Infant Behavior Questionnaire-Revised Research Articles

Early Regulatory Skills and Social Communication Development in Infants with Down Syndrome

Children with Down syndrome (DS) demonstrate substantial variability in communication and language outcomes. One potential source of variability in this skill area may be early regulatory function. Characterizing the early link between regulatory function and early social communication may benefit infants with DS at risk of difficulties with social communication and language skill acquisition. Forty-three infants with DS were assessed at two time points, six months apart. At Time 1, the average chronological age was 9.0 months (SD = 3.9) and caregivers completed the Infant Behavior Questionnaire-Revised (IBQ-R) to assess regulatory function. Six months later, caregivers rated infant communication at the second visit using the Communication and Symbolic Behavior Scales Infant Toddler Checklist (CSBS-ITC). Infant developmental level was assessed at both visits using the Bayley Scales of Infant and Toddler Development, Third Edition and caregivers reported on developmental history and biomedical comorbidities. Infant regulatory function at Time 1 predicted social communication outcomes at Time 2, six months later. Findings from this study suggest that elevated risk for pronounced communication challenges may be detectable as early as infancy in DS.

The Infant Behavior Questionnaire – Revised: psychometric properties at 2 weeks, 3, 6 and 12 months of life

BackgroundTemperament characteristics are key elements for infants' development. The Infant Behavior Questionnaire – Revised (IBQ-R) is one of the most used measures to assess temperament in infants aged between 3 and 12 months. Its reliability and factor structure have not yet been examined in infants younger than 3 months. AimsTo analyze the reliability of the IBQ-R at 2 weeks and the IBQ-R factor structure from 2 weeks to 12 months of life. MethodA longitudinal repeated measures design was used. Three hundred mothers completed the IBQ-R when their infants were 2 weeks, and 3, 6 and 12 months. ResultsAt 2 weeks the proportion of “non-applicable” responses was higher in duration of orienting, high intensity pleasure, approach and smiling and laughter scales. The Cronbach's alpha for the IBQ-R dimensions ranged between 0.62 and 0.63 and the McDonald's omega ranged between 0.67 and 0.80, all dimensions exhibited a mean-scale correlation above 0.15, and more than half of the scales revealed a scale-dimension correlation higher than 0.30. The same factor structure was found at 2 weeks, and at 3, 6, and 12 months: surgency/extraversion, p < 0.001, negative affectivity, p < 0.001, and orienting regulation, p = 0.007. ConclusionsThe IBQ-R may be applied in the first weeks of life and its factor structure remains stable when applied across different ages throughout infancy.

Subgroups of Temperament Associated with Social-Emotional Difficulties in Infants with Early Signs of Autism.

Links between temperament and social-emotional difficulties are well-established in normative child development but remain poorly characterized in autism. We sought to characterize distinct temperament subgroups and their associations with concurrent internalizing and externalizing symptoms in a sample of 103 infants (Mage = 12.39 months, SD = 1.97; 68% male) showing early signs of autism. Latent profile analysis was used to identify subgroups of infants with distinct temperament trait configurations on the Infant Behavior Questionnaire-Revised. Derived subgroups were then compared in terms of internalizing and externalizing symptoms on the Infant-Toddler Social and Emotional Assessment. Three distinct temperament subgroups were identified: (a) inhibited/low positive (n = 22), characterized by low Smiling and Laughter, low High-Intensity Pleasure, low Vocal Reactivity, and low Approach; (b) active/negative reactive (n = 23), characterized by high Activity Level, high Distress to Limitations, high Sadness, high Fear, and low Falling Reactivity; and (c) well-regulated (n = 51), characterized by high Cuddliness, high Soothability, and high Low-Intensity Pleasure. There were no differences in infant sex ratio, mean age or developmental/cognitive ability. Inhibited/low-positive infants had significantly more behavioral autism signs than active/negative reactive and well-regulated infants, who did not differ. Inhibited/low-positive and active/negative reactive infants had higher internalizing symptoms, relative to well-regulated infants, and active/negative reactive infants also had higher externalizing symptoms. These findings align closely with those garnered in the context of normative child development, and point to child temperament as a putative target for internalizing and externalizing interventions. LAY SUMMARY: This study explored whether infants with early signs of autism could be grouped according to temperament characteristics (i.e., emotional, behavioral, and attentional traits). Three subgroups were identified that differed with respect to emotional and behavioral difficulties. Specifically, "inhibited/low-positive" infants had high emotional difficulties, "active/negative reactive" infants had high emotional and behavioral difficulties, while "well-regulated" infants had the lowest difficulties.

