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Abstract
Background: Maternal stress in neonatal intensive care units (NICUs) is well acknowledged. However, there is currently no well-defined support at how to best assist mothers during their infants’ hospitalization. Not only must they confront at the same time their infant’s fragility, but also their own personal trials. In this exploratory study, we examined whether the Multiple-Stressor mediational modeling approach commonly used in Ecology could be used to better assist these parents. This approach calls attention to the overall impact that multiple stressors can have on an organism, i.e., not only in regard to their individual effects, but just as importantly, through their interactions with each other, be they positive or negative. It is hypothesized that the use of such mediational modeling could improve our understanding of the overall impact that multiple stressors can have on NICU mothers. Methods: At 2 weeks postpartum, 30 mothers with infants born between 24 and 29 weeks gestation responded to the following self-reported psychological outcome measures: Affect Intensity Measure (AIM); Crowne-Marlowe Social Desirability Scale (CM); Edinburgh Postnatal Depression Scale (EDPS); Brief Symptom Inventory-Anxiety (BSI-Anx); Parental Stress Scale: NICU (PSS:NICU); Multidimensional Scale of Perceived Social Support (MSPSS); and Coping Inventory for Stressful Situations (CISS). The “Best Subsets Regression” analysis (www.minitab.com) was used to identify the four interactive maternal outcome measures that best correlated with the mediational stress models of interest, namely, Depression, Anxiety, parental NICU stress, Perceived Social Support, and Coping skills. Results: The following mediational models of maternal stress outcomes during their infant’s NICU hospitalization were identified: depression, anxiety, stress of the sights and sounds in the NICU, “the looks of my baby”, my “inability” to be a parent, perceived social support, and coping skills. Conclusions: It is advanced that the use of the Multiple-Stressor approach, with its ability to identify factors associated with particular stressors, can offer psychosocial providers a more tangible understanding of the maternal key elements at the source of maternal stress in NICUs. It is expected that to ease the stressful experiences these mothers encounter, such approach will facilitate the development of more effective interventions to assist these parents’ challenges than currently available.
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Affiliation(s)
- Chantal Lau
- Baylor College of Medicine, Department of Pediatrics, Houston, TX, USA
| | - Marie R Turcich
- Baylor College of Medicine, Department of Pediatrics, Houston, TX, USA
| | - J Kennard Fraley
- Baylor College of Medicine, Department of Pediatrics, Houston, TX, USA
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Katusic MZ, Mensah-Bonsu NE, Miller JA, Turcich MR, Iovino I, Vinson-Sellers S, Voigt RG, Demmler-Harrison GJ. The Impact of Asymptomatic Congenital Cytomegalovirus on Adult Quality of Life. J Dev Behav Pediatr 2021; 42:46-54. [PMID: 33055522 PMCID: PMC7752848 DOI: 10.1097/dbp.0000000000000843] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 04/22/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Children born with asymptomatic congenital cytomegalovirus infection (AcCMV) have increased risk for hearing loss, which may affect their quality of life into adulthood. We aim to determine quality of life outcomes among adults who were identified at birth with AcCMV compared with controls, using the cohort of the Houston Congenital CMV Longitudinal Study. METHODS Quality of life was determined using the self-reported Quality of Life Inventory (QOLI). Sixty-one of 109 AcCMV subjects and 23 of 51 controls completed QOLI. Percentile scores of subjects were compared with percentile scores of controls using Student t tests. QOLI percentile scores were compared among AcCMV subjects with (N = 14) and without hearing loss (N = 47). RESULTS There was no difference in mean percentile scores on QOLI between AcCMV subjects (59.8 [SD = 27.6]) and controls (57.3 [SD = 35.3]; p = 0.754). Percentile scores indicate an average overall quality of life classification for AcCMV subjects and controls. There was no difference in mean percentile scores on the QOLI between AcCMV subjects with and without hearing loss (54.8 [SD = 25.2]) and 61.3 [SD = 28.3]; p = 0.440, respectively). CONCLUSION Adults born with AcCMV do not seem to have lower ratings of quality of life compared with uninfected controls. Although our study had small sample size, hearing loss does not seem to be a significant predictor of QOLI percentile scores among AcCMV subjects. Quality of life in adulthood does not seem to be affected by an individual's awareness of screening positive for CMV, which supports the notion of "no harm" occurring from universal newborn screening for congenital CMV infection.
