23 PROSPECTIVE STUDY OF FACTORS PREDISPOSING TO NON-ORGANIC FAILURE-TO-THRIVE (NOFT)

Abstract

A 40 minute standarized interview (INT) based on factors previously associated with child neglect and abuse, was given to 1400 consecutive low income prenatal patients after informed consent. Using arbitrary criteria, 273 were selected as high risk (HR). NOFT (< 2/3 average weight gain due to inadequate feeding) was diagnosed and managed without knowledge of HR status. The incidence of NOFT in 228 infants born to HR mothers was compared to 200 infants selected randomly from all remaining mothers (LR). NOFT occurred in: 20 of 197 HR and 5 of 180 LR infants at age 2-18 weeks (p < .01): 16 of 159 HR and 4 of 132 LR at 8-18 weeks (p < .05): 14 of 110 HR and 3 of 110 LR at 18-32 weeks (p < .01). The correlations (r) of individual INT parameters with NOFT were determined in 274 mothers selected randomly from all 1400. Family life stress, and maternal (MAT) nurturance as child, support from others and parenting discipline skills had highest r (p < .05): MAT pregnancy attitude, personality traits and child development knowledge had lower r (p < .05). Non-INT parameters with highest r were poor MAT child-rearing attitudes at 8 months gestation and perception of her child as difficult to care for a 1 and 3 months; r approached p .05 for low birth weight and female sex of infant, and low MAT education. MAT age parity race and pregnancy complications, and Brazelton scores, had low r (p > .05).