Abstract
Introduction: Although preterm birth represents a risk factor for early mother-infant interactions, few studies have focused on toddlerhood, an important time for the development of symbolic play, autonomous skills, and child's socialization competences. Moreover, no study has looked at the effect of birth weight on mother-child interactions during this period. Expanding on the available literature on prematurity, the main objective of this study was to explore the quality of mother-toddler interactions during play, using a longitudinal research design, as well as taking into account the effect of birth weight.Method: 16 Extremely Low Birth Weight (ELBW), 24 Very Low Birth Weight (VLBW), 25 full-term children, and their mothers were recruited for the present study. Mother-child dyads were evaluated at 18, 24, and 30 months of child age. Ten minutes of mother-child play interaction were recorded and later coded according to the Emotional Availability Scales (EAS). Furthermore, the child's level of development was assessed through the Griffiths Scale, and its contribution controlled for.Results: ELBW dyads showed an overall lower level of emotional availability, compared to VLBW and full-term dyads, but no main effect of birth weight was found on specific EA dimensions. Moreover, a significant effect of child age emerged. Overall scores, and Child Responsiveness and Involvement scores improved over time, independently of birth weight. Lastly, a significant effect of the interaction between birth weight and child age was found. Between 18 and 30 months, the overall quality of the interaction significantly increased in ELBW and VLBW dyads. Additionally, between 18 and 30 months, VLBW children significantly improved their responsiveness, while their mothers' sensitivity, structuring, and non-intrusive behaviors improved. In contrast, no change emerged in full-term dyads, although scores were consistently higher than those of the other groups.Discussion: Birth weight affects the quality of mother-toddler interactions. Monitoring the relational patterns of preterm dyads during toddlerhood is important, especially in the case of ELBW children.
Highlights
Preterm birth represents a risk factor for early mother-infant interactions, few studies have focused on toddlerhood, an important time for the development of symbolic play, autonomous skills, and child’s socialization competences
Extremely Low Birth Weight (ELBW) dyads showed an overall lower level of emotional availability, compared to Very Low Birth Weight (VLBW) and full-term dyads, but no main effect of birth weight was found on specific EA dimensions
Between 18 and 30 months, the overall quality of the interaction significantly increased in ELBW and VLBW dyads
Summary
Preterm birth represents a risk factor for early mother-infant interactions, few studies have focused on toddlerhood, an important time for the development of symbolic play, autonomous skills, and child’s socialization competences. Prematurity represents a serious risk factor for several crucial domains of infant life, including development (Bhutta et al, 2002), maternal mental health (Voegtline et al, 2010; Agostini et al, 2014; Neri et al, 2015), and the quality of the mother-infant relationship (Bozzette, 2007; Korja et al, 2012; Bilgin and Wolke, 2015) In this regard, a number of studies have found poorer motherinfant interactions in preterm dyads compared to full-term ones (Forcada-Guex et al, 2006; Bozzette, 2007; Feldman, 2007; Potharst et al, 2012). Some studies found mothers of preterm infants to be less sensitive than mothers of full term infants (Forcada-Guex et al, 2006, 2011; Korja et al, 2012), others failed to find significant differences (Montirosso et al, 2010; Agostini et al, 2014; Rahkonen et al, 2014; Bilgin and Wolke, 2015)
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