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Affiliation(s)
- Maja Z Katusic
- Department of Developmental Behavioral Pediatrics, Baylor College of Medicine/Texas Children's Hospital, Houston, TX
| | - Noël E Mensah-Bonsu
- Department of Developmental Behavioral Pediatrics, Baylor College of Medicine/Texas Children's Hospital, Houston, TX
| | - Jerry A Miller
- Department of Pediatric Infectious Disease, Baylor College of Medicine/Texas Children's Hospital, Houston, TX
| | - Marie R Turcich
- Department of Developmental Behavioral Pediatrics, Baylor College of Medicine/Texas Children's Hospital, Houston, TX
| | - Isabella Iovino
- Department of Child Psychology, Baylor College of Medicine/Texas Children's Hospital, Houston, TX
| | - Sherry Vinson-Sellers
- Department of Developmental Behavioral Pediatrics, Baylor College of Medicine/Texas Children's Hospital, Houston, TX
| | - Robert G Voigt
- Department of Developmental Behavioral Pediatrics, Baylor College of Medicine/Texas Children's Hospital, Houston, TX
| | - Gail J Demmler-Harrison
- Department of Pediatric Infectious Disease, Baylor College of Medicine/Texas Children's Hospital, Houston, TX
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Lau C, Turcich MR, Smith EO. Early detection of parenting stress in mothers of preterm infants during their first-year home. BMC Psychol 2020; 8:66. [PMID: 32576260 PMCID: PMC7313173 DOI: 10.1186/s40359-020-00435-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 06/17/2020] [Indexed: 11/11/2022] Open
Abstract
Background Maternal stress following the birth of an infant is well acknowledged. It is particularly so when infants are born prematurely as their mothers cannot fully take on their parenting role until their infant(s) is discharged from neonatal intensive care units (NICUs). In this exploratory study, we examined whether these mothers’ parenting stress would lessen during their first-year reunification with their infant(s) as they settle into motherhood at home. Methods Two groups of mothers with infants born between 24- and 33-week gestational age were recruited. A group of 25 mothers were monitored at their infants’ 1-month corrected age (CA) and a second group of 24 mothers were monitored at their infants’ 12-month CA. Subjects completed the long form Parental Stress Index (PSI) ranking how stressful they perceive the individual subscales in the Child and Parent Domains of the self-reported questionnaire (PSI-3; Abidin; PAR Inc). The PSI theorizes that the stress mothers perceive is a resultant of their respective characteristics, interactions with their infant(s), family, and environment. Statistical analyses include descriptive statistics, χ2 square analysis, and independent t-test. Results There was no significant difference in the levels of perceived stress in the PSI subscales between the two groups of mothers at 1- and 12-month CA. Scores for the majority of respondents fell within the 15th to 80th percentile (% ile) distribution of Abidin’s normative population, with some mothers falling below the 15th % ile. Discussion/conclusion The data collected suggest that: 1. the perceived stress experienced by mothers during their first-year reunited with their preterm infants is within the normal range observed in Abidin’s normative population. 2. As the PSI is a self-reported survey, care providers need to be aware that some mothers may downplay their stress responses. 3. With the ability to monitor individual participants, the PSI can be readily offered to mothers at their infants’ first year routine clinical visits to assist in the early identification of parenting issues that may threaten the development of a healthy mother-infant dyad. Early appropriate guidance and social support would help “at-risk” mothers develop more constructive parenting routines.
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Affiliation(s)
- C Lau
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, 77030, USA.
| | - M R Turcich
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, 77030, USA
| | - E O Smith
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, 77030, USA
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Lopez AS, Lanzieri TM, Claussen AH, Vinson SS, Turcich MR, Iovino IR, Voigt RG, Caviness AC, Miller JA, Williamson WD, Hales CM, Bialek SR, Demmler-Harrison G. Intelligence and Academic Achievement With Asymptomatic Congenital Cytomegalovirus Infection. Pediatrics 2017; 140:peds.2017-1517. [PMID: 29066580 PMCID: PMC5654402 DOI: 10.1542/peds.2017-1517] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/23/2017] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To examine intelligence, language, and academic achievement through 18 years of age among children with congenital cytomegalovirus infection identified through hospital-based newborn screening who were asymptomatic at birth compared with uninfected infants. METHODS We used growth curve modeling to analyze trends in IQ (full-scale, verbal, and nonverbal intelligence), receptive and expressive vocabulary, and academic achievement in math and reading. Separate models were fit for each outcome, modeling the change in overall scores with increasing age for patients with normal hearing (n = 78) or with sensorineural hearing loss (SNHL) diagnosed by 2 years of age (n = 11) and controls (n = 40). RESULTS Patients with SNHL had full-scale intelligence and receptive vocabulary scores that were 7.0 and 13.1 points lower, respectively, compared with controls, but no significant differences were noted in these scores among patients with normal hearing and controls. No significant differences were noted in scores for verbal and nonverbal intelligence, expressive vocabulary, and academic achievement in math and reading among patients with normal hearing or with SNHL and controls. CONCLUSIONS Infants with asymptomatic congenital cytomegalovirus infection identified through newborn screening with normal hearing by age 2 years do not appear to have differences in IQ, vocabulary or academic achievement scores during childhood, or adolescence compared with uninfected children.
