Impaired prospective memory but intact episodic memory in intellectually average 7- to 9-year-olds born very preterm and/or very low birth weight

Relatively little is known about episodic memory (EM: memory for personally-experienced events) and prospective memory (PM: memory for intended actions) in children born very preterm (VP) or with very low birth weight (VLBW). This study evaluates EM and PM in mainstream-schooled 7- to 9-year-olds born VP (≤ 32 weeks) and/or VLBW (< 1500 g) and matches full-term children for comparison (n = 35 and n = 37, respectively). Additionally, participants were assessed for verbal and non-verbal ability, executive function (EF), and theory of mind (ToM). The results show that the VP/VLBW children were outperformed by the full-term children on the memory tests overall, with a significant univariate group difference in PM. Moreover, within the VP/VLBW group, the measures of PM, verbal ability and working memory all displayed reliable negative correlations with severity of neonatal illness. PM was found to be independent of EM and cognitive functioning, suggesting that this form of memory might constitute a domain of specific vulnerability for VP/VLBW children.     

Early indications of delayed cognitive development in preschool children born very preterm: evidence from domain‐general and domain‐specific tasks

Cognitive impairment often follows preterm birth but its early underlying nature is not well understood. We used a novel approach by investigating the development of colour cognition in 54 very preterm children born ?30 weeks gestational age without severe neurosensory impairment and 37 age‐matched term‐born controls, aged 2–5 years. Quantitative and qualitative differences in the development of colour cognition are well charted throughout the preschool years, enabling delayed from deviant development to be determined. Standardized domain‐general and experimental colour‐specific tests of language, attention, and memory were employed. Very preterm children showed significantly depressed language than term controls, with very preterm group girls significantly outperforming boys. Very preterm children also showed poorer attention and memory than term controls, but not significantly so. Importantly, colour‐specific tests showed qualitatively similar performance, but for naming and executive planning quantitatively poorer performance, across groups, indicating typical but delayed development. Hence, even before school entry, compared with term‐born peers, very preterm children show delayed development of cognitive processes that underpin later scholastic abilities, but the nature by which these processes operate appears to be typical of term children. If left untreated these early developmental delays may underpin later deviations from the typical developmental trajectory. Copyright © 2010 John Wiley & Sons, Ltd.     

处于生存极限的低出生体重儿该如何决策救治

我国极低及超低出生体重儿的出生比例已接近发达国家。但因为经济、文化、技术及社会保障制度等原因,相当多的患儿得不到合理救治。这与发达国家相比有很大差距。让医护人员做到合理评估和告知,适时放弃治疗,完善社会保障制度,加强社会舆论监督和教育,加快相关制度、法规的建立等措施有望改变这一现状。     

The association between maternal interaction and infant cortisol stress reactivity among preterm and full term infants at 4 months adjusted age

The purpose of this study was to assess the association between maternal interactive behavior and infant cortisol stress reactivity in response to the Still Face paradigm (SF) in a cohort of four-month old infants (adjusted age) born preterm (<32 weeks gestation, N = 22) compared with infants born full term (>37 weeks gestation, N = 28). Infant cortisol reactivity was calculated as area under the curve (AUC) from baseline to the third cortisol sample (30 min post-SF) using the trapezoidal rule, while the percent of time mothers spent using a contingent interaction style was measured (0–100%) during episodes 1 (Play; baseline), 3 (Reunion#1), and 5 (Reunion#2) while mother-infant dyads participated in the SF paradigm. We hypothesized that because infants born preterm are at increased risk for dysregulation, they would show, compared to full-term infants, a blunted stress response, involving under-responsiveness. We found blunted cortisol stress reactivity among the preterm infants. We also found that mothers of preterm infants demonstrated less contingent maternal interaction during Renion#1 of the SF; and that contingent maternal interaction at Reunion#2 of the SF was protective against cortisol stress reactivity in response to the SF. However, we did not find that the influence of maternal interaction on cortisol reactivity was moderated by gestational age group (full term vs preterm): the association between contingent maternal interaction and stress reactivity was similar for both gestational groups across episodes. In order to improve self-regulation and longer term social and cognitive developmental outcomes in medically at-risk infants, future research is warranted to determine how these findings relate to infants’ stress reactions in naturalistic settings, and the directionality and temporal relationship between cortisol stress responses and maternal interactive behavior.     

