Developmental Dimensions in Preterm Infants During the 1st Year of Life: The Influence of Severity of Prematurity and Maternal Generalized Anxiety

Abstract

Background: The literature has recognized premature birth as a risk factor for infant development and maternal anxiety. This study investigated the impact of the severity of birth weight, as well as of maternal anxiety at 3 months of infants' corrected age, on infants' outcomes during the 1st year postpartum. Moreover, it described the longitudinal trajectories of developmental outcomes, additionally exploring the impact of anxiety. Methods: The study compared 147 mothers and their 147 newborns, differentiated in 25 Extremely Low Birth Weight (ELBW), 41 Very Low Birth Weight (VLBW), and 81 Full-Term (FT) infants. At 3, 9, and 12 months (corrected age in the case of preterm infants) the level of infants' development was investigated according to the 5 quotients (Locomotor, Personal and Social, Hearing and Language, Eye-hand Coordination and Performance) of the Griffiths Mental Development Scales (GMDS-R). During the assessment of 3 months, mothers fulfilled Penn State Worry Questionnaire (PSWQ) to evaluate the presence of generalized anxiety. Results: Among the 5 GMDS-R quotients, significant effect of severity of birth weight emerged only for Performance quotient: preterm infants (ELBW at 3 months; VLBW at 12 months) showed lower scores than FT ones. Moreover, this quotient decreased from 3 to 9 and to 12 months for VLBW and FT infants, while it was stable for ELBW ones. A significant interaction between severity of birth weight and maternal anxiety emerged for Hearing and Language and Locomotor quotients. In the first case, scores for ELBW infants, independently from maternal anxiety, decreased from 9 to 12 months. The same results emerged for VLBW infants, in the case of non-anxious mothers. Regarding Locomotor quotient, mean scores decreased from 3 to 9 and to 12 months for all groups in the case of non-anxious mothers. Conversely, when mothers were anxious, this decrease emerged only for VLBW infants. Lastly, ELBW, VLBW and FT showed difference in the growth and slope of the trajectories of different quotients.

Reciprocal Influence of Depressive Symptoms Between Mothers and Fathers During the First Postpartum Year: A Comparison Among Full-Term, Very Low, and Extremely Low Birth Weight Infants

“…This result stresses the relevance to distinguish among different preterm populations in research and clinical intervention. Indeed, parents' mental state may be especially impaired in case of higher severity of prematurity, and this is supported by our previous studies ( 21 , 22 , 64 ). For ELBW parents, the first postpartum trimester can represent a highly vulnerable period due to baby's health issues and the parental adjustment after discharge from NICU, and these factors do play a key role in increasing the risk for PND ( 65 , 66 ).…”

“…EPDS mean and categorical scores according to birth weight, time of assessment and parental gender. 64. ± 0.49 4.84 ± 0.44 3.87 ± 0.41 7.83 ± 0.70 5.71 ± 0.62 4.11 ± 0.58 5.46 ± 0.70 3.97 ± 0.62 3.63 ± 0.58 VLBW 4.92 ± 0.42 4.10 ± 0.37 4.00 ± 0.35 5.66 ± 0.59 4.44 ± 0.52 4.32 ± 0.49 4.19 ± 0.60 3.75 ± 0.53 3.69 ± 0.50 FT 4.94 ± 0.33 4.43 ± 0.29 3.92 ± 0.27 5.19 ± 0.45 4.76 ± 0.40 4.19 ± 0.38 4.70 ± 0.47 4.10 ± 0.41 3.65 ± 0.39…”

Effect of family-centered care interventions on motor and neurobehavior development of very preterm infants: a protocol for systematic review

“…Family and home-based environments are considered to have the greatest and permanent effect on an infant's growth within ecological system, even when taking into consideration of certain other aspects such as education and socioeconomic status of the parents [10]. Birth of a very preterm infant affects the mental well-being of the parents, leading to distress and anxiety and alters the sense of bonding and parenting skills to care [11]. A review conducted to see the effects of discharge communication practices in pediatric emergency care reported, parental education as an early intervention strategy that might provide a signi cant opportunity for improving parent comprehension along with bene ts of health outcomes of children [12].…”

Effect of Family-centered Care Interventions on Motor and Neurobehavior Development of Very Preterm Infants: A Protocol of Systematic Review

“…Family and home-based environments are considered to have the greatest and permanent effect on an infant's growth within the ecological system, even when taking into consideration of certain other aspects such as education and socioeconomic status of the parents [9]. The birth of a very preterm infant affects the mental well-being of the parents, leading to distress and anxiety and alters the sense of bonding and parenting skills to care [10]. A review on the effects of early intervention for very preterm infants found that early intervention strategies addressing the relationship between parent-child was effective when compared to interventions centered on the child or the parent alone.…”