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Affiliation(s)
| | | | - Angelika H. Claussen
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sherry S. Vinson
- Texas Children’s Hospital, Houston, Texas;,Baylor College of Medicine, Houston, Texas; and
| | - Marie R. Turcich
- Texas Children’s Hospital, Houston, Texas;,Baylor College of Medicine, Houston, Texas; and
| | - Isabella R. Iovino
- Texas Children’s Hospital, Houston, Texas;,Baylor College of Medicine, Houston, Texas; and
| | - Robert G. Voigt
- Texas Children’s Hospital, Houston, Texas;,Baylor College of Medicine, Houston, Texas; and
| | | | - Jerry A. Miller
- Texas Children’s Hospital, Houston, Texas;,P3S Corporation, San Antonio, Texas
| | | | - Craig M. Hales
- National Center for Immunization and Respiratory Diseases, and
| | | | - Gail Demmler-Harrison
- Texas Children’s Hospital, Houston, Texas;,Baylor College of Medicine, Houston, Texas; and
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Jensen CL, Voigt RG, Prager TC, Zou YL, Fraley JK, Rozelle JC, Turcich MR, Llorente AM, Anderson RE, Heird WC. Effects of maternal docosahexaenoic acid intake on visual function and neurodevelopment in breastfed term infants. Am J Clin Nutr 2005; 82:125-32. [PMID: 16002810 DOI: 10.1093/ajcn.82.1.125] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Normal brain and visual development is thought to require exogenous docosahexaenoic acid (DHA; 22:6n-3) intake, but the amount needed is debatable. Because the supplementation of breastfeeding mothers with DHA increases the DHA content of their infants' plasma lipids, we hypothesized that it might also improve brain or visual function in the infants. OBJECTIVE The objective was to determine the effect of DHA supplementation of breastfeeding mothers on neurodevelopmental status and visual function in the recipient infant. DESIGN Breastfeeding women received capsules containing either a high-DHA algal oil ( approximately 200 mg DHA/d) or a vegetable oil (no DHA) for 4 mo after delivery. Outcome variables included the fatty acid pattern of maternal plasma phospholipid and milk lipids 4 mo postpartum, the fatty acid pattern of plasma phospholipids and visual function in infants at 4 and 8 mo of age, and neurodevelopmental indexes of the infants at 12 and 30 mo of age. RESULTS Milk lipid and infant plasma phospholipid DHA contents of the supplemented and control groups were approximately 75% and approximately 35% higher, respectively, at 4 mo postpartum. However, neither the neurodevelopmental indexes of the infants at 12 mo of age nor the visual function at 4 or 8 mo of age differed significantly between groups. In contrast, the Bayley Psychomotor Development Index, but not the Mental Development Index, of the supplemented group was higher (P < 0.01) at 30 mo of age. CONCLUSION DHA supplementation of breastfeeding mothers results in higher infant plasma phospholipid DHA contents during supplementation and a higher Bayley Psychomotor Development Index at 30 mo of age but results in no other advantages either at or before this age.
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Affiliation(s)
- Craig L Jensen
- US Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center and the Meyer Center for Developmental Pediatrics, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA.
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Jensen CL, Voigt RG, Prager TC, Zou YL, Fraley JK, Rozelle JC, Turcich MR, Llorente AM, Anderson RE, Heird WC. Effects of maternal docosahexaenoic acid intake on visual function and neurodevelopment in breastfed term infants. Am J Clin Nutr 2005. [DOI: 10.1093/ajcn/82.1.125] [Citation(s) in RCA: 185] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Craig L Jensen
- From the US Department of Agriculture/Agricultural Research Service Children’s Nutrition Research Center (CLJ, JKF, and WCH) and the Meyer Center for Developmental Pediatrics (RGV, JCR, MRT, and AML), Department of Pediatrics, Baylor College of Medicine, Houston, TX; the Hermann Eye Center, University of Texas Health Science Center, Houston, TX (TCP and YLZ); and the Dean A McGee Eye Institute, U
| | - Robert G Voigt
- From the US Department of Agriculture/Agricultural Research Service Children’s Nutrition Research Center (CLJ, JKF, and WCH) and the Meyer Center for Developmental Pediatrics (RGV, JCR, MRT, and AML), Department of Pediatrics, Baylor College of Medicine, Houston, TX; the Hermann Eye Center, University of Texas Health Science Center, Houston, TX (TCP and YLZ); and the Dean A McGee Eye Institute, U
| | - Thomas C Prager
