Parental Psychological Well-Being and Behavioral Outcome of Very Low Birth Weight Infants at 3 Years

Huhtala, Mira; Korja, Riikka; Lehtonen, Liisa; Haataja, Leena; Lapinleimu, Helena; Rautava, Päivi

doi:10.1542/peds.2011-2411

Cited by 115 publications

(81 citation statements)

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“…16 Some studies of preschool children born preterm have used the well-known instrument the Child Behavior Checklist (CBCL), 17,18 which defines domains of dysfunction, and have reported increased CBCL Total Problem scores and Internalizing and Externalizing scores, but none of the studies has reported on the CBCL-Dysregulation Profile (CBCL-DP). 19–21 The CBCL-DP has been defined as representing a syndrome not defined by the DSM and is related to severe psychopathology and outcomes 22 in youth.…”

Section: Introductionmentioning

confidence: 99%

Antecedents of the Child Behavior Checklist–Dysregulation Profile in Children Born Extremely Preterm

Frazier

Wood

Ware

et al. 2015

Journal of the American Academy of Child & Adolescent Psych

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Objective Extremely preterm newborns are at heightened risk for emotional and behavioral dysregulation later in childhood. Our goal was to systematically evaluate the antenatal and early postnatal antecedents that might mediate the association between extreme preterm birth and emotional and behavioral dysregulation at age 2 years (corrected age). Method In a multi-site, prospective study, the parents of 826 infants born before 28 weeks gestation completed a Child Behavior Checklist (CBCL) when the child was 2 years corrected age. We compared the maternal, pregnancy, placenta, delivery, and newborn characteristics, as well as early postnatal characteristics and exposures of those who satisfied criteria for the CBCL-dysregulation profile (CBCL-DP) to those of their peers. We then used time-oriented logistic regression models, starting first with antenatal variables that distinguished children with the CBCL-DP profile from their peers, and then added the distinguishing postnatal variables. Results Approximately 9% of the children had a CBCL-DP. In the time-oriented logistic regression model with antenatal variables only, low maternal education achievement, passive smoking, and recovery of Mycoplasma from the placenta were associated with increased risk, while histologic chorioamnionitis was associated with reduced risk. None of the postnatal variables added statistically significant discriminating information. Conclusion Very preterm newborns who later manifest the CBCL-DP at age two years differ in multiple ways from their preterm peers who do not develop the CBCL-DP, raising the possibility that potentially modifiable antenatal and early postnatal phenomena contribute to the risk of developing emotional and behavioral dysregulation.

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Section: Introductionmentioning

confidence: 99%

Antecedents of the Child Behavior Checklist–Dysregulation Profile in Children Born Extremely Preterm

Frazier

Wood

Ware

et al. 2015

Journal of the American Academy of Child & Adolescent Psych

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“…A possible contributing factor to positive behavioural outcomes may be due to an increased interaction between parents and their children in both groups during the study period and perhaps this was reinforced by the regular email communication with parents. A similar outcome was found by Huhtala et al, who reported that their cohort of very low birth weight children at three years of age did not have more behavioural problems than their full-term peers (Huhtala et al, 2012).…”

Section: Discussionsupporting

confidence: 84%

Physiotherapy intervention for 4-5 year old children born extremely preterm and/or extremely low birth weight

Brown¹

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Neurodevelopmental impairments amongst the extremely low birth weight (ELBW) or extremely preterm population are well recognised. However, support services for these children who have mild impairments are lacking. This research aimed to explore the performance of a group of non-disabled ELBW or extremely preterm children with minimal/mild impairments over a 12 month period at a critical time-point, coinciding with the commencement of formal education. Performance of these children was established, as well as whether impairments persist. Persistence of impairments may suggest a widening gap between performance of these children and expected performance of term born peers. Additionally, this research aimed to investigate the short term and longer term impact of group-based physiotherapy intervention compared to standard care. SubjectsFifty children born ELBW and/or extremely preterm (26 males; mean birth weight: 838.8g, SD 174.8g; mean gestational age: 27.0 weeks, SD 2.0 weeks) with minimal/mild motor impairments and a mean age (corrected for prematurity) of 50 months (SD 2.6 months) at baseline. Twenty-four children were randomised to intervention and 26 children to standard care. MethodsChildren were assessed by paediatric physiotherapists blinded to group allocation. A set testing protocol was used. Baseline assessment included: Movement Assessment Battery for Children second-edition (MABC-2), tests of postural stability and limb strength, Child Behavior Checklist (CBCL) and Beery Visual-Motor Integration Test 5 th Edition (Beery VMI). Following baseline assessment, children were randomly allocated to intervention or standard care. All children were assessed on motor and postural tests at the conclusion of the intervention. Goal Attainment Scaling (GAS) was utilised within the intervention group. At one year post baseline assessment, all children were assessed on baseline tests, as well as Peabody Picture Vocabulary Test 4 th Edition (PPVT-4). The group had low average motor co-ordination, lower than expected postural stability and strength, and acceptable behaviour. Mean percentile rank on MABC-2 was 31%.However, 30% of children had a score less than or equal to the 15 th percentile, indicating at risk of or having a definite motor problem and these children had poorer postural outcomes compared to children with normal motor performance. Behaviour was within normal range according to performance on CBCL, although between 11-15% of children had a score within the clinical range. Behaviour of males was poorer than that of females. Study IV: GAS to explore effect of group-based physiotherapy intervention on personal growth of non-disabled ELBW children Intervention was effective with GAS mean T score of the group exceeding the expected level (mean=58.17, SD=0.82). Goal attainment was associated with motor co-ordination 4 and children with better motor skills post intervention, were more successful in reaching goals. Females improved more than males on GAS. Study V: Behaviour of 4-5 year old non-disabled E...

