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

Erica Neri,Marcello Stella,Elena Trombini,Francesca Agostini,Fiorella Monti,Augusto Biasini,Federica Genova

doi:10.3389/fpsyg.2020.00455

Erica Neri, Marcello Stella + Show 5 more

Open Access

https://doi.org/10.3389/fpsyg.2020.00455

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Abstract

BackgroundThe 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.MethodsThe 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 Co-ordination 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.ResultsAmong 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.ConclusionThe severity of birth weight for preterm infants, also in interaction with maternal anxiety, had significant and specific impact on different dimensions of infants’ development. Clinical implications of these results underline the need for individualized interventions.

Highlights

Prematurity is globally defined as every childbirth which occurs before the 37 gestational weeks (World Health Organization, 2012); today, preterm infants represent a large and heterogeneous population according to their clinical conditions
In line with the third aim, we explored the trajectories of each GMDS-R quotient in ELBW, VLBW and Full Term (FT) infants as a function of time and maternal anxiety
Regarding the Performance quotient, which measures skills in manipulation, speed of working and precision, as well as the ability to apply them in novel situations (Griffith, 1996), a first result showed that, independently from time of assessment, both ELBW and VLBW infants had lower scores than FT ones

Summary

Introduction

Prematurity is an unexpected and traumatic event during childbirth (Korja et al, 2012; Helle et al, 2016; Neri et al, 2017) and it represents a serious risk factor for child development, with possible sequelae and/or impairments in the brief and long term (Anderson, 2014; Jarjour, 2015; Rogers and Hintz, 2016; Vungarala and Rajeswari, 2018; Marchman et al, 2019).A preterm birth negatively influences the transition to parenthood (Rieves et al, 2016; Kerr et al, 2017), as parents, especially mothers, feel disoriented and frightened and might experience feelings of guilt, grief and recurrent worries about their baby’s survival and health (Mendelsohn, 2005; Korja et al, 2009, 2010; Shah et al, 2011; Lasiuk et al, 2013; Ionio et al, 2019; Pisoni et al, 2019).According to an estimation by the World Health Organization, each year approximately 15 million babies are born prematurely, worldwide (Blencowe et al, 2012). Prematurity is globally defined as every childbirth which occurs before the 37 gestational weeks (World Health Organization, 2012); today, preterm infants represent a large and heterogeneous population according to their clinical conditions. 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. It described the longitudinal trajectories of developmental outcomes, exploring the impact of anxiety

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Conclusion