Impact Of Postpartum Exercise On Maternal Health And Infant Physical Activity And Sleep Behaviours

Physical activity (PA) has many implications for health, including effects on weight loss, body mass index (BMI), and sleep behaviours. The literature has established a relationship between mother-child physical activity, however, the impact of this interaction is unknown during the postpartum period. PURPOSE: To determine if a structured postpartum resistance training intervention with strollers and babies (60 minutes/session, twice/week for 10 weeks) improves maternal health outcomes and if infant physical activity (IPA) levels and infant sleep behaviours (ISB) are impacted. METHODS: Forty-six women voluntarily enrolled in the Active Mom, Active Baby Intervention. Measures were taken at baseline (t1), 5-weeks (t2; mid-intervention), and 10-weeks (t3; post-intervention). At each time point, maternal weight (kg) was used to calculate BMI (kg/m2), and maternal physical activity (MPA) levels were measured using the self-reported International Physical Activity Questionnaire-long form (IPAQ-L). Infants were assessed using the Rothbart Infant Behaviour Questionnaire-Revised (IBQ-R) for PA and sleep behaviours. A nonparametric test was conducted to determine if there was a significant change in maternal weight, BMI, and PA levels (light, moderate, and vigorous) across the intervention. Comparisons in IPA and ISB were made using a one-way ANOVA with repeated-measures. A post hoc comparison was completed using the Bonferroni test through the three time points. RESULTS: Maternal age of participants (n=46) was 32.0±3.5 years at 16.6±7.5 weeks postpartum. The results showed a significant (p<0.001) decrease in maternal weight (-1.4±0.04kg) and BMI (-0.5±0.005kg/m2) across the intervention. There was no significant difference in light- or moderate- PA in the mother, however, vigorous-intensity PA increased from t1 (214.2±331.3MET-mins/week) to t2 (837.3±516.7MET-mins/week; p<0.001) and was maintained until t3 (736.0±582.6MET-mins/week; p>0.001). There was a significant increase in scores for IPA from t1 (3.89±0.85) to t2 (4.47±0.83; p<0.001) to t3 (4.80±0.93; p<0.001). No change in infant sleep behaviour was found between time points. CONCLUSION: A postpartum exercise intervention with babies can increase physical activity in both mother and infant, resulting in maternal weight loss.

