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Kelly MM, Brace M. Influence of Preterm Birth and Environmental Context on Academic Performance and Neurodevelopmental Outcomes. Nurs Res 2024; 73:342-353. [PMID: 38861366 DOI: 10.1097/nnr.0000000000000751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2024]
Abstract
BACKGROUND Preterm birth affects 10% of all births annually in the United States. Outcomes of people born preterm are challenging to predict because of multiple influences, including gestational age, birth weight, and social and environmental contexts, that contribute to an individual's growth and developmental trajectory. The influence of toxic stress is underrepresented in the literature assessing preterm birth outcomes. OBJECTIVES The current analyses use the eco-bio-developmental model of poverty and preterm birth as a framework to model the pathways among toxic stress, preterm birth, and neurodevelopmental outcomes. Poverty and toxic stress were hypothesized to increase the risk for impaired neurodevelopmental and academic outcomes-both directly and indirectly. METHODS The analytic sample of 55,873 children aged 6-17 years was derived from the National Survey of Children's Health 2020-2021. Structural equation models with combined measurement and path models for each dependent variable were constructed using latent toxic stress variables. The structural path equations included direct paths from the latent measure of prenatal toxic stress, preterm birth status, and the latent measure of childhood toxic stress to the neurodevelopmental outcome, as well as an indirect, mediated path from prenatal toxic stress through preterm birth status to the outcome. RESULTS Across models, higher levels of prenatal toxic stress were significantly associated with preterm birth and lower birth weight ranges. Preterm low birth weight status was associated with a greater likelihood of neurodevelopmental impairment, repeating a grade, and special education plans. The predicted probabilities of neurodevelopmental impairment, repeating grades, and special education plans are significantly higher with above-average levels of exposure to prenatal and childhood toxic stress. DISCUSSION There is a need for prospective studies that assess predictors and outcomes of preterm birth that are stratified by gestational age and consider the timing, chronicity, and influence of toxic stress and environmental exposures. There is an imperative for public health programs and policies designed to support families, caregivers, and children to address the individual and structural social determinants of health that contribute to toxic stress, thereby increasing preterm birth rates and negatively affecting the outcomes of children born preterm.
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Camden C, Zwicker JG, Morin M, Schuster T, Couture M, Poder TG, Maltais DB, Battista MC, Baillargeon JP, Goyette M, Pratte G, Hurtubise K, Phoenix M, Nguyen T, Berbari J, Tousignant M. Web-based early intervention for children with motor difficulties aged 3–8 years old using multimodal rehabilitation (WECARE): protocol of a patient-centred pragmatic randomised trial of paediatric telerehabilitation to support families. BMJ Open 2021. [PMCID: PMC8039274 DOI: 10.1136/bmjopen-2020-046561] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Introduction Mild motor difficulties in children are underdiagnosed despite being highly prevalent, leaving such children often underserved and at higher risk for secondary consequences such as cardiovascular disease and anxiety. Evidence suggests that early patient-oriented interventions, coaching parents and providing children with early stimulation should be provided, even in the absence of a diagnosis. Such interventions may be effectively delivered via telerehabilitation. Methods and analysis A family-centred, pragmatic randomised controlled trial will be carried out to evaluate the real-world effectiveness of a Web-based Early intervention for Children using multimodAl REhabilitation (WECARE). Families of children with motor difficulties, 3–8 years of age, living in Quebec, Canada, and receiving no public rehabilitation services (n=118) will be asked to determine up to 12 performance goals, evaluated using the Canadian Occupational Performance Measure (COPM, the primary outcome). Families will be randomised to receive either usual care or the WECARE intervention. The WECARE intervention will be delivered for 1 year via a web-based platform. Families will have access to videoconferences with an assigned rehabilitation therapist using a collaborative coaching approach, a private chat function, a forum open to all intervention arm participants and online resources pertaining to child development. Participants will be asked to re-evaluate the child’s COPM performance goals every 3 months up to 1 year post allocation. The COPM results will be analysed using a mixed Poisson regression model. Secondary outcomes include measures of the child’s functional ability, parental knowledge and skills and health-related quality of life, as well as qualitative outcomes pertaining to parental satisfaction and service delivery trajectories. Investigators and quantitative data analysts will be blinded to group allocation. Ethics and dissemination The CIUSSS de l’Estrie—CHUS ethics committee approved this trial (2020-3429). Study results will be communicated via peer-reviewed journal publications, conference presentations and stakeholder-specific knowledge transfer activities. Trial registration number NCT04254302.
