of 20 mothers who had crying babies under 16 weeks of age (average age 6.15 weeks) completed questionnaires, including the Crying Patterns Questionnaire and the Edinburgh Postnatal Depression Scale, before and 3−4 weeks after their first consultation with trained primary care practitioners. Preliminary evaluation is promising. The Crying Patterns Questionnaire showed a significant decrease in crying and fussing duration, by 1 h in the evening (P = 0.001) and 30 min at night (P = 0.009). The median total amount of crying and fussing in a 24-h period was reduced from 6.12 to 3 h. The Edinburgh Postnatal Depression Scale showed a significant improvement in depressive symptoms, with the median score decreasing from 11 to 6 (P = 0.005). These findings are corroborated by an analysis of results for the subset of 16 participants whose babies were under 12 weeks of age (average age 4.71 weeks). These preliminary results demonstrate significantly decreased infant crying in the evening and during the night and improved maternal mood, validating an innovative interdisciplinary clinical intervention for cry-fuss problems in the first few months of life. This intervention, delivered by trained health professionals, has the potential to mitigate the costly problem of health professionals giving discipline-specific and conflicting advice post-birth.
Collapse
|
45
|
Jaekel J, Bartmann P, Schneider W, Wolke D. Neurodevelopmental pathways to preterm children's specific and general mathematic abilities. Early Hum Dev 2014; 90:639-44. [PMID: 25173650 DOI: 10.1016/j.earlhumdev.2014.07.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Revised: 07/15/2014] [Accepted: 07/29/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Preterm children have problems with mathematics but knowledge about the predictors of specific mathematic abilities in preterm populations is scarce. AIMS This study investigated neurodevelopmental pathways to children's general and specific mathematic abilities across the full gestational age range. STUDY DESIGN Prospective geographically defined longitudinal investigation in Germany. SUBJECTS 947 children across the full gestational age range (23-41 weeks). Outcome measures. At 8 years, children's cognitive and mathematic abilities were measured and residuals of a regression predicting mathematic scores by IQ were used to identify specific mathematic abilities. RESULTS Neurodevelopmental cascade models revealed that adverse effects of preterm birth on mathematic abilities were mediated by neonatal risk. Specific mathematic abilities were uniquely predicted by the duration of hospitalization and ventilation. CONCLUSIONS Prolonged neonatal medical treatment and, in particular, mechanical ventilation may lead to specific impairments in mathematic tasks. These findings have implications for the mode of respiratory support in neonates, routine follow-up and intervention planning as well as research about brain reorganization after preterm birth.
Collapse
Affiliation(s)
- Julia Jaekel
- Department of Developmental Psychology, Ruhr-University Bochum, Bochum, Germany; Department of Psychology, University of Warwick, Coventry, UK
| | - Peter Bartmann
- Institute of Neonatology, University Hospital Bonn, Bonn, Germany
| | | | - Dieter Wolke
- Department of Psychology, University of Warwick, Coventry, UK; Warwick Medical School, University of Warwick, Coventry, UK.
| |
Collapse
|
46
|
Schmid G, Wolke D. Preschool regulatory problems and attention-deficit/hyperactivity and cognitive deficits at school age in children born at risk: different phenotypes of dysregulation? Early Hum Dev 2014; 90:399-405. [PMID: 24951075 DOI: 10.1016/j.earlhumdev.2014.05.001] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Revised: 10/04/2013] [Accepted: 05/01/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND Early regulatory problems (RP), i.e., excessive crying, feeding, and sleeping difficulties, have been reported to be predictors of cognitive and attention-deficit/hyperactivity problems. However, previous studies had limitations such as small sample size or retrospective design. AIM To investigate whether persistent RP from infancy until preschool age are precursors of ADHD problems and cognitive deficits at school age. STUDY DESIGN A prospective study from birth to 8.5years of age. SUBJECTS 1120 infants born at risk. MEASURES RP were assessed at 5months (i.e., excessive crying, feeding, and sleeping problems), 20, and 56months (i.e., eating and sleeping problems) via parent interviews and neurological examination. At 8.5years of age, IQ was assessed by a standard test (K-ABC), and ADHD problems by direct observations in the test situation and by the Mannheimer Parent Interview (MPI, DSM-IV diagnosis of ADHD). RESULTS 23.8% of the sample born at risk had RP at least at two measurement points until preschool age. Persistent RP predicted lower IQ (β=-.17; 95% CI (-.21; -.10)), behaviour problems (β=-.10; 95% CI (-.15; -.03)), attention (OR 2.43; 95% CI (1.16; 5.09)) and hyperactivity problems (OR 3.10; 95% CI (1.29; 7.48)), and an ADHD diagnosis (OR 3.32; 95% CI (1.23; 8.98)) at school age, even when controlled for psychosocial and neurological confounders. CONCLUSIONS Early persistent RP increased the odds of ADHD and associated problems at school age, indicating a cascade model of development, i.e., infant behaviour problems provide the starting point of a trajectory of dysregulation through time.