0161 Greater Negative Affectivity Predicts Shorter Infant Sleep Duration

Abstract Introduction Certain temperament characteristics in infants have been shown to be associated with infant sleep patterns. However, other sleep-related practices, such as co-sleeping and breastfeeding, are also known to be associated with sleep in infancy and are not always taken into account in studies assessing the association between temperament and sleep. Thus, this study aims to examine the associations between infant temperament and sleep parameters at six months of age, while controlling for co-sleeping and breastfeeding practices. Methods Mother-infant dyads (n=60) were recruited in the metropolitan Montreal area and consented to participate in the study. Infant sleep was reported by mothers at six months of age (±1 month) using sleep diaries (two-week period). Total nocturnal and longest consecutive sleep duration were retrieved from the diaries and averaged through the two-week period. Temperament was measured with the Infant Behaviour Questionnaire-Revised (IBQ-R). Sleep-related parental practices (co-sleeping and breastfeeding) were measured using the Sleep Practices Questionnaire (SPQ). Multiple regression analyses were conducted to determine the degree to which the temperament composite negative affectivity predicted total nocturnal and longest consecutive sleep duration while controlling for breastfeeding and co-sleeping practices. Results Regression analyses revealed significant regression models for total nocturnal (F(3,44)=6.25, p=.001, R2=.30), and longest consecutive sleep duration (F(3,44)=6.26, p=.001, R2=.30). Greater infant negative affectivity predicted shorter nocturnal sleep duration (β;;=-0.28, p=.034) and shorter longest consecutive sleep duration (β;;=-0.34, p=.010) after adjusting for breastfeeding and co-sleeping practices. Conclusion Findings suggest infants with greater negative affectivity sleep for fewer hours during the night and have shorter periods of consecutive sleep, even when sleep-related parental practices are considered. These results provide further support for the relationship between infant temperament and sleep at six months of age. Future research should investigate the relationship between infant temperament and sleep using paternal report in addition to maternal report. Support SSHRC

Maternal choline and respiratory coronavirus effects on fetal brain development

Prenatal COVID-19 infection is anticipated by the U.S. Centers for Disease Control to affect fetal development similarly to other common respiratory coronaviruses through effects of the maternal inflammatory response on the fetus and placenta. Plasma choline levels were measured at 16 weeks gestation in 43 mothers who had contracted common respiratory viruses during the first 6–16 weeks of pregnancy and 53 mothers who had not. When their infants reached 3 months of age, mothers completed the Infant Behavior Questionnaire-Revised (IBQ-R), which assesses their infants’ level of activity (Surgency), their fearfulness and sadness (Negativity), and their ability to maintain attention and bond to their parents and caretakers (Regulation). Infants of mothers who had contracted a moderately severe respiratory virus infection and had higher gestational choline serum levels (≥7.5 mM consistent with U.S. Food and Drug Administration dietary recommendations) had significantly increased development of their ability to maintain attention and to bond with their parents (Regulation), compared to infants whose mothers had contracted an infection but had lower choline levels (<7.5 mM). For infants of mothers with choline levels ≥7.5 μM, there was no effect of viral infection on infant IBQ-R Regulation, compared to infants of mothers who were not infected. Higher choline levels obtained through diet or supplements may protect fetal development and support infant early behavioral development even if the mother contracts a viral infection in early gestation when the brain is first being formed.

Association between Gut Microbiota and Infant's Temperament in the First Year of Life in a Chinese Birth Cohort.

Infant temperament characteristics play a critical role in children’s developmental pathways and can predict adulthood psychopathology. The diversity and composition of the gut microbiota are associated with human temperament in both adults and young children. However, the relationship between the gut microbiota and temperament in 12-month-old infants is rarely studied; this developmental period is when temperament reaches a relatively stable stage. We used high-throughput sequencing methods to explore whether temperament characteristics were associated with gut microbiota diversity and composition. Infants’ fecal samples were collected at 12 months of age for the gut microbiota analysis. Based on the primary caregivers’ reports, infants’ temperaments were measured using the Infant Behavior Questionnaire-revised (IBQ-R). This study included 51 infants, including 20 boys and 31 girls, with a mean age of 12.25 months. Results showed that soothability was positively correlated with maternal education level (β = 0.29, p = 0.043, adjust p = 0.025) and the abundance of Bifidobacterium genera (β = 0.62, p = 0.004, adjust p = 0.002). Conversely, cuddliness was negatively correlated with the abundance of Hungatella genera. There was no significant difference in temperament based on gender. This study demonstrated that gut microbiota composition was associated with temperament in 12-month-old infants. These results point to the importance of gut microbiota balance. Future studies on the mechanisms behind the gut microbiota affecting temperament are warranted.

Effect of Maternal Distress on Perceptions of Infant Behavior May Differ in Chinese-American and European-American Mothers and Infants.