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“…16,17 Preterm infants' behavioral, emotional, and neurologic problems at later ages have been shown to be multietiologic and explained in part by neurologic and cognitive deficits due to prematurity 1,2,[18][19][20][21] and psychosocial factors. [22][23][24] The role of the preterm infant' s regulatory competence in the development of later behavioral symptoms is still unknown. Persistent crying problems that last beyond 3 months of age have been related to later hyperactivity and other behavioral problems in the full-term population.…”

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confidence: 99%

Preterm Infant’s Early Crying Associated With Child’s Behavioral Problems and Parents’ Stress

Korja¹,

Huhtala

Maunu³

et al. 2014

Pediatrics

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WHAT'S KNOWN ON THIS SUBJECT: Preterm infants are at an increased risk of regulatory difficulties during infancy and of behavioral problems in childhood. In the full-term population, persistent crying problems that last beyond 3 months of age have been related to later behavioral problems. WHAT THIS STUDY ADDS:Excessive crying by a preterm infant may reflect an increased risk for later behavioral problems and higher parenting stress even years later. Therefore, it is clinically relevant to assess systematically the crying behavior of preterm infants.abstract OBJECTIVE: To study how the early crying behavior of preterm infants at term, 6 weeks, and 5 months of corrected age is related to later behavioral problems at age 3 and 4 years and parenting stress at 2 and 4 years. METHODS:The study group included 202 live-born, low birth weight infants (birth weight #1500 g) born from January 2001 through December 2006 at the Turku University Hospital, Finland. A Baby Day Diary was used to assess the preterm infants' crying behavior at term, 6 weeks, and 5 months of corrected age. The children' s behavior was assessed using the Child Behavior Check List at 3 and 4 years old, and parenting stress was assessed by using the Parenting Stress Index when the child was 2 and 4 years old. RESULTS:The duration and frequency of crying bouts in infancy was associated with Child Behavior Check List scores at 4 years old and to both mothers' and fathers' stress when the child was 2 and 4 years old.CONCLUSIONS: Early excessive crying, especially if lasting up to 5 months of corrected age, is a clinically relevant signal in preterm infants because it may reflect infants' regulatory problems and/or parenting stress. The crying behavior of preterm infants should be systematically inquired about at well-baby clinics. Copyright © 2014 by the American Academy of Pediatrics FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose. FUNDING:Funding for the full-time research work was received from the Emil Aaltonen Foundation and by the Hospital District of South-West Finland. The funding sources had no role in the study design; in the collection, analysis, or interpretation of data; in the writing of the article; or in the decision to submit it for publication. POTENTIAL CONFLICT OF INTEREST:The authors have indicated they have no potential conflicts of interest to disclose. Preterm infants are at a higher risk than term-born infants for regulatory difficulties during infancy and for behavioral problems in childhood. [1][2][3][4] During infancy, 1 sign of regulatory problems is excessive crying and fussing. It has been suggested that an infant' s crying pattern is biologically based but may be modified by environmental factors, such as caregiving styles and physical holding. [5][6][7][8] In test situations in previous studies, preterm infants exhibited more irritability and difficulties in negative affect and state regulation. 9,10 However, in the home environment, preterm infa...

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Parental Psychological Well-Being and Behavioral Outcome of Very Low Birth Weight Infants at 3 Years

Cited by 115 publications

References 50 publications

Antecedents of the Child Behavior Checklist–Dysregulation Profile in Children Born Extremely Preterm

Antecedents of the Child Behavior Checklist–Dysregulation Profile in Children Born Extremely Preterm

Physiotherapy intervention for 4-5 year old children born extremely preterm and/or extremely low birth weight

Preterm Infant’s Early Crying Associated With Child’s Behavioral Problems and Parents’ Stress

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