Effects of Infant Risk Status and Maternal Psychological Distress on Maternal-Infant Interactions During the First Year of Life

Abstract

The associations of infant medical risk, prematurity, and maternal psychological distress with the quality of maternal-infant interactions during the first year of life were evaluated in a prospective, longitudinal follow-up from birth. A total of 103 high-risk very low birth weight (VLBW) infants with bronchopulmonary dysplasia, 68 low-risk VLBW infants without bronchopulmonary dysplasia, and 117 healthy term infants were seen at 1, 8, and 12 months of age. Videotaped feedings at each age were rated using the Nursing Child Assessment Feeding Scale, and mothers completed the Brief Symptom Inventory as a measure of psychological distress. VLBW infant status was related to both maternal and infant behaviors as well as to maternal distress, and these relationships varied with infant age. Overall, VLBW infants displayed fewer responsive, clear interactions, with differences from term infants increasing over time. Maternal distress was related to less cognitive growth fostering for all mothers. Because maternal distress is more prevalent in mothers of VLBW infants postpartum, intervention efforts should focus on assessment of maternal distress and the challenges posed by the interactive behaviors of VLBW infants.

The influence of maternal and child characteristics and paternal support on interactions of mothers and their medically fragile infants

“…Developmental stimulation was the combination of two mother behaviors (talking and teaching) and the provision of play materials subscale of the HOME. These variables were derived theoretically to capture two major types of positive maternal interactive behaviors known to affect development in premature and medically fragile infants and to be affected by maternal depression (Berlin et al, 1995;Field, 1995;Poehlmann & Fiese, 2001;Singer et al, 2003). Each mother behavior and HOME subscale score was converted into a Z-score, using 6 and 12 months data separately (thereby removing age-related differences).…”

“…Depressive symptoms were found to affect feeding interactions between mothers and their VLBW infants with and without bronchopulmonary dysplasia (BPD; Singer, Davillier, Preuss, et al, 1996) and the feeding competency and caregiving of mothers of non-chronically ill preterm infants (Pridham et al, 2005;Pridham, Lin, & Brown, 2001). Mothers of low-risk, high-risk VLBW and term infants with higher levels of psychological distress provided less cognitive growth promoting stimulation than mothers with lower levels of psychological distress (Singer et al, 2003). Adaptation to the infant's signals and positive touch were each negatively related to elevated maternal depressive symptoms in mothers of VLBW infants (Keren, Feldman, Eidelman, Sirota, & Lester, 2003).…”

“…Mothers experience stress and alterations in parental roles during their infants' long hospitalizations (Lau & Morse, 2003;Miles, Holditch-Davis, Brunssen, Burchinal, & Wilson, 2002;Miles, Holditch-Davis, Burchinal, & Nelson, 1999). After hospital discharge, caring for the infant's severe health conditions can be overwhelming (Landry, Chapieski, Richardson, Palmer, & Hall, 1990;Singer et al, 2003). In the medically fragile infant's first year, mothers spend much of their time involved with physical treatments and thus may be less aware of infant social behaviors than mothers of healthier infants (Kashiwagi & Shirataki, 1995).…”

The Effect of Maternal Depressive Symptoms and Early Maternal Feeding Behavior on Later Infant Feeding Behavior

“…Infants must be able to master internal regulation of physiological systems before a dyadic quality is possible in their interactions. Singer and her colleagues 19 found full-term infants to be more responsive and give clearer cues than premature infants during the first year of life. Premature infants who experience more health complications at birth typically exhibit more interactional difficulty through the first postterm year than infants with fewer medical complications such as periventricular leukomalacia, bronchopulmonary dysplasia, and acute respiratory disease.…”

“…Premature infants who experience more health complications at birth typically exhibit more interactional difficulty through the first postterm year than infants with fewer medical complications such as periventricular leukomalacia, bronchopulmonary dysplasia, and acute respiratory disease. [19][20][21] …”