This study examined the associations between maternal distress (symptoms of depression and anxiety) and observer and maternal ratings of infant temperament in Chinese-American (CA) and European-American (EA) 4-month-old infants (N = 114 dyads). Maternal distress was obtained through self-reported symptoms of depression and anxiety. Mothers reported infant temperament (distress at limitations, soothability, and fear) through the short form of the Infant Behavior Questionnaire-Revised. To obtain observer-rated infant reactivity, infants were administered a battery of visual and auditory stimuli in the laboratory, in which infant behaviors (fret/cry, limb activity, and arching of the back) were coded. Maternal distress accounted more for the maternal perception of her infant among EA mothers than among CA mothers, but the relation was only observed for soothability. Higher maternal distress was associated with maternal report of lower soothability for EA mothers. Observer-rated infant reactivity, but not maternal distress, was positively associated with EA and CA maternal report of distress at limitations. Observer-rated infant negativity was associated with somewhat higher ratings of infant fear for EA mothers, although this association for EA mothers was not significantly different from CA mothers. Potential biases in maternal report of infant behavior due to effects from maternal distress may not be generalizable across cultures but may vary because of cultural norms for emotional experience and expectations for infant behavior. EA mothers' ratings of infant distress and soothability, but not fear, may be influenced by maternal distress.

Reflective function in first-time mothers and fathers: Association with infant temperament and parenting stress

ObjectiveInfant temperament is biologically determined. However, there is increasing proof that environmental factors may also have a relevant influence. The present study focuses on the role of parental reflective function (RF; Fonagy et al., 1998), that is, the psychological basis of emotion regulation. MethodsRF was assessed in 40 low-risk first-time parents during the seventh month of pregnancy, using the Adult Attachment Interview (AAI; Main, Goldwyn, & Hesse, 1984–2002). At the baby's sixth month, parents responded to the Infant Behavior Questionnaire–Revised (Gartstein & Rothbart, 2003), aimed to evaluate the child's perceived temperament and the Parenting Stress Index–SF (Abidin, 1995). Parents’ depression was measured with the Edinburgh Postnatal Depression Scale (EPDS; Benvenuti et al., 1999). ResultsNo difference was found between mothers and fathers regarding RF and depression scores. Self-reported depression was associated with lower scores of RF. Lower RF during pregnancy was associated with higher child dysfunctional interaction in both mothers and fathers. Also, lower maternal RF was associated with higher perceived infant sadness whereas lower paternal RF was associated with higher infant negative affectivity. ConclusionsEarly parenting programs should enhance maternal and paternal reflective functioning to promote sensitive caregiving behaviors and support the child's development.

The relationships among MAOA, COMT Val158Met, and 5-HTTLPR polymorphisms, newborn stress reactivity, and infant temperament.

IntroductionVariance in hypothalamic–pituitary–adrenal (HPA) axis reactivity is considered to be one of the sources of differences in infant temperament. The cortisol enters into interactions with dopamine and serotonin, so it is expected that polymorphisms in genes coding monoamine metabolism influence both HPA axis reactivity and temperament.MethodsWe therefore explore the relationship among 5‐HTTLPR S/L, MAOA H/L, and COMT Val158Met polymorphisms, the stress reaction of newborn infants after a heel stick blood draw (measured by determining salivary cortisol at three time points), and temperament assessed at the age of 3 months using Rothbart's Infant Behavior Questionnaire—Revised (IBQ‐R) with a sample of 84 infants.ResultsThe decrease in the salivary cortisol correlated with nine primary scales and all three secondary scales of IBQ‐R. Children with a greater cortisol decrease were assessed as less susceptible to negative emotions, more extraverted, and more regulated. The polymorphisms that were observed were related both to the course of the stress reaction and to temperament. The 5‐HTTLPR S allele was connected to higher scores for Negative Emotionality and lower scores for Orienting/Regulatory Capacity. The presence of the MAOA L allele predisposed its carriers to higher scores for Negative Emotionality, lower scores for Orienting/Regulatory Capacity, and a lower decrease in cortisol. The Met allele of COMT Val158Met polymorphism was connected to a higher Positive Affectivity/Surgency and Orienting/Regulatory Capacity and a greater cortisol decrease.ConclusionsContrary to previous studies referring mainly basal cortisol and its increase, the results of our study emphasize the importance of cortisol elimination in infant temperament. Another interesting finding was a higher cortisol increase, higher Distress to Limitations, Negative Emotionality, and Approach in MAOA LL homozygotes which are traditionally understood as more vulnerable toward early stress in developing later externalizing behavior.