Collapse
Affiliation(s)
- Gabriele Schmid
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universitaet Muenchen, Germany.
| | - Dieter Wolke
- Department of Psychology and Division of Mental Health and Wellbeing, University of Warwick, UK
| |
Collapse
|
47
|
Muscat T, Obst P, Cockshaw W, Thorpe K. Beliefs about infant regulation, early infant behaviors and maternal postnatal depressive symptoms. Birth 2014; 41:206-13. [PMID: 24684274 DOI: 10.1111/birt.12107] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/28/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Young infants may have irregular sleeping and feeding patterns. Such regulation difficulties are known correlates of maternal depressive symptoms. Parental beliefs about their role in regulating infant behaviors also may play a role. We investigated the association of depressive symptoms with infant feeding/sleeping behaviors, parent regulation beliefs, and the interaction of the two. METHOD In 2006, 272 mothers of infants aged up to 24 weeks completed a questionnaire about infant behavior and regulation beliefs. Participants were recruited from general medical practices and child health clinics in Brisbane, Australia. Depressive symptomology was measured using the Edinburgh Postnatal Depression Scale. Other measures were adapted from the ALSPAC study. RESULTS Regression analyses were run controlling for partner support, other support, life events, and a range of demographic variables. Maternal depressive symptoms were associated with infant sleeping and feeding problems but not regulation beliefs. The most important infant predictor was sleep behaviors with feeding behaviors accounting for little additional variance. An interaction between regulation beliefs and sleep behaviors was found. Mothers with high regulation beliefs were more susceptible to postnatal depressive symptoms when infant sleep behaviors were problematic. CONCLUSION Mothers of young infants who expect greater control are more susceptible to depressive symptoms when their infant presents challenging sleep behavior.
Collapse
Affiliation(s)
- Tracey Muscat
- School of Psychology and Counseling and Institute for Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | | | | | | |
Collapse
|
48
|
Richter N, Reck C. Positive maternal interaction behavior moderates the relation between maternal anxiety and infant regulatory problems. Infant Behav Dev 2013; 36:498-506. [DOI: 10.1016/j.infbeh.2013.04.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2012] [Revised: 01/23/2013] [Accepted: 04/30/2013] [Indexed: 10/26/2022]
|
49
|
Abstract
There is much written in the medical and lay literature about managing babies who cry too much. Healthcare professional often feel bewildered about how to go about trying to help a baby and their carer, usually the mother. They often undertake investigations, prescribe medication or alter the baby's diet. The assumption made by this approach is that the crying reflects pain or discomfort. In a normal infant who is growing well, it is rare to be able to identify any quickly treatable medical underlying disorder. Those who are inexperienced may find the idea of a behavioural approach very challenging but perhaps this would be a better alternative.
Collapse
|
50
|
Taubner S, Munder T, Unger A, Wolter S. Wirksamkeitsstudien zu Frühen Hilfen in Deutschland. KINDHEIT UND ENTWICKLUNG 2013. [DOI: 10.1026/0942-5403/a000122] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Frühe Hilfen richten sich primär und sekundär präventiv an Eltern mit kleinen Kindern (pränatal bis drei Jahre) und sollen die Beziehungs- und Erziehungskompetenz verbessern, um Kindern gute Entwicklungen zu ermöglichen sowie Kindesmisshandlung und Vernachlässigung zu verhindern. Im Rahmen eines narrativen Review wurden sechs Datenbanken für den Zeitraum zwischen 2003 und 2013 zu Studien zur Programmwirksamkeit Früher Hilfen in Deutschland durchsucht. Die Einschlusskriterien erfüllten 8 Studien, deren Forschungsdesigns, Studiendurchführung und Programmeffekte zusammengefasst wurden. Die Studienqualität wird als heterogen eingeschätzt; besonderer Verbesserungsbedarf wird hinsichtlich der Adhärenzprüfung, der Randomisierung der Teilnehmerinnen und der Kontrolle von Allegiance-Effekten diskutiert.
Collapse
|