Corrigendum: Protocol for a prospective multicenter longitudinal randomized controlled trial (CALIN) of sensory-tonic stimulation to foster parent child interactions and social cognition in very premature infants

[This corrects the article DOI: 10.3389/fped.2022.913396.].

Effect of tactile and/or kinesthetic stimulation therapy of preterm infants on their parents' anxiety and depressive symptoms: A systematic review

BACKGROUND

In the case of preterm birth, the idealized postnatal period is replaced by an anxious and even traumatic experience for parents. Higher prevalence of parental anxiety, postnatal depression, and posttraumatic stress disorder has been observed in mothers of preterm infants up to 18 months after childbirth. There is increasing evidence that proprioceptive stimulation has a beneficial effect on preterms' short-term outcomes. Could this care also have an impact on parental anxiety and depressive symptoms? We reviewed recent publications on the impact on parents' anxiety and depressive symptoms of delivering tactile and/or kinesthetic stimulation to their premature newborn.

METHODS

We conducted a systematic review by searching the PubMed, PsycInfo, Scopus, ScienceDirect and Google Scholar databases for English-language publications from the past 10 years. We focused on the mothers or fathers of infants born preterm (before 37 weeks of gestation) who provided tactile and/or kinesthetic stimulation to their premature newborn in the neonatal intensive care unit. Relevant outcomes were the parents' anxiety, stress, depressive symptoms, and symptoms of posttraumatic stress disorder, assessed with reliable standardized inventories.

RESULTS

Eleven articles were included in the systematic review. Results suggested a beneficial effect of parents' early tactile and kinesthetic stimulation of their preterm infants.

CONCLUSIONS

These interventions may act as protective factors against the occurrence of anxiety and depressive symptoms in parents and deserve to be studied further in this population.

[Crisis consultations in child and adolescent psychiatry in Reims: Cross-sectional study of the population of accompanied minors]

INTRODUCTION

The crisis consultation unit (CCU) of the child psychiatry department of the Reims University Hospital was created to respond to an increasing demand for rapid interventions with minors.

OBJECTIVE

The objective of this study is to observe the characteristics of the population received in this facility and to explore the links between the data, to hypothesize about its specificities.

METHOD

We conducted a cross-sectional study of data collected during telephone assessments between June 2016 and January 2018. A univariate analysis was performed using EpiInfo© software and the pvalue.io© statistical interface using R statistical software. A total of 263 telephone contacts were counted.

RESULTS

A greater activity of the service is found during the school period. The majority of minors did not have any psychiatric or psychological follow-up at the time of the call. Boys consulted earlier, preferably for externalized disorders. The youngest children are often referred to prevent symptoms following an acute stress.

CONCLUSION

Our study allowed us to draw up a sociodemographic profile and to show certain trends observed within the CCU of the child psychiatry department of the Reims University Hospital, in particular the multiplicity of reasons for consultation. At a time when the health crisis is impacting the mental health of the entire population and increasing the time required for treatment, this type of system is particularly relevant to the possible reorganization of the care offered by the CMP. The CCU would make it possible to report the most urgent situations, which would then benefit from specific care (hospitalization, medication, specific consultations).

Protocol for a prospective multicenter longitudinal randomized controlled trial (CALIN) of sensory-tonic stimulation to foster parent child interactions and social cognition in very premature infants

Introduction

Premature birth is associated with long-term somatic and neurological disorders, including cognitive, social and behavioral impairments. Moreover, the mothers of infants born preterm exhibit a higher prevalence of anxiety and depressive symptoms after birth. Early rehabilitation, developmental care, and parenting support have already been shown to have a positive impact on neurological outcome. However, no randomized controlled study has so far assessed the effects on parenting and long-term neurological outcomes of proprioceptive stimulation to trigger positive brain plasticity in very preterm babies. The CALIN project will therefore investigate the impact of sensory-tonic stimulation (STS) of extremely preterm infants by their parents on child parent interactions, infants' morphological and functional brain development and subsequent cognition (including social cognition), and parents' anxiety and depressive symptoms in the postpartum period.