Maternal pre-pregnancy body mass index and offspring temperament at 3 months

Introduction: Pre-pregnancy obesity has been linked to emotional and behavioural problems in offspring, though it remains unclear when the presence of these difficulties first emerges.&#x0D; Method: We examined the association between maternal pre-pregnancy body mass index (BMI) and temperament at 3 months of age in the offspring of 16 women residing in Hamilton, Ontario. Infant temperament was measured using the Infant Behaviour Questionnaire Revised, which specifically examined surgency/extraversion, negative affectivity, and orienting/regulation.&#x0D; Results: A statistically significant association was observed between maternal BMI and infant negative affectivity (B=0.05, 95% CI=0.01-0.08), which remained significant after adjusting for confounding variables (B=0.04, 95% CI=0.01-0.08).&#x0D; Conclusion: The current study provides evidence that fetal exposure to high maternal BMI during pregnancy is associated with increased negative affectivity in infants at 3 months of age. The results suggest that the intrauterine environment associated with high maternal BMI may influence temperament at a very early stage in development.

Gut microbiota composition is associated with temperament traits in infants

BackgroundOne of the key behavioral phenotypes in infancy are different temperament traits, and certain early life temperament traits have been shown to precede later mental health problems. Differences in the gut microbiota composition (GMC) have been suggested to link with neurodevelopment. For example, toddler temperament traits have been found to associate with differences in GMC; however, studies in infants are lacking although infancy is a rapid period of neurodevelopment as well as GM development. Thus, we aimed to investigate association between infant GMC and temperament. MethodsThe study population (n = 301, 53% boys) was drawn from the FinnBrain Birth Cohort Study. Stool samples were collected from the 2.5-month-old infants and sequenced with 16S Illumina MiSeq platform. GMC taxonomic composition (at Genus and OTU level), observed sample clusters, diversity and richness were investigated in relation to the maternal reports of Infant Behavior Questionnaire -Revised (IBQ-R) at the age of 6 months. ResultsThree sample clusters (Bifidobacterium/Enterobacteriaceae, Bacteroides, V. Dispar) based on GMC were identified, of which Bifidobacterium/Enterobacteriaceae–cluster presented with higher scores on the IBQ-R main dimension regulation and its subscale duration of orienting compared to Bacteroides-cluster. The clusters associated with temperament in a sex-dependent manner. The IBQ-R main dimension surgency (positive emotionality) was associated positively both with genus Bifidobacterium and Streptococcus. Alpha diversity had a negative association with negative emotionality and fear reactivity. ConclusionThis is the first study demonstrating associations, but not causal connections, between GMC and temperament in young infants in a prospective design.

Influence of in utero exposure to maternal depression and natural disaster-related stress on infant temperament at 6 months: The children of Superstorm Sandy.

