Compared with full-terms, preterm individuals are more at risk from infancy to adulthood for developing internalizing symptoms. Early maternal interactive behavior, especially maternal sensitivity, has been found to be a resilience factor in the developmental outcome of preterm children. The present longitudinal study aimed at examining whether early interactive parenting behaviors have a long term impact on the internalizing symptoms of preterm-born young adolescents. A total sample of 36 very preterm and 22 full-term children participated in an 11-year follow-up study. Maternal interactive behavior was assessed during a mother-infant interaction when the infant was 18 months old. At 11 years, internalizing symptoms were assessed with the Child Behavior Checklist (CBCL). Hierarchical regression analyses revealed that the interaction between groups (preterm/full-term) and maternal sensitivity at 18 months significantly explained CBCL internalizing symptoms at 11 years (β = -0.526; p < 0.05). Specifically, although prematurity was related to internalizing problems, preterm children with higher maternal sensitivity did not differ from their full-term-born peers on the CBCL internalizing problems domain. These results suggest that maternal sensitivity is a long-term resilience factor preventing the development of internalizing problems at early adolescence in very preterm individuals.

IntroductionPreterm birth may generate significant distress among the parents, who often present with difficulties in appropriating their parental role. Parental stress and low perceived parental self-efficacy may interfere with the infant’s socioemotional and cognitive development, particularly through disrupted parent–infant interactions. Perceived parental self-efficacy represents the belief of efficacy in caring for one’s own infant and successful incarnation of the parental role, as well as the perception of one’s own abilities to complete a specified task. Interventions to support parental role, as well as infant development, are needed, and parental self-efficacy represents a useful indicator to measure the effects of such early interventions.Methods and analysisThis study protocol describes a randomised controlled trial that will test an early intervention in the neonatal intensive care unit (NICU) (JOIN: Joint Observation In Neonatology) carried out by an interdisciplinary staff team. Mothers of preterm neonates born between 28 and 32 6/7 weeks of gestational age are eligible for the study. The intervention consists of a videotaped observation by a clinical child psychologist or child psychiatrist and a study nurse of a period of care delivered to the neonate by the mother and a NICU nurse. The care procedure is followed by an interactive video guidance intended to demonstrate the neonate’s abilities and resources to his parents. The primary outcome will be the difference in the perceived maternal self-efficacy between the intervention and control groups assessed by self-report questionnaires. Secondary outcomes will be maternal mental health, the perception of the parent– infant relationship, maternal responsiveness and the neurodevelopment of the infant at 6 months corrected age.Ethics and disseminationEthical approval was granted by the Human Research Ethics Committee of the Canton de Vaud (study number 496/12). Results from this study will be disseminated at national and international conferences, and in peer-reviewed journals.Trial registration numberNCT02736136, Pre-results.

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Suite à une naissance prématurée, les parents vivent un stress parfois intense et l’enfant expérimente un début de vie particulier où les contacts corporels proches sont quelque peu entravés. Ces éléments peuvent marquer la mise en place de la régulation émotionnelle chez le petit enfant. Les capacités de mentalisation s’ancrent au moins en partie sur ces capacités de régulation émotionnelle qui se construisent dans la relation à l’autre et l’on peut faire l’hypothèse que la prématurité peut marquer les capacités de mentalisation du parent comme de l’enfant et ceci même chez des enfants nés très prématurément exempts de séquelles. C’est ce qu’a voulu mettre en évidence l’étude présentée ici. A partir des entretiens d’attachement réalisés 18 mois puis 11 ans après la naissance, cette étude montre comment la naissance d’un grand prématuré (≤ à 32 semaines de gestation) peut affecter les capacités de mentalisation d’une dyade mère-enfant confrontée à cet événement périnatal.After a premature birth, the parental stress could be very intense and the child could experience a particular start of life without usual skin and body contact. These elements could strongly affect the initial adjustment allowing the future emotional regulation capacities of the child. The mentalization competencies are based at least in part on this emotional regulation which develops through the relationship with others. Thus, we can make the hypothesis that the premature birth could affect the mentalization competencies even with preterm born children without after-effects due to the prematurity. This is the purpose of the present study. On the basis of attachment interviews with parents and children 18 months and 11 years after the birth, this study shows how prematurity impacts the mentalization competencies of the mother-child dyad confronted to this adverse perinatal event

L’objectif de cette étude est de valider une nouvelle grille de codage pour le Lab-TAB (Goldsmith et Rothbart, 1999). Cette grille mesure l’intensité émotionnelle et les comportements de régulation chez l’enfant âgé de six mois. L’accord interjuges se révèle satisfaisant. Les analyses factorielles ont mis en évidence trois facteurs - attention , niveau d’activité et détournement actif – retrouvés dans la littérature comme stratégies de régulation émotionnelle. Les analyses de consistance interne démontrent une bonne homogénéité de ces facteurs. La validité externe se révèle satisfaisante aux niveaux concourant et prédictif. Enfin, cet outil de codage permet de distinguer les prématurés et les nés à terme. L’ensemble de ces résultats indiquent que l’outil élaboré présente de bonnes qualités psychométriques.