Methods and analysis

Infants born between 25 and 32 weeks of gestation will be randomly assigned to the "STS + Kangaroo care" or "Kangaroo care" group. The primary endpoint, child and parent interactions, will be rated at 12 months corrected age using the Coding Interactive Behavior system. Secondary endpoints include: 1/functional and anatomical brain maturation sequentially assessed during neonatal hospitalization using electroencephalogram (EEG), amplitude-integrated EEG (aEEG), cranial ultrasound and MRI performed at term-corrected age, 2/social and cognitive outcomes assessed at 15 months, 2, 4 and 6 years, and 3/parents' anxiety and depressive symptoms assessed at 7 ± 1 weeks after birth, using dedicated questionnaires.

Ethics and dissemination

This study was approved by the French Ethics Committee for the Protection of Persons on 18 October 2021. It is registered with the French National Agency for the Safety of Medicines and Health Products (ANSM; no. 2020-A00382-37). The registry number on ClinicalTrials.gov is NCT04380051.

Pregnancy denial: a complex symptom with life context as a trigger? A prospective case-control study

Objective

To identify risk factors for a woman to experience pregnancy denial.

Design, setting and population

A French multicentric prospective case–control study with 71 mother–infant dyads having experienced a pregnancy denial versus a control group of 71 dyads.

Methods

Data were collected in the week after delivery using an observational leaflet and two psychiatric scales (MINI and QSSP).

Main outcome measures

Statistically significant differences between the two groups regarding social, demographic, medical and psychiatric data.

Results

Not being in a stable relationship (odds ratio [OR] 17.18, 95% CI 3.37–87.60]; P < 0.0001), not having a high school diploma (OR 1.11, 95% CI 1.04–1.38]; P < 0.0001) and having a psychiatric history (OR 6.33, 95% CI 1.62–24.76; P = 0.0002) were risk factors to experience pregnancy denial, whereas being older was a protective factor (OR 0.86, 95% CI 0.79–0.93; P = 0.0054) (logistic regression, Wald 95% CI). Other risk factors included late declarations of pregnancy history and past pregnancy denials (case n = 7, 9.7% versus 0% in controls; P = 0.01), past pregnancy denials in the family (case n = 13, 18% versus control n = 4, 5.6%; P = 0.03), and use of a contraceptive method (75% for cases versus 7% in control; P < 0.0001), primarily an oral contraceptive (75%).

Conclusion

Family or personal history of pregnancy denial should be part of the systematic anamnesis during the first visit of a patient of child‐bearing age. Further, our study points out that life context (young age, single status, socio‐economic precarity, pill‐based contraception) could be a trigger for pregnancy denial in certain women.

Tweetable abstract

Life context can be a trigger for pregnancy denial.

Life context can be a trigger for pregnancy denial.

Prevalences and predictive factors of maternal trauma through 18 months after premature birth: A longitudinal, observational and descriptive study

Posttraumatic reactions are common among mothers of preterm infants and can have a negative influence on their quality of life and lead to interactional difficulties with their baby. Given the possible trajectories of posttraumatic reactions, we hypothesized that prevalences of postpartum posttraumatic reactions at given times underestimate the real amount of mothers experiencing these symptoms within 18 months following delivery. Additionally, we examined whether sociodemographic and clinical characteristics of dyads influence the expression of posttraumatic symptoms among these mothers. A sample of 100 dyads was included in this longitudinal study led by 3 french university hospitals. Preterm infants born before 32 weeks of gestation and their mothers were followed-up over 18 months and attended 5 visits assessing the infants’ health conditions and the mothers’ psychological state with validated scales. Fifty dyads were retained through the 18 months of the study. The period prevalence of posttraumatic reactions was calculated and a group comparison was conducted to determine their predictive factors. Thirty-six percent of the mothers currently suffered from posttraumatic symptoms 18 months after their preterm delivery. The 18 months period prevalence was 60.4% among all the mothers who participated until the end of the follow-up. There was a statistical link between posttraumatic symptoms and a shorter gestational age at delivery, C-section, and the mother’s psychological state of mind at every assessment time. Only a small proportion of mothers were receiving psychological support at 18 months. Preterm mothers are a population at risk of developing a long-lasting postpartum posttraumatic disorder, therefore immediate and delayed systematic screenings for posttraumatic symptoms are strongly recommended to guide at-risk mothers towards appropriate psychological support.