This study examined the effects of in utero exposure to maternal depression and Superstorm Sandy, a hurricane that hit metropolitan New York in 2012, on infant temperament at 6 months. Temperament was assessed using the Infant Behavior Questionnaire-Revised. Maternal depression was measured by the Edinburgh Postnatal Depression Scale. The main effects and the interaction of maternal depression and Sandy exposure on infant temperament were examined using a multivariable generalized linear model. Results show that prenatal maternal depression was associated with lower emotion regulation and greater distress. Stratification and interaction analyses suggested that the adverse effects of prenatal maternal depression on problematic temperament were amplified by in utero Sandy exposure. This study underscores the importance of providing prenatal screening and treatment for maternal depression during pregnancy while also identifying high-risk families who may have suffered from disaster-related traumas to provide necessary services. As the frequency of natural disasters may increase due to climate change, it is important to understand the consequences of in utero stress on child development and to formulate plans for early identification.

Infant temperament, maternal feeding behaviours and the timing of solid food introduction.

Despite guidance from the World Health Organization and the U.K. Department of Health, many mothers introduce solid food before their infant is 6 months old. The current study aimed to investigate relationships between maternal feeding behaviours (preintroduction and postintroduction to solids), infant temperament, and the timing of introduction to solid food. Eighty‐one women were recruited on low‐risk maternity units and were contacted at 1 week, 3, and 6 months postpartum. Mothers of infants (45 males, 36 females, mean birth weight 3.52 kg [SD 0.39]) completed the behaviours component of the Infant Feeding Style Questionnaire via telephone interview at 3 months. At 6 months, they were observed feeding their infant solid food at home and reported infant temperament using the Infant Behaviour Questionnaire‐Revised (short form). Partial correlations (covariates: birth weight, maternal age, breastfeeding duration, and postnatal depression) revealed negative associations between age of introduction to solid food and temperament (smiling and laughter) and laissez‐faire milk feeding behaviours; and positive associations between age of introduction to solid food and restrictive milk feeding behaviours and verbal involvement during an observed mealtime. Hierarchical multiple regression analysis revealed that an infant's birth weight and the degree to which their mothers perceive them to smile and laugh are key predictors of when they will be introduced to solid food, over and above other variables of interest (e.g., maternal milk feeding behaviours, breastfeeding duration, and postnatal depression).

Attentional bias assessed by a facial expression cuing paradigm in infants

To disambiguate infants’ attentional bias towards fearful facial expressions, we applied a facial expression cueing paradigm to 36 6-month-old and 33 12-month-old infants, with 21 infants taking part at both ages. Infants made saccades towards a peripheral target preceded by a happy, fearful, or neutral cue directing their attention to the target location (congruent) or the wrong location (incongruent). The results show that infants were faster to respond when shown a fearful (vs. happy) face as a congruent cue, which is consistent with previous studies referring to fearful vigilance, while an incongruent fearful cue reduces attention shifts to the target on the opposite side of the monitor to a greater extent than an incongruent happy cue at 12 months, implying that a fearful facial expression prolongs attentional disengagement or is associated with a greater narrowing of attention. Additionally, the latencies of 6-month-olds were significantly faster than those of 12-month-olds in a congruent condition. The relationship between attentional bias and temperamental disposition was examined using the Infant Behavior Questionnaire–Revised. High temperamental orienting scores partly correlated with attentional bias at 12 months. The contributions of attentional brain networks to socio-cognitive and emotional development are also discussed.

Newborn amygdala connectivity and early emerging fear

Connectivity between the amygdala, insula (Amygdala-aI) and ventral medial prefrontal cortex (Amygdala-vmPFC) have been implicated in individual variability in fear and vulnerability to psychiatric disorders. However, it is currently unknown to what extent connectivity between these regions in the newborn period is relevant for the development of fear and other aspects of negative emotionality (NE), such as sadness. Here, we investigate newborn Am-Ins and Am-vmPFC resting state functional connectivity in relation to developmental trajectories of fear and sadness over the first two years of life using data from the Infant Behavior Questionnaire Revised (IBQ-R) and Early Childhood Behavior Questionnaire (ECBQ) (N=62). Stronger newborn amygdala connectivity predicts higher fear and sadness at 6-months-of-age and less change from 6 to 24-months-of-age. Interestingly, Am-Ins connectivity was specifically relevant for fear and not sadness, while Am-vmPFC was associated only with sadness. Associations remained consistent after considering variation in maternal sensitivity and maternal postnatal depressive symptomology. Already by the time of birth, individual differences in amygdala connectivity are relevant for the expression of fear over the first two-years-of-life. Additionally, specificity is observed, such that connections relevant for fear development are distinct from those predicting sadness trajectories.

