Predictors of Individual Differences in Attention Among Low Birth Weight Children

Robson, Ann L.; Pederson, David R.

doi:10.1097/00004703-199702000-00004

Cited by 21 publications

(15 citation statements)

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“…At 8 months of age, preterm infants of adolescent mothers in the control arm had the lowest Bayley Mental Development Index (MDI) scores (101) compared with preterm infants with adolescent mothers in the intervention arm (MDI 110), preterm infants with older mothers (MDI 111), and term infants with any aged mother (MDI 113.5). In a report of NRN data focusing on neurodevelopment outcomes relative to higher maternal age, Vohr et al 17 found an increased incidence of NDI or death in ELBW infants of adolescent mothers at 18 to 22 months corrected age (68% ,20 years old versus (24) 407 (24) .99 3+…”

Section: Discussionmentioning

confidence: 99%

“…8,22 Infant temperament, maternal depression, unwanted pregnancy, and quality of home environment have been found to be statistical predictors of behavioral problems, inattention, and aggression. [23][24][25] These same risk factors are embedded in adolescent motherhood. 9,26 Also, language delays in the first 10 months have been associated with psychopathology at school age, 25 and low levels of adult speech at 1 year predict later diagnosis of childhood behavior and psychiatric disorders.…”

Section: Discussionmentioning

confidence: 99%

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Developmental Outcomes of Extremely Preterm Infants Born to Adolescent Mothers

et al. 2015

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BACKGROUND AND OBJECTIVES: Extremely preterm infants and infants born to adolescent mothers are at risk for adverse developmental. The objectives were to evaluate development and behavior outcomes of extremely low birth weight (ELBW) infants born to adolescent mothers ,20 compared with adult mothers $20 years and to identify socioeconomic risk factors that affect outcomes.METHODS: Retrospective cohort analysis of 211 infants .27 weeks of adolescent mothers and 1723 infants of adult mothers at Neonatal Research Network centers from 2008 to 2011. Groups were compared and regression models were run to predict 18-to 22-month adverse outcomes. Primary outcomes were Bayley-III scores, neurodevelopmental impairment, and Brief Infant Toddler Social Emotional Assessment problem scores (BITSEA/P) $75th percentile.RESULTS: Adolescent mothers were more often single, Hispanic, less educated, and had public insurance. By 18 to 22 months, their children had significantly increased rates of having lived $3 places (21% vs 9%), state supervision (7% vs 3%), rehospitalization (56% vs 46%), and BITSEA/ P $75th percentile (50% vs 32%) and nonsignificant Bayley-III language scores ,85 (56% vs 49%, P = .07). In regression analysis, children of adolescent mothers were more likely to have BITSEA/P $75th percentile (relative risk 1.50, 95% confidence interval 1.08-2.07). Living $3 places and nonwhite race were predictors of adverse behavior. State supervision was an independent predictor of each Bayley-III composite ,70 and neurodevelopmental impairment.CONCLUSIONS: ELBW infants of adolescent mothers experience high social and environmental risks that are associated with adverse behavior outcomes. These findings inform the need for comprehensive follow-up, coordinated care services, and behavior interventions for ELBW infants of adolescent mothers.WHAT'S KNOWN ON THIS SUBJECT: Infants born extremely premature and infants born to adolescent mothers are at risk for adverse developmental and behavior outcomes. There is limited research on the dual risk imparted to infants born extremely premature to adolescent mothers. WHAT THIS STUDY ADDS:Extremely premature infants of adolescent mothers have significantly increased rates of behavior problems. Nonwhite race and living in $3 places by 18 to 22 months of age are risk factors for adverse behavior outcomes among infants of adolescent mothers. Dr Hoffman conceptualized and designed the study, drafted the initial manuscript, and approved the final manuscript as submitted; Dr Bann performed all the statistical analysis; Dr Higgins reviewed and approved the research protocol and final manuscript; and Dr Vohr mentored and assisted Dr Hoffman in conceptualizing and designing the study, revising the manuscript, and approving of the final manuscript as submitted. There are multiple coexisting socioeconomic and biologic factors that place extremely preterm infants of adolescent mothers at increased risk for adverse developmental and behavioral outcomes. Previous studies of extremely preterm in...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Developmental Outcomes of Extremely Preterm Infants Born to Adolescent Mothers