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Affiliation(s)
- Chantal Camden
- École de réadaptation, Universite de Sherbrooke Faculté de Médecine et des Sciences de la Santé, Sherbrooke, Québec, Canada
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke, CIUSSS de l'Estrie—CHUS, Sherbrooke, Québec, Canada
| | - Jill G Zwicker
- Occupational Science & Occupational Therapy, The University of British Columbia, Vancouver, British Columbia, Canada
- BC Children’s Hospital, Vancouver, British Columbia, Canada
| | - Melanie Morin
- École de réadaptation, Universite de Sherbrooke Faculté de Médecine et des Sciences de la Santé, Sherbrooke, Québec, Canada
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke, CIUSSS de l'Estrie—CHUS, Sherbrooke, Québec, Canada
| | - Tibor Schuster
- Department of Family Medicine, McGill University, Montreal, Québec, Canada
| | - Melanie Couture
- École de réadaptation, Universite de Sherbrooke Faculté de Médecine et des Sciences de la Santé, Sherbrooke, Québec, Canada
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke, CIUSSS de l'Estrie—CHUS, Sherbrooke, Québec, Canada
| | - Thomas G Poder
- School of Public Health, Université de Montréal, Montreal, Québec, Canada
- Centre de recherche de l’Institut universitaire en santé mentale de Montréal, Montreal, Québec, Canada
| | - Desiree B Maltais
- Département de réadaptation, Universite Laval, Québec City, Québec, Canada
| | - Marie-Claude Battista
- Department of Medicine, Universite de Sherbrooke Faculté de Médecine et des Sciences de la Santé, Sherbrooke, Quebec, Canada
| | - Jean-Patrice Baillargeon
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke, CIUSSS de l'Estrie—CHUS, Sherbrooke, Québec, Canada
- Universite de Sherbrooke Faculté de Médecine et des Sciences de la Santé, Sherbrooke, Quebec, Canada
| | - Mathieu Goyette
- Département de sexologie, Université du Québec à Montréal, Montreal, Québec, Canada
| | - Gabrielle Pratte
- École de réadaptation, Universite de Sherbrooke Faculté de Médecine et des Sciences de la Santé, Sherbrooke, Québec, Canada
| | - Karen Hurtubise
- École de réadaptation, Universite de Sherbrooke Faculté de Médecine et des Sciences de la Santé, Sherbrooke, Québec, Canada
| | - Michelle Phoenix
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Tram Nguyen
- School of Epidemiology & Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Jade Berbari
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke, CIUSSS de l'Estrie—CHUS, Sherbrooke, Québec, Canada
| | - Michel Tousignant
- École de réadaptation, Universite de Sherbrooke Faculté de Médecine et des Sciences de la Santé, Sherbrooke, Québec, Canada
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Mossad SI, Muscat C, Pang EW, Taylor M. Emerging atypical connectivity networks for processing angry and fearful faces in very preterm born children. Hum Brain Mapp 2020; 41:3794-3806. [PMID: 32533810 PMCID: PMC7416058 DOI: 10.1002/hbm.25088] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 05/13/2020] [Indexed: 12/13/2022] Open
Abstract
Very preterm born (VPT) children are those born before 32/40 weeks' gestational age and comprise 10% of the 15 million babies born prematurely worldwide each year. Due to advancements in neonatal medicine, the survival rate of VPT birth has increased, but few studies have investigated the nonmedical, social-cognitive morbidities that affect these children. In this study, we examined emotional face processing networks in VPT compared to age and sex matched full-term born (FT) children. Magnetoencephalography (MEG) was used to test VPT and FT born children at 6 years (n = 78) and 8 years (n = 83). Children were assessed using an implicit emotion face-processing task. Happy, fearful, and angry faces were presented for 150 ms, but children were asked to respond by button press to the location of a control pixelated image of the face displayed on the side of the screen opposite to the face. Children rated the valence of the images on a five-point scale. Group differences showed that VPT children rated angry faces more positively than their FT peers. VPT children had reduced connectivity for angry and fearful faces at 8 years in networks including regions such as the bilateral amygdala, superior temporal sulci, and anterior cingulate gyrus. Interventions should target both emotion recognition, as well as higher cognitive processes related to emotional control and thinking about one's own emotions.