Behavioural Characteristics of Children with Developmental Disorder Risks

The article is devoted to the study of the temperament and behaviour of children with developmental disorder risks. Early age is most significant in terms of early identifying deviant development markers for implementing effective programmes for early intervention. The article deals with the peculiarities of using the Infant Behaviour Questionnaire - Revised (IBQ-R) and its application in scientific research; the results of domestic and foreign research into temperament as a marker/predictor of deviant behaviour are presented. The paper describes the results of a pilot study of differences in behaviour in a sample of 49 children aged 5.6 months. The research involved two groups of test children, a reference group (typically developing children) and the children of developmental risk groups (which included prematurity, family risk of autism spectrum disorders (ASD)/attention deficit and hyperactivity disorder (ADHD), paediatric arterial ischemic stroke). The significant impact of developmental disorder risks on the Perceptual Sensitivity Scale (IBQ-R) as well as the effect of sexand risks on the Approach, Vocal Reactivity (IBQ-R) scale were discovered. There are suggestions that prematurity may have a negative impact on the development of temperament in children aged 6 months. However, in comparison with such factors as the genetic predisposition to atypical development or local brain damage due to paediatric arterial ischemic stroke, prematurity (excluding extremely premature) probably has less influence on the development of temperament and behavioural characteristics. There is a significant heterotypic continuity of individual differences in temperament indicators at an early age, which highlights the need for further research into the issue and the formation of large cohorts of children.&#x0D; Keywords: deviant development markers, behaviour, IBQ-R questionnaire.

Effect of Docosahexaenoic Acid Supplementation vs Placebo on Developmental Outcomes of Toddlers Born Preterm

ImportanceIntake of dietary docosahexaenoic acid (DHA) among toddlers is low. Supplementation may benefit developmental outcomes of toddlers who were born preterm.ObjectiveTo determine whether 6 months of daily DHA supplementation improves developmental outcomes of toddlers who were born preterm.Design, Setting, and ParticipantsA randomized, fully masked, placebo-controlled trial was conducted from April 26, 2012, to March 24, 2017, at a large US pediatric academic center with 9 neonatal intensive care units. Children born at less than 35 weeks’ gestation who were 10 to 16 months corrected age underwent 6 months of intervention. Of 2363 children assessed, 982 were eligible, 605 declined, and 377 enrolled and were randomized. Analyses were according to intent to treat.InterventionsOne-to-one allocation to receive daily microencapsulated DHA, 200 mg, and arachidonic acid (AA), 200 mg (DHA+AA), or microencapsulated corn oil (placebo).Main Outcomes and MeasuresThe primary outcome specified a priori was Bayley Scales of Infant and Toddler Development, third edition (Bayley-III), cognitive composite score at 16 to 22 months corrected age. Secondary outcomes were Bayley-III language and motor composite scores and Infant Behavior Questionnaire–Revised and Early Childhood Behavior Questionnaire effortful control and activity level scores. Subgroup analyses defined a priori were by income, sex, and birth weight.ResultsAmong 377 children randomized and included in the analysis (182 girls and 195 boys; median corrected age, 15.7 months), 338 children (89.7%) had complete data on the primary outcome. Bayley-III cognitive scores did not differ between the DHA+AA and placebo groups (difference in change, 0.5 [95% CI, –1.8 to 2.8]; effect size, 0.05; P = .66). Assignment to the DHA+AA group had a small to medium negative effect on Bayley-III language scores among children with lower birth weights (eg, a child with a birth weight of 1000 g assigned to receive DHA+AA experienced a 4.1-point relative decrease, while a child assigned to placebo did not; P = .03 for interaction). Supplementation had a similar negative effect on effortful control scores among children with annual household incomes greater than $35 000 (difference in change, –0.3 [95% CI, –0.4 to –0.1]; effect size, –0.37; P = .01). Bayley-III motor scores and activity level scores were unaffected.Conclusions and RelevanceDaily supplementation with 200 mg of DHA and 200 mg of AA for 6 months resulted in no improvement in cognitive development and early measures of executive function vs placebo, and may have resulted in negative effects on language development and effortful control in certain subgroups of children. These findings do not support DHA supplementation in the second year of life for children who are born preterm.Trial RegistrationClinicalTrials.gov Identifier: NCT01576783