- From the US Department of Agriculture/Agricultural Research Service Children’s Nutrition Research Center (CLJ, JKF, and WCH) and the Meyer Center for Developmental Pediatrics (RGV, JCR, MRT, and AML), Department of Pediatrics, Baylor College of Medicine, Houston, TX; the Hermann Eye Center, University of Texas Health Science Center, Houston, TX (TCP and YLZ); and the Dean A McGee Eye Institute, U
| | - Yali L Zou
- From the US Department of Agriculture/Agricultural Research Service Children’s Nutrition Research Center (CLJ, JKF, and WCH) and the Meyer Center for Developmental Pediatrics (RGV, JCR, MRT, and AML), Department of Pediatrics, Baylor College of Medicine, Houston, TX; the Hermann Eye Center, University of Texas Health Science Center, Houston, TX (TCP and YLZ); and the Dean A McGee Eye Institute, U
| | - J Kennard Fraley
- From the US Department of Agriculture/Agricultural Research Service Children’s Nutrition Research Center (CLJ, JKF, and WCH) and the Meyer Center for Developmental Pediatrics (RGV, JCR, MRT, and AML), Department of Pediatrics, Baylor College of Medicine, Houston, TX; the Hermann Eye Center, University of Texas Health Science Center, Houston, TX (TCP and YLZ); and the Dean A McGee Eye Institute, U
| | - Judith C Rozelle
- From the US Department of Agriculture/Agricultural Research Service Children’s Nutrition Research Center (CLJ, JKF, and WCH) and the Meyer Center for Developmental Pediatrics (RGV, JCR, MRT, and AML), Department of Pediatrics, Baylor College of Medicine, Houston, TX; the Hermann Eye Center, University of Texas Health Science Center, Houston, TX (TCP and YLZ); and the Dean A McGee Eye Institute, U
| | - Marie R Turcich
- From the US Department of Agriculture/Agricultural Research Service Children’s Nutrition Research Center (CLJ, JKF, and WCH) and the Meyer Center for Developmental Pediatrics (RGV, JCR, MRT, and AML), Department of Pediatrics, Baylor College of Medicine, Houston, TX; the Hermann Eye Center, University of Texas Health Science Center, Houston, TX (TCP and YLZ); and the Dean A McGee Eye Institute, U
| | - Antolin M Llorente
- From the US Department of Agriculture/Agricultural Research Service Children’s Nutrition Research Center (CLJ, JKF, and WCH) and the Meyer Center for Developmental Pediatrics (RGV, JCR, MRT, and AML), Department of Pediatrics, Baylor College of Medicine, Houston, TX; the Hermann Eye Center, University of Texas Health Science Center, Houston, TX (TCP and YLZ); and the Dean A McGee Eye Institute, U
| | - Robert E Anderson
- From the US Department of Agriculture/Agricultural Research Service Children’s Nutrition Research Center (CLJ, JKF, and WCH) and the Meyer Center for Developmental Pediatrics (RGV, JCR, MRT, and AML), Department of Pediatrics, Baylor College of Medicine, Houston, TX; the Hermann Eye Center, University of Texas Health Science Center, Houston, TX (TCP and YLZ); and the Dean A McGee Eye Institute, U
| | - William C Heird
- From the US Department of Agriculture/Agricultural Research Service Children’s Nutrition Research Center (CLJ, JKF, and WCH) and the Meyer Center for Developmental Pediatrics (RGV, JCR, MRT, and AML), Department of Pediatrics, Baylor College of Medicine, Houston, TX; the Hermann Eye Center, University of Texas Health Science Center, Houston, TX (TCP and YLZ); and the Dean A McGee Eye Institute, U
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Llorente AM, Sines MC, Rozelle JC, Turcich MR, Casatta A. Effects of test administration order on children's neuropsychological performance: emerging one-word expressive and receptive language skills. Clin Neuropsychol 2000; 14:162-72. [PMID: 10916190 DOI: 10.1076/1385-4046(200005)14:2;1-z;ft162] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Differences in neuropsychological performance associated with specific test presentation sequences have been reported in adults. However, these effects have received little attention in children. The EOWPVT-R, a measure of one-word expressive language, and the PPVT-R, a measure of receptive language, were administered to 6- to 14-year-olds (control [n = 17] and experimental [n = 22] groups) in a counterbalanced fashion to investigate the potential effects of test presentation sequence on neuropsychological performance. Group findings were not evidenced subsequent to variation in test administration sequence. In contrast, order of test presentation revealed differences in performance. Administration of the PPVT-R prior to the EOWPVT-R resulted in enhanced EOWPVT-R expressive language scores in both groups of participants. Presentation of the PPVT-R after the EOWPVT-R did not affect performance. Applied and theoretical implications associated with these findings are discussed.
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Affiliation(s)
- A M Llorente
- Departments of Pediatrics, Baylor College of Medicine, TX, USA.
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