Infant physiological regulation and maternal risks as predictors of dyadic interaction trajectories in families with a preterm infant.

Abstract

This longitudinal study examined predictors of rates of growth in dyadic interaction quality in children born preterm who did not experience significant neurological findings during neonatal intensive care unit (NICU) hospitalization. Multiple methods were used to collect data from 120 preterm infants (48% girls, 52% boys) and their mothers. Infant heart rate variability (HRV), gestational age, neonatal health, feeding route, and maternal socioeconomic (SES) risks were assessed at NICU discharge (mean of 36 weeks postconception). Mother–child interactions were observed at 4, 9, 16, and 24 months postterm and analyzed with hierarchical linear modeling. On average, children’s quality of play, interest, and attention increased over time while their dysregulation and irritability decreased, whereas average maternal positive affect and involvement declined in quality (ps < .05), although there was individual variation in rates of change. Mothers of infants with higher postfeeding HRV (i.e., vagal regulation) exhibited less decrease in positive affect and involvement between 4 months and 24 months, compared with mothers of infants with lower HRV (p < .05). Although infants with higher postfeeding HRV showed less positive affect and communication at 4 months, they exhibited significantly greater increases in positive affect and social competence and decreases in dysregulation and irritability between 4 months and 24 months, compared with infants with lower HRV (ps < .05). Dyads experiencing more SES risks showed less optimal interactions at 4 months; this difference remained as children grew older (ps < .05). Results have implications for our understanding of social development in preterm infants.

Quality of caregiver-child play interactions with toddlers born preterm and full term: Antecedents and language outcome

“…We individually matched FT to PT participants to ensure that group comparisons were not the result of differences that might affect caregiver-child interactions: age corrected for the degree of prematurity, sex [14], and socioeconomic status [22]. SES was assessed using the Hollingshead Four-Factor Index [27].…”

“…For example, in a longitudinal study of caregiver-child interactions, children born PT from families with greater SES risks tended to have caregivers who exhibited higher levels of maternal intrusiveness and insensitivity compared to children born PT from families with lower SES risks [22]. However, difference in interactional qualities may arise because PT children show decreased responsiveness with caregivers [23] and high-risk PT children show less exploration with objects, compared to children born FT [24].…”

“…PT vs. FT group membership would not moderate the associations between socioeconomic status (SES), sex, and child interactional behavior on a composite of caregiver interactional behaviors [13–15, 22–25]. …”

Predictors of parenting stress trajectories in premature infant–mother dyads.

“…The PCERA has an acceptable range of internal consistency (Clark, 1999; in the current study, on average, across times: PCERA 1 = .95, PCERA 2 = .89, PCERA 3 = .93) and discriminate validity between high-risk and well-functioning mothers (Clark, Paulson, & Conlin, 1993). The PCERA has been used previously with preterm infants (Brown, 2007), and has been linked to their subsequent developmental and behavioral outcomes (Poehlmann, Schwichtenberg, Bolt, et al, 2011; Poehlmann, Schwichtenberg, Shlafer, et al, 2011). …”

“…Even though some neonatal problems may be viewed as temporary, parent–infant dyads who began their relationships under stressful circumstances may continue to experience greater interactive difficulty than those who did not experience this difficult beginning (Muller-Nix et al, 2004). Premature birth may affect parental perceptions and attitudes, thereby distorting normal parent–child interactions and relationships (Poehlmann, Schwichtenberg, Bolt, et al, 2011). …”