“Weathering the storm:” Mothers’ and fathers’ experiences of parenting a preterm infant

Parenting preterm infants is a unique experience distinct from parenting full-term infants, characterized by a delayed transition to parenthood and limited caregiving opportunities. This study explored mothers’ and fathers’ lived experiences of parenting during infancy in the context of preterm birth. Semistructured qualitative interviews were conducted with 13 parents (6 fathers, 7 mothers) of preterm infants. Data were analyzed using interpretative phenomenological analysis. Four superordinate themes emerged: (a) An unnatural disaster: The traumatic nature of preterm birth, (b) The immediate aftermath: Disconnected and displaced, (c) Breaking the ice: Moving from frozen to melted, and (d) Aftershocks: Transitioning home. Both parents experienced preterm birth as traumatic. Similarities and differences in mothers’ and fathers’ experiences were identified. Preterm birth posed challenges for nurturant and social caregiving and resulted in anxiety, hypervigilance, and overprotective parenting behavior. The results highlight the need for trauma-informed care and further research developing and testing empirically based interventions.     

Religious Geography and County‐Level Sex Ratios in China

The sex ratio at birth in China is highly imbalanced in favor of boys. Past research on sex ratios in China emphasizes economic factors for their weakening effect on the Confucian tradition of son preference. Research in the sociology of religion suggests that religious geography may affect sex ratios through the spill‐over of religious teachings to those living in areas dominated by a religious tradition. To assess this linkage, we investigate the relationship between religious geography and county‐level child sex ratios using the 2000 China Population Census and the 2004 China Economic Census, the most complete and recent data available on religious presence in China. Applying spatial analyses of 2,685 counties (over 90% of all counties), we find that counties with a greater presence of Daoist temples have more imbalanced (male‐biased) sex ratios, whereas a greater presence of Buddhist temples and Islamic mosques is associated with less imbalanced sex ratios.     

Psychological aspects of childbirth: Evidence for a birth‐related mindset

Psychological research on childbirth is rare, even though research from other scientific fields such as obstetrics or midwifery highlights the importance of psychological factors in childbirth. In this article, the theoretical construct of a birth‐related mindset and direct and indirect measures for assessing the mindset are proposed. It is assumed that childbirth can be mentally presented as a rather natural (natural mindset) or a rather medicalized (medicalized mindset) event. In three online studies (Study 1: N = 117, Study 2: N = 206, Study 3: N = 192), we aimed to explore whether the proposed birth‐related mindset is related to the retrospectively reported process of labor and birth (operationalized, e.g., by performed interventions, duration of birth, place of birth). For this, the relation between the mothers’ birth‐related decisions and outcomes of childbirth and the mothers' birth‐related mindsets were analyzed. Results indicated that (1) birth‐related criteria such as place of birth, epidural anesthesia, and C‐sections were associated with the birth‐related mindset, (2) these aspects of the delivery were related to the evaluation of the birth (birth experience), (3) the birth‐related mindset moderated the relationship between C‐section and birth experience, and (4) the indirect measures had little to no added explanatory value to the developed Mindset and Birth Questionnaire. Thus, the results indicate that the birth process experienced by the women and the mental representations of birth (birth‐related mindset) are closely related. Future studies need to investigate to what extend the experienced birth process influences the mindset of birth, or the mindset the experienced birth process, or both.     

Bittersweet: a qualitative exploration of mothers’ experiences of raising a single surviving twin

Loss of a child from a multiple birth pregnancy is not uncommon yet the idiographic experience of parents who have lost a single twin from a multiple birth pregnancy is underexplored. This novel study sought to explore the experiences of mothers bereaved after loss of a twin from a multiple birth pregnancy, focusing on the dual challenges of parenting and grieving. Eighteen mothers at least 12 months post loss were recruited from a private UK based Facebook page dedicated to supporting parents after loss from a multiple birth. Eligible mothers completed an independent qualitative open-ended survey to explore maternal experiences of loss. Data were analysed using Thematic Analysis. Findings represented a sense of duality for participants, with mothers experiencing conflict between roles and identities as well as the nature of their loss. Key themes identified include ‘Narrating a story of family and loss’, ‘Finding a place for the twins within the family’ and ‘A changing sense of self’. Findings fit with theoretical conceptualisations of bereavement that acknowledge retaining relationships with the deceased. Practically, suggestions for supporting mothers to identify stock answers to often asked questions about family make up were suggested.