et al. 2015

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“…Further work is also needed to examine contexts that may contribute to differences in infant regulation. The negative impact of adverse or social risk environments on the behavioral and developmental trajectories of preterm infants are well known (Hack et al, 1992; Robson & Pederson, 1997; Robson & Cline, 1998). In preterm infants, caregiver and home context have been shown to moderate continuity between infant attention and later cognition (e.g., Sigman, Cohen, & Beckwith, 1997).…”

Section: Future Directions and Concluding Commentsmentioning

confidence: 99%

“…Attention problems found in preschool and older children born preterm are frequently described as attention deficit hyperactivity disorder (Bhutta, Cleves, Casey, Cradock, & Anand, 2002; Mick, Biederman, Prince, Fischer, & Faraone, 2002; Stjernqvist & Svenningsen, 1995; Szatmari, Saigal, Rosenbaum, Campbell, & King, 1990). However some propose that the attention problems in children born preterm may be more clearly understood as problems of self‐regulation (Grunau, 2003; Robson & Cline, 1998; Robson & Pederson, 1997) or of adaptive functioning (Schothorst & van Engeland, 1996). Consistent with this concept, many very preterm children have difficulty self‐regulating in structured situations, need ongoing adult support and feedback in learning or evaluation settings, and show significantly more “backing off” behaviors during cognitive assessment (Grunau, 2003; Whitfield, Grunau, & Holsti, 1997).…”

Section: Introductionmentioning

confidence: 99%

Focused attention, heart rate deceleration, and cognitive development in preterm and full‐term infants

Thomas

Whitfield

Oberlander

et al. 2011

Developmental Psychobiology

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The majority of children who are born very preterm escape major impairment, yet more subtle cognitive and attention problems are very common in this population. Previous research has linked infant focused attention during exploratory play to later cognition in children born full-term and preterm. Infant focused attention can be indexed by sustained decreases in heart rate (HR). However there are no preterm studies that have jointly examined infant behavioral attention and concurrent HR response during exploratory play in relation to developing cognition. We recruited preterm infants free from neonatal conditions associated with major adverse outcomes, and further excluded infants with developmental delay (Bayley Mental Development Index [MDI < 70]) at 8 months corrected age (CA). During infant exploratory play at 8 months CA, focused attention and concurrent HR response were compared in 83 preterm infants (born 23–32 weeks gestational age [GA]) who escaped major impairment to 46 full-term infants. Focused attention and HR response were then examined in relation to Bayley MDI, after adjusting for neonatal risk. MDI did not differ by group, yet full-term infants displayed higher global focused attention ratings. Among the extremely preterm infants born <29 weeks, fewer days on mechanical ventilation, mean longest focus, and greater HR deceleration during focused attention episodes, accounted for 49% of adjusted variance in predicting concurrent MDI. There were no significant associations for later-born gestational age (29–32 weeks) or full-term infants. Among extremely preterm infants who escape major impairment, our findings suggest unique relationships between focused attention, HR deceleration, and developing cognition.

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“…10,11 VLBW infants also have an increased risk for hearing loss, [12][13][14][15] speech and language delays, 12,[15][16][17][18][19][20][21][22] and behavioral and attentional disorders. 12,[22][23][24][25][26][27][28][29][30][31] Approximately 6% to 20% of VLBW children have cerebral palsy and related neurologic disability, compared with lower rates among NBW children. 12,32 Infants with bronchopulmonary dysplasia (with prolonged ventilation), history of severe intracranial hemorrhage, and cerebral white matter damage are particularly at risk for poor neurodevelopmental outcomes.…”

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confidence: 99%