Maternal Sensitivity in Parenting Preterm Children: A Meta-analysis

Bilgin, Ayten; Wolke, Dieter

doi:10.1542/peds.2014-3570

Cited by 119 publications

(112 citation statements)

References 85 publications

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“…Furthermore, we hypothesized that very preterm birth as a proximate of neurodevelopmental vulnerability would be related to regulatory problems. In contrast, we hypothesized that preterm birth would be unrelated to maternal sensitivity in accordance with findings of a recent meta-analysis [16]. …”

Section: Introductionsupporting

confidence: 53%

Development of comorbid crying, sleeping, feeding problems across infancy: Neurodevelopmental vulnerability and parenting

Bilgin

Wolke

2017

Early Human Development

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Background: Regulatory problems (excessive crying, feeding, and sleeping difficulties), specifically their comorbidity, are early warning signs of future problems. Insensitive parenting and neurodevelopmental vulnerabilities have been suggested as factors explaining development or maintenance of regulatory problems. Nevertheless, none of the previous studies investigated these factors within the same sample across infancy, taking into account the reciprocal influences between maternal sensitivity and regulatory problems.Aim: To investigate the prospective association between very preterm birth, comorbid regulatory problems and maternal sensitivity.Subjects: 178 participants including 73 very preterm/very low birth weight and 105 full-term infants and their caretakers.Study Design: A prospective study from birth to 18 months.Measures: Regulatory problems were measured at term, 3 months and 18 months with a structured parental interview. Maternal sensitivity was measured with a nurse observation at term; and a researcher observation of play tasks at 3 months and at 18 months.Results: Very preterm birth was associated with regulatory problems at term (β=0.19, SE= 0.10, p< 0.05) and at 18 months (β=0.21, SE= 0.10, p< 0.05), while it had no association to maternal sensitivity across infancy. There were no cross-lagged reciprocal effects between maternal sensitivity and regulatory problems across infancy. Maternal sensitivity at term had a negative association to regulatory problems at 3 months (β=-0.26, SE= 0.12, p< 0.05), but not from 3 to 18 months.Conclusions: Neurodevelopmental vulnerabilities provided more consistent prediction of regulatory problems in comparison to sensitive parenting.

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Section: Introductionsupporting

confidence: 53%

Development of comorbid crying, sleeping, feeding problems across infancy: Neurodevelopmental vulnerability and parenting

Bilgin

Wolke

2017

Early Human Development

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“…This may be especially true for parents of VP infants born in the NICU whose self-efficacy may be diminished in this very stressful period with the infant medically at risk and partially cared for by others such as nurses. Although parents of VP/VLBW infants may not be overall less sensitive than those of term-born infants, 24 VP/VLBW infants may require a higher quality of parenting for favorable cognitive development.…”

Section: Discussionmentioning

confidence: 99%

Neonatal predictors of cognitive ability in adults born very preterm: a prospective cohort study

Breeman

Jaekel

Baumann

et al. 2017

Develop Med Child Neuro

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Aim To identify neonatal predictors to allow a developmental prognosis of the cognitive abilities of survivors born very preterm/very low birthweight (VLBW) into adult life. Method The Bavarian Longitudinal Study is a prospective whole‐population study that followed 260 infants born very preterm/VLBW from birth to adulthood. Regression analyses examined which neonatal factors predicted adult IQ. Results Neonatal morbidity, neonatal treatment, and early social environment of infants born very preterm/VLBW explained 37.6% of the variance in adult IQ. Seven unique early‐life predictors of lower adulthood IQ were found: respiratory distress syndrome, intraventricular haemorrhage, problems with mobility, mechanical ventilation, less parenteral nutrition, low/middle socioeconomic status, and poor early parent–infant relationships. Specifically, modifiable factors such as mechanical ventilation predicted a drop of 0.43 IQ points for each day of treatment, adjusted for initial respiratory problems. Good early parent–infant relationships predicted an approximately 5‐point increase in adult IQ, adjusted for other significant predictors such as socioeconomic status. Interpretation Mechanical ventilation, parenteral feeding, and early parenting were identified as significant modifiable factors that were strongly related to adult IQ. Mechanical ventilation policies have changed but there is scope for early interventions that focus on positive parenting, which may reduce the adverse effects of very preterm/VLBW birth on cognitive abilities.

