0791 The Association of Sleep with Developmental and Behavioral Factors in Premature Infants

Abstract

Abstract Introduction Children with neurodevelopmental conditions often experience sleep problems. Whereas sleep is a predictor of behavioral outcomes in children, there is limited evidence regarding sleep as an indicator of neurodevelopmental concerns. This study examined the prevalence of sleep issues and neurodevelopmental conditions in children with a history of prematurity, as well as the role of sleep as a potential indicator for future developmental and behavioral concerns. Methods Electronic health records of 57 young children (M = 31.9 gestational weeks, range = 23 to 40 weeks; 35.1% girls) presenting to a neonatal follow-up clinic were reviewed. Caregivers completed the Brief Infant Sleep Questionnaire (BISQ-R) between 6-16 corrected months (Mage = 11.6 mos) and then completed the Modified Checklist for Autism in Toddlers (M-CHAT) between 16-26 corrected months (Mage = 20.9 mos). Caregivers also completed the Survey of Wellbeing of Young Children (SWYC; n = 56; Mage = 20.9 mos) and the Brief Infant-Toddler Social and Emotional Assessment (BITSEA; n = 32; Mage = 17.4 mos). Results Approximately one-quarter (26.3%) of subjects had a caregiver-perceived child sleep problem at ages 6-16 corrected months. A total of 40.4% of children had clinically significant autism concerns on the M-CHAT and 67.9% had clinically significant concerns on the SWYC. Subsequent caregiver ratings showed that 25.0% of children exhibited challenging behaviors and 34.4% lower social-emotional competency on the BITSEA. Children who demonstrated clinically significant autism risk on the M-CHAT were more likely to have a prior caregiver-identified child sleep problem. Those who later failed the M-CHAT also had increased night waking frequency (2.43 vs 1.82 wakings) earlier in development. Logistic regression indicated that caregiver-identified sleep problems significantly predicted subsequent challenging behaviors on the BITSEA but not later neurodevelopmental concerns on the SWYC or social-emotional competencies on the BITSEA. Conclusion These pilot data suggest that a caregiver-identified child sleep problem at age 6-16 months corrected is linked to more frequent challenging child behaviors in toddlerhood (16-26 corrected months). Caregiver-identified child sleep problems and more night wakings also predicted later neurodevelopmental concerns. Sleep problems in premature infants may thus be an early indication of later behavioral and neurodevelopmental issues. Support (if any)