The Association of Maternal Exposure to Domestic Violence During Childhood With Prenatal Attachment, Maternal-Fetal Heart Rate, and Infant Behavioral Regulation.

Human and animal models suggest that maternal hormonal and physiological adaptations during pregnancy shape maternal brain functioning and behavior crucial for offspring care and survival. Less sensitive maternal behavior, often associated with psychobiological dysregulation and the offspring's behavioral and emotional disorders, has been observed in mothers who have experienced adverse childhood experiences. Strong evidence shows that children who are exposed to domestic violence (DV) are at risk of being abused or becoming abusive in adulthood. Yet little is known about the effect of childhood exposure to DV on the expecting mother, her subsequent caregiving behavior and related effects on her infant. Thus, the present study examined the association of maternal exposure to DV during childhood on prenatal maternal attachment, maternal heart rate reactivity to an infant-crying stimulus and post-natal infant emotional regulation. Thirty-three women with and without exposure to DV during childhood were recruited during the first trimester of pregnancy and followed until 6-month after birth. The Maternal Antenatal Attachment Scale (MAAS) was used to measure prenatal attachment of the mother to her fetus during the second trimester of pregnancy, maternal and fetal heart rate reactivity to an infant-crying stimulus was assessed at the third trimester of pregnancy, and the Infant Behavior Questionnaire-Revised (IBQ-R) was used to assess infant emotional regulation at 6-months. Results showed that pregnant women that were exposed to DV during childhood had a poorer quality of prenatal attachment of mother to fetus, regardless of whether they also experienced DV during adulthood. In addition, maternal exposure to DV during childhood was associated with increased maternal heart rate to infant-crying stimulus and worse infant emotional regulation. These findings highlight the importance of prenatal screening for maternal exposure to DV during childhood as a risk factor for disturbances in the development of maternal attachment, dysfunctional maternal behavior and emotion dysregulation.

Placental MAOA expression mediates prenatal stress effects on temperament in 12-month-olds.

The placenta adapts to maternal environment and its alterations may have a lasting impact on child's temperament development. Prenatal stress has been linked to both a downregulation of monoamine oxidase A (MAOA) gene expression in the placenta and to difficult temperament. Capitalizing on an ongoing longitudinal study, we analysed data from 95 mother-child dyads to investigate whether MAOA mediates the association between prenatal stress and infant temperament. Prenatal stress was defined as exposure to Superstorm Sandy (Sandy) during pregnancy. Infant temperament was measured by Infant Behaviour Questionnaire-Revised. MAOA gene expression was quantified in placenta tissue. The Smiling and Laughter subscale score was independently associated with Sandy exposure and MAOA placental gene expression. Mediation analysis confirmed that MAOA expression partially mediated the relationship between Sandy and Smiling and Laughter subscale, suggesting that in utero exposure to Sandy could induce lower frequency of smiling and laughter via downregulation of placental MAOA gene expression. These effects could compromise optimal temperamental trajectory and contribute to risk for psychological problems. Placental epigenetic markers can contribute to a multidimensional model of early intervention for high-risk children.