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“…17,18 Furthermore, the finding that mothers of VP/VLBW show, on average, no differences in their sensitivity in interaction compared to FT mothers is also consistent with findings of a recent meta-analysis of thirty-four studies. 30 The investigation of the association between feeding problems and maternal sensitivity showed that in VP/VLBW infants, low maternal sensitivity was not a predisposing factor for feeding problems across infancy. Rather, when VP/VLBW infants had difficulties in feeding, there was a decline in subsequent maternal sensitivity at the next assessment point, i.e.…”

Section: Discussionmentioning

confidence: 99%

“…This finding is in line with the literature showing that the challenges of preterm birth do not translate into poorer maternal sensitivity. 30 There are some strengths and limitations of the study. The main strength of this study is that it assessed maternal sensitivity and feeding problems longitudinally at the same time points which allowed us to use a cross-lagged design.…”

Section: Discussionmentioning

confidence: 99%

Associations Between Feeding Problems and Maternal Sensitivity Across Infancy: Differences in Very Preterm and Full-Term Infants

Bilgin

Wolke

2017

J Dev Behav Pediatr

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Objectives: To determine the influence of maternal sensitivity on infant feeding problems in very preterm/very low birth weight (VP/VLBW) and full-term (FT) infants.Methods: Longitudinal study of 178 infants (73 VP/VLBW and 105 FT). Feeding problems and maternal sensitivity were assessed at term, 3 and 18 months. A cross-lagged path model was tested to assess the longitudinal associations.Results: The direction of the association between maternal sensitivity and feeding problems differed among VP/VLBW and FT infants. In VP/VLBW infants, higher feeding problems at term and 3 months were associated with less maternal sensitivity at 3 months (β = -0.27, p < 0.05) and at 18 months (β = -0.36, p < 0.05), respectively. In FT infants, a reciprocal relationship of feeding problems and maternal sensitivity over time was found. Feeding problems at 3 months were associated with decreased maternal sensitivity at 18 months (β = -0.32, p < 0.05) while decreased maternal sensitivity at 3 months was related to increased feeding problems at 18 months (β = -0.25, p < 0.05).Conclusions: Feeding problems are frequent in VP/VLBW infants and subsequently are associated with poorer maternal sensitivity. In FT infants, poorer levels of maternal sensitivity were both predicted by feeding problems but also were associated with more feeding problems over time.Keywords: feeding, maternal sensitivity, preterm birth, infancy. 2 INTRODUCTIONFeeding problems are a major concern during infancy and toddlerhood with a prevalence rate of approximately 20% to 30%. 1 The earlier the onset of these problems, the more severe and persistent the consequent eating problems tend to be. Parent-infant relationships have most often been studied in those referred for feeding problems.11 The observed maladaptive interactions in such dyads may be the result of the feeding problems 12,13 and do not allow any conclusions that these have been their precursors.Longitudinal studies identified family factors 2,14 or maternal negative emotionality 15 as precursors of persisting feeding problems, however, these were all based on parent selfreports rather than direct observations of mother-infant interaction. We are aware of two prospective studies that observed maternal sensitivity and feeding problems over time, one of which revealed no longitudinal influence of maternal sensitivity on feeding problems at 10 months and 2 years of age; 16 the other study showed that maternal mind-mindedness at 6 months, which may predict maternal sensitivity, was related to positive feeding behaviors at 1 year of age. 9 There is thus a surprising lack of prospective cross-lagged designs to disentangle the currently unclear direction of associations between infant feeding problems and maternal sensitivity over time. This study investigated, firstly, whether VP/VLBW infants have more feeding problems in infancy compared to FT infants and whether there are any differences in between the groups in maternal sensitivity. Secondly, the direction of the association between maternal sen...

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Maternal Sensitivity in Parenting Preterm Children: A Meta-analysis

Cited by 119 publications

References 85 publications

Development of comorbid crying, sleeping, feeding problems across infancy: Neurodevelopmental vulnerability and parenting

Development of comorbid crying, sleeping, feeding problems across infancy: Neurodevelopmental vulnerability and parenting

Neonatal predictors of cognitive ability in adults born very preterm: a prospective cohort study

Associations Between Feeding Problems and Maternal Sensitivity Across Infancy: Differences in Very Preterm and Full-Term Infants

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