Impact of Executive Functions and Parental Anxiety on the Development of Social Cognition in Premature Children: A Cross-Sectional Case-Control Protocol

Background: Recent research has identified neuropsychological disorders, specifically executive function disorders, in premature children. Executive functions support goal-oriented mental activity and play a role in the development of social cognition. This underlies the social and emotional behavior of individuals. Parental anxiety is also an important environmental factor that can influence the psycho-emotional development of children. Objectives: The present protocol aims to compare the development of social cognition in school-age children born prematurely to that of school-age children born full-term, and to determine the impact of executive (dys)function and parental anxiety on such development. Methods/Design: In this cross-sectional protocol, 28 prematurely born children aged 7-10 years ("preterm") and 28 full-term born children aged 7-10 years ("control") will be included. The "preterm" and "control" groups will be matched for sex and age. The neuropsychological evaluation will include that of non-verbal intellectual efficiency (Raven's colored progressive matrices), verbal level (WISC-IV subtests), and executive functions (NEPSY II subtests and the opposite worlds of TEA-CH). The evaluation of social cognition will be conducted via tests of the theory of cognitive and affective mind. Several dimensions of the level of parental anxiety will be collected through the Spielberg Trait Anxiety Inventory Form Y, Beck Depression Inventory, Social Support Questionnaire-6, Parental Stress Index and, specifically for mothers, the Modified Perinatal Post-Traumatic Stress Disorder Questionnaire. Discussion: The results of this protocol will aid our understanding of the development of social cognition in premature children and to determine the factors that influence such development. This clinical research project, although following a fundamental approach, will have clinical implications because a more precise description of the development of social cognition in this school-age population will make it possible to better determine the cognitive targets of therapeutic actions and to search for predictive indices of the efficacy of practices. Trial Registration:https://clinicaltrials.gov/ct2/show/NCT03007095, identifier: NCT03007095.

Pregnancy denial and early infant development: a case-control observational prospective study

Background

The denial of pregnancy is the non-recognition of the state of the current pregnancy by a pregnant woman. It lasts for a few months or for the whole pregnancy, with generally few physical transformations. In this study, we will consider the denial of pregnancy as a late declaration of pregnancy (beyond 20 weeks of gestation) as well as a lack of objective perceptions of this pregnancy. The main objective of this study is to explore the relationship between pregnancy denial and the development of the infant (attachment pattern of the infant, early interactions of mother-infant dyads, and early development of the infant).

Methods

The design is a case-control prospective study, which will compare two groups of mother-infant dyads: a “case” group with maternal denials of pregnancy and a “control” group without denials of pregnancy. A total of 140 dyads (mother + infant) will be included in this study (70 cases and 70 controls) and followed for 18 months. The setting is a national recruitment setting with 10 centers distributed all over France. The follow-up of the “cases” and the “controls” will be identical and will occur over 5 visits. It will include measures of the infant attachment pattern, the quality of early mother-infant interaction and infant development.

Discussion

This study aims to examine the pathogenesis of pregnancy denial as well as its consequences on early infant development and early mother-infant interaction.

Trial registration

Clinical Trial Number: NCT02867579 on the date of 16 August 2016 (retrospectively registered).

