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...