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Affiliation(s)
- Sarah I Mossad
- Department of Diagnostic ImagingThe Hospital for Sick ChildrenTorontoOntarioCanada
- Neurosciences & Mental HealthSickKids Research InstituteTorontoOntarioCanada
- Department of PsychologyUniversity of TorontoTorontoOntarioCanada
| | - Christine Muscat
- Department of PsychologyUniversity of TorontoTorontoOntarioCanada
| | - Elizabeth W. Pang
- Neurosciences & Mental HealthSickKids Research InstituteTorontoOntarioCanada
- Division of NeurologyHospital for Sick ChildrenTorontoOntarioCanada
| | - Margot Taylor
- Department of Diagnostic ImagingThe Hospital for Sick ChildrenTorontoOntarioCanada
- Neurosciences & Mental HealthSickKids Research InstituteTorontoOntarioCanada
- Department of PsychologyUniversity of TorontoTorontoOntarioCanada
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Scott A, Winchester SB, Sullivan MC. Trajectories of problem behaviors from 4 to 23 years in former preterm infants. INTERNATIONAL JOURNAL OF BEHAVIORAL DEVELOPMENT 2018; 42:237-247. [PMID: 29430071 PMCID: PMC5805147 DOI: 10.1177/0165025417692899] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Premature infants have significant risk for later behavior problems. This study examined growth trajectories of three problem behaviors across five developmental age points from preschool to early adulthood in a well-characterized sample of premature infants. The effects of neonatal risk, gender, and socioeconomic context were modeled on these trajectories. The longitudinal sample was comprised of preterm infants (N = 160) with full variation of neonatal morbidity and birth weight (640-1950 grams). Trajectories of externalizing, internalizing and attention problem behaviors from 4 to 23 years, measured by the Child Behavior Checklist, were tested using latent growth curve modeling. The results indicate individual variation in the number of externalizing and internalizing problems over time. Externalizing problems were not significantly different for males and females, but male scores were consistently higher. Neonatal risk was significantly associated with higher internalizing problems at age 4, but was not predictive at school age and beyond. Attention problem scores increased from early preschool through adolescence for males, but females had little change over the same ages. SES was not predictive of any problem behavior trajectories and no significant two-way interactions were found. The results advance understanding of stability and change of three important problem behaviors through preschool, childhood and adolescence to young adulthood in prematurely born infants in order to inform clinicians about timely assessment and the refinement of effective interventions.