Mother's Emotional and Posttraumatic Reactions after a Preterm Birth: The Mother-Infant Interaction Is at Stake 12 Months after Birth

OBJECTIVES

Very preterm infants are known to be at risk of developmental disabilities and behavioural disorders. This condition is supposed to alter mother-infant interactions. Here we hypothesize that the parental coping with the very preterm birth may greatly influence mother-infant interactions.

METHODS

100 dyads were included in 3 university hospitals in France. Preterm babies at higher risk of neurodevelopmental sequelae (PRI>10) were excluded to target the maternal determinants of mother-infant interaction. We report the follow-up of this cohort during 1 year after very preterm birth, with regular assessment of infant somatic state, mother psychological state and the assessment of mother-infant interaction at 12 months by validated scales (mPPQ, HADS, EPDS, PRI, DDST and PIPE).

RESULTS

We show that the intensity of post-traumatic reaction of the mother 6 months after birth is negatively correlated with the quality of mother-infant interaction at 12 months. Moreover, the anxious and depressive symptoms of the mother 6 and 12 months after birth are also correlated with the quality of mother-infant interaction at 12 months. By contrast, this interaction is not influenced by the initial affective state of the mother in the 2 weeks following birth. In this particular population of infants at low risk of sequelae, we also show that the quality of mother-infant interaction is not correlated with the assessment of the infant in the neonatal period but is correlated with the fine motor skills of the baby 12 months after birth.

CONCLUSIONS

This study suggests that mothers' psychological condition has to be monitored during the first year of very preterm infants' follow-up. It also suggests that parental interventions have to be proposed when a post-traumatic, anxious or depressive reaction is suspected.

Emotional reactions of mothers facing premature births: study of 100 mother-infant dyads 32 gestational weeks

OBJECTIVES

This current study has been conducted to clarify the relationship between the mother's post-traumatic reaction triggered by premature birth and the mother-infant interactions. In this article, the precocious maternal feelings are described.

METHODS

A multicenter prospective study was performed in three French hospitals. 100 dyads with 100 very premature infants and their mothers were recruited. Mothers completed, at two different times self-questionnaires of depression/anxiety, trauma and social support. The quality of interactions in the dyads was evaluated.

RESULTS

Thirty-nine percent of the mothers obtained a score at HADS suggesting a high risk of depression at the first visit and approximately one-third at visit two. Seventy-five percent of the mothers were at risk of suffering from an anxiety disorder at visit one and half remained so at visit two. A "depressed" score at visits one and two correlated with a hospitalization for a threatened premature labor. We noted a high risk of trauma for 35% of the mothers and high interactional synchrony was observed for approximately two-thirds of the dyads. The mothers' psychological reactions such as depression and anxiety or postnatal depression correlate strongly with the presence of an initial trauma. At visit one and visit two, a high score of satisfaction concerning social support correlates negatively with presence of a trauma. A maternal risk of trauma is more frequent with a C-section delivery.

CONCLUSIONS

Mothers' psychological reactions such as depression and anxiety correlate greatly with the presence of an initial trauma. The maternal traumatic reaction linked to premature birth does not correlate with the term at birth, but rather with the weight of the baby. Social support perceived by the mother is correlated with the absence of maternal trauma before returning home, and also seems to inhibit from depressive symptoms from the time of the infant's premature birth.

Bipolar affective disorder and early dementia onset in a male patient with SHANK3 deletion

The SHANK3 protein is a scaffold protein known to stabilize metabotropic glutamate receptor mGluR5 in the post-synaptic membrane of neurons. It is associated with genetic vulnerability in autism and schizophrenia. Here we report the case of an 18 year-old male patient who displayed psychiatric features of bipolar affective disorder associated with early setting of dementia. This mental status is related to sporadic occurrence of SHANK3 gene complex multiple deletions. A low beta amyloid protein rate (479 mg/L) found in cerebrospinal fluid suggests a possible link between SHANK3 deletion syndrome-associated regression and dementia of Alzheimers's type. In addition, we propose an overview of the phenotype related to SHANK3 deletion.