Persistence of Effects of VLBW/PT Birth Status and Maternal Emotional Availability (EA) on Child EA Trajectories

Abstract

Few studies have examined the longitudinal impact of birth status on the infant–mother relationship and on children’s socio-emotional development. In the present study we investigated developmental patterns of such relationships [using the Emotional Availability (EA) Scales] in fullterm and VLBW/PT infants from infancy to emerging school age. Our objectives were to: (a) model the developmental trajectories of EA dimensions (maternal sensitivity, structuring, non-hostility; child responsiveness, involvement) in a VLBW/PT and fullterm sample, (b) identify potential effects of VLBW/PT status on these trajectories, and (c) determine whether the effects of VLBW/PT status on children’s socio-emotional development (child EA) remained after accounting for the effect of maternal EA. Child–mother dyads (n = 109) were observed in home-based interactions (face-to-face and free play) when children were 6, 12, 18, and 57-months-old in fullterm (37–41 weeks, >2500 g; n = 48) and healthy VLBW/PT (26–32 weeks gestation, birth weight 800–1500 g, corrected for gestational age; n = 61) children. Developmental trajectories of maternal and child EA were assessed using multilevel growth modeling in Mplus. Results indicated that, even after controlling for maternal EA, there was a persistent negative effect of VLBW/PT birth status on child EA trajectories. Both initially and over time, VLBW/PT infants lagged behind their fullterm counterparts on levels of responsiveness and involvement with mothers. There was also a persistent positive effect of maternal EA (sensitivity and structuring) on child EA trajectories. Higher average levels of maternal sensitivity and structuring across time were also associated with higher and persistent levels of child responsiveness and involvement of their mothers. Importantly, results held after modeling both effects together, and after controlling for maternal education and child gender. Our results have implications for VLBW/PT children’s development, the parent–child relationship, and integrating family level factors and relationship dimensions in early prevention and intervention programs.

Association of Neonatal Pain-Related Stress and Parent Interaction With Internalizing Behaviors Across 1.5, 3.0, 4.5, and 8.0 Years in Children Born Very Preterm

“…18 Moreover, considerable literature suggests that supportive and structured parenting is associated with improved neurodevelopmental and behavioral outcomes in children born very preterm 19,20 ; however, few longitudinal studies have investigated long-term benefits. 6,21,22 In an earlier cohort, 9 we found that sensitive and warm (nonhostile) parent interactions partially ameliorated the negative association of neonatal painrelated stress on internalizing behaviors at age 1.5 years, whereas parenting stress was associated with greater prevalence of these behaviors. It is unknown whether a supportive parenting environment (parenting stress and parent behavior) attenuates the association between neonatal pain-related stress and child internalizing behaviors beyond 1.5 years.…”

Emotional Availability: Clinical Populations and Clinical Applications

“…Because the EA-Z were not available with the 2nd edition of the EA Scales, we did not have information on "emotional attachment" of these children using the EA-Z. Findings from Salvatori et al (2016) echo the Stack et al (2019) findings in that when the mothers' EA improved between 18 and 30 months, the child's EA also improved over this time period. However, what was clear in the Salvatori et al (2016) study was that the EA-Z were lowest in the extremely low birth weight (ELBW) group compared to the VLBW and control groups (note that the weight of the VLBW is slightly higher than that of the ELBW), whereas Human Development 2022;66:192-215 DOI: 10.1159/000525256 they were not able to pick up these EA issues in any of the individual dimensions.…”

“…Very Low Birth Weight/Prematurity. To our knowledge, the study by Stack et al (2019) is not the first study of EA in families with a child with very low birth weight (VLBW) or prematurity, but they are the first to follow these children over time, in line with the clear increase in the use of EA in longitudinal work. Stack et al (2019) conducted a 4-wave longitudinal (child age 6, 12, 18, and 57 months) of infants born with VLBW (VLBW and preterm [PT], defined as 800-1,500 g, corrected for gestational age).…”

“…To our knowledge, the study by Stack et al (2019) is not the first study of EA in families with a child with very low birth weight (VLBW) or prematurity, but they are the first to follow these children over time, in line with the clear increase in the use of EA in longitudinal work. Stack et al (2019) conducted a 4-wave longitudinal (child age 6, 12, 18, and 57 months) of infants born with VLBW (VLBW and preterm [PT], defined as 800-1,500 g, corrected for gestational age). Their results indicated that VLBW/PT infants (both initially at 6 months and over time until 57 months) had lower child EA toward their mothers (responsiveness and involvement of the mother) when compared to full-term infants.…”

A Study of Maternal Competence in Preterm Birth Condition, during the Transition from Hospital to Home: An Early Intervention Program’s Proposal

“…Furthermore, evolutionary frailties in preterm infants may impair their ability to express emotional states, including crying, making it difficult for mothers to attune to their child's needs. Several studies have associated preterm birth with altered maternal behaviours [21][22][23][24][25][26]. Mothers of preterm infants are likely to touch, smile at, and speak to their babies much less frequently than mothers of full-term babies [22,27].…”