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Affiliation(s)
- Allie Scott
- University of Rhode Island, Department of Psychology, Kingston, Rhode Island
| | | | - Mary C Sullivan
- University of Rhode Island, College of Nursing, Kingston, Rhode Island
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Hawes K, McGowan E, O'Donnell M, Tucker R, Vohr B. Social Emotional Factors Increase Risk of Postpartum Depression in Mothers of Preterm Infants. J Pediatr 2016; 179:61-67. [PMID: 27502105 DOI: 10.1016/j.jpeds.2016.07.008] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 06/06/2016] [Accepted: 07/06/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To examine the association of maternal mental health, perceptions of readiness at neonatal intensive care unit (NICU) discharge, and social risk factors with depressive symptoms 1 month postdischarge in mothers of early (<32 weeks), moderate (32-33 weeks), and late (34-36 weeks) preterm infants. A secondary objective was to compare depressive symptoms among mothers in all preterm groups. STUDY DESIGN Mothers (n = 734) of preterm infants cared for >5 days in the NICU and participating in a Transition Home Program completed the Fragile Infant Parent Readiness Evaluation prior to discharge for perceptions of NICU staff support, infant well-being, maternal well-being (emotional readiness/competency), and maternal comfort (worry about infant). Mental health history and social risk factors were obtained. At 1 month postdischarge the Edinburgh Postnatal Depression Scale was administered. Group comparisons and logistic regression analyses were run to predict possible depression (Edinburgh Postnatal Depression Scale ≥10). RESULTS Mothers of early, moderate, and late preterm infants reported similar rates of possible depression (20%, 22%, and 18%, respectively) 1 month after NICU discharge. History of mental health disorder, decreased perception of maternal well-being, decreased maternal comfort regarding infant, and decreased perception of family cohesion were associated with possible depression at 1 month postdischarge. CONCLUSIONS Mothers with a previous mental health disorder and experiencing negative perceptions of self and infant at NICU discharge were at increased risk for depressive symptomatology 1 month postdischarge regardless of infant gestational age. Comprehensive mental health assessment prior to discharge is essential to identify women at risk and provide appropriate referral.
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Affiliation(s)
- Katheleen Hawes
- Women and Infants Hospital of Rhode Island, Providence, RI; Alpert School of Medicine, Brown University, Providence, RI; College of Nursing, University of Rhode Island, Kingston, RI.
| | - Elisabeth McGowan
- Women and Infants Hospital of Rhode Island, Providence, RI; Alpert School of Medicine, Brown University, Providence, RI
| | | | - Richard Tucker
- Women and Infants Hospital of Rhode Island, Providence, RI; Alpert School of Medicine, Brown University, Providence, RI
| | - Betty Vohr
- Women and Infants Hospital of Rhode Island, Providence, RI; Alpert School of Medicine, Brown University, Providence, RI
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de Boer JC, van Rosmalen J, Bakker AB, van Dijk M. Appropriateness of care and moral distress among neonatal intensive care unit staff: repeated measurements. Nurs Crit Care 2015; 21:e19-27. [DOI: 10.1111/nicc.12206] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 07/23/2015] [Accepted: 07/28/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Jacoba Coby de Boer
- Department of Pediatrics; Erasmus University Medical Centre, Sophia Children's Hospital; Rotterdam The Netherlands
| | - Joost van Rosmalen
- Department of Biostatistics; Erasmus University Medical Centre; Rotterdam The Netherlands
| | - Arnold B. Bakker
- Department of Work and Organizational Psychology; Erasmus University Rotterdam; Rotterdam The Netherlands
| | - Monique van Dijk
- Department of Pediatrics; Erasmus University Medical Centre, Sophia Children's Hospital; Rotterdam The Netherlands
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Dempsey AG, Keller-Margulis M, Mire S, Abrahamson C, Dutt S, Llorens A, Payan A. School-aged children born preterm: review of functioning across multiple domains and guidelines for assessment. ACTA ACUST UNITED AC 2014. [DOI: 10.1080/1754730x.2014.978117] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Alduncin N, Huffman LC, Feldman HM, Loe IM. Executive function is associated with social competence in preschool-aged children born preterm or full term. Early Hum Dev 2014; 90:299-306. [PMID: 24661446 PMCID: PMC4240273 DOI: 10.1016/j.earlhumdev.2014.02.011] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Revised: 02/22/2014] [Accepted: 02/25/2014] [Indexed: 11/24/2022]
Abstract
