Stability of developmental status and risk of impairment at 24 and 36 months in late preterm infants

BackgroundFew studies investigated whether late preterm infants might have developmental delays in several domains in early life and how stable the lag in developmental status might be.AimWe aimed to examine the stability of potential delays across developmental domains at 24 and 36 months of age in late preterm (34°-36⁶ weeks) and term (≥37 weeks) children and whether the risk of delays remained high at 36 months.Study design, subjects, and outcome measureWe conducted a prospective cohort analysis of the children of pregnant women participating in the Vitamin Antenatal Asthma Reduction Trial (VDAART). 652 children who were prospectively followed up and had parent-completed Ages Stages Questionnaires (ASQ-3) questionnaires at both 24 and 36 months were analyzed to assess their domain-specific developmental status.Results6.61 % (42/635) of children had a late preterm birth. Developmental delays were stable between 24 and 36 months on all 5 domains for the children born preterm and on 4/5 domains for those born at term. The developmental domains with the status stability at 24 and 36 months in both late preterm and term children were the gross motor, communication, personal-social skills, and problem-solving. Late preterm children compared with term children remained at higher risk of delays at 36 months for gross motor, communication, and problem-solving skills (aOR = 4.54, 95 %CI: 1.81−10.79; aOR = 8.60, 95 %CI: 3.10−23.28 and aOR = 3.80, 95 %CI: 1.58−8.73, respectively).ConclusionLate preterm birth is associated with suboptimal development and stability in several domains at both 24 and 36 months and compared with term birth, requiring early monitoring and assessment of the developmental lag to avoid potential long-term implications.     

Does Smoking by Pregnant Women Influence IQ, Birth Weight, and Developmental Disabilities in Their Infants? A Methodological Review and Multivariate Analysis

Neuropsychologists are asked frequently to address the issue of the cause of a variety of central nervous system problems that may affect higher cortical function. One such issue is the relationship of maternal smoking to adverse reproductive outcomes involving neocortical insult including mental retardation, learning disabilities, attention-deficit hyperactivity disorder, and other insults that may be related to prolonged hypoxic states in utero. The instant paper develops the issue of causation as a scientific inquiry, reviews several traditional, applicable models, and critiques these models. An additional model of motility is proposed and discussed. The issue of the relationship of maternal smoking to adverse reproductive outcomes is then addressed from a review perspective along with new empirical analyses, the latter demonstrating that researchers tend to draw causal conclusions independent of whether the respective design of their studies would support conclusions about the causation of an event. Causal conclusions in the absence of causal designs have often lead to incomplete and incorrect conclusions. It is necessary to match conclusions not only to the outcomes of a research project but also to its design and accompanying limitations.     

The Embodiment of Birth

This paper rejects dualism between mind and body toview the self as an embodied biological entity. Rather thanseeing the body operating by passive mechanisms as Descartesargues, it holds it actively moves in and even defines its world. Carrying this perspective to medicine presents an attempt toincorporate or work with internal processes of the body; it issensitive to how patients identify with their bodies. Thecurrent discussion over the extent to which women should try tohave natural childbirths provides a concrete example of thedifferences between mechanistic and embodied approaches tomedicine.     

Birth cohort changes in Chinese adolescents' mental health

In China, rapid economic growth and increasing social problems constitute two basic characteristics of contemporary social change. During the process of dramatic social change, an emerging question is how adolescents' mental health has changed across birth cohorts. The present paper reviews four studies of crosstemporal meta-analysis conducted by us. By meta-analysis of previous literature, we examined changes in mean scores on mental health measures over time (from the early 1990s to the mid-2000s). It was found that since the early 1990s, Chinese adolescents' mental health deteriorated across birth cohorts, shown in increased scores on the negative indicators of mental health (e.g. mental problems, anxiety, and depression), whereas self-esteem as a positive trait decreased. The dropping trend in Chinese adolescents' mental health could be attributed to social change, especially increasing social problems. Therefore, adequate attention must be paid to