BACKGROUND Executive function (EF), defined as higher-order cognitive processes used in planning and organizing actions and emotions, is often impaired in children born preterm. Few studies have assessed social competence, the processes and resources required to meet social demands and achieve social goals, in children born preterm. The relations between EF and social competence in preterm and full term preschoolers have not been well characterized. AIMS To characterize social competence and assess the relationship between EF and social competence in preschool-aged children born preterm or full term. STUDY DESIGN Cross-sectional study. SUBJECTS Study subjects had a history of preterm birth (≤34weeks of gestation) and birth weight <2500g (n=70). Controls were born full term (≥37weeks) (n=79). OUTCOME MEASURES Children completed a battery of EF tasks; a mean age-adjusted z-score for the battery was generated for each child. Parents rated child EF on one scale and child social competence on two standardized scales. RESULTS Compared to full term children, preterm children showed a lower mean EF battery z-score, poorer parent-rated EF, and poorer scores on the two social competence scales. In hierarchical multiple regression models, EF battery z-score and parent-rated EF made independent contributions to both measures of social competence. Preterm birth explained additional variance for one measure of social competence. CONCLUSIONS Standard assessment of EF skills and social competence in young preschool children, including children born preterm, may identify at-risk children for long-term social difficulties and may also provide targets for intervention.
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Affiliation(s)
- Nidia Alduncin
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford CA 94305
| | - Lynne C. Huffman
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford CA 94305
| | - Heidi M. Feldman
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford CA 94305
| | - Irene M. Loe
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford CA 94305
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Correia SKB, Saur AM, Loureiro SR. Comportamento de Escolares Estratificados pelo Peso ao Nascer e Idade Gestacional. PSICOLOGIA: TEORIA E PESQUISA 2014. [DOI: 10.1590/s0102-37722014000200007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
O peso e a idade gestacional são critérios relevantes para avaliação das condições de nascimento das crianças. O objetivo do presente estudo foi caracterizar e comparar o desempenho comportamental de uma coorte de crianças estratificada pelo peso ao nascer e pelo peso ao nascer em relação à idade gestacional. Avaliaram-se, aos 10/11 anos, 677 crianças por meio do Questionário de Capacidades e Dificuldades. Verificou-se, com significância estatística, os seguintes resultados: o grupo Baixo Peso apresentou mais sintomas emocionais que o grupo Peso Normal; o grupo Muito Baixo Peso mostrou mais hiperatividade em comparação aos outros; o grupo Pequeno para a Idade Gestacional apresentou mais dificuldades no escore total e mais sintomas emocionais em relação aos demais grupos. Concluiu-se que a estratificação por dois critérios permitiu a identificação de dificuldades específicas quanto ao desempenho comportamental.
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Saur AM, Correia SKB, Bettiol H, Barbieri MA, Loureiro SR. Variables associated with cognitive, behavioral and emotional development: a cohort of schoolchildren. PSICO-USF 2014. [DOI: 10.1590/s1413-82712014000100013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This study aimed to identify possible variables associated with cognitive, behavioral and emotional development in a cohort of school children, based on biological (sex, gestational age and birth weight) and socioeconomic variables (marital status, maternal and paternal education, occupation of head of household, socioeconomic status, and number of household members). We evaluated 790 children born in a cohort of Ribeirão Preto (SP), Brazil, with 10/11 years of age. The Raven Test was used for cognitive assessment and the Strengths and Difficulties Questionnaire was utilized for emotional and behavioral assessment. By means of multivariate logistic regression analysis (CI 95%) we found that: 1) low maternal schooling was associated with behavioral and emotional problems and poor cognitive function, 2) being female was considered as a protective factor against behavioral problems and 3) low birth weight and prematurity were not associated with the outcomes investigated.
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12
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School readiness of moderately preterm children at preschool age. EUROPEAN JOURNAL OF PSYCHOLOGY OF EDUCATION 2012. [DOI: 10.1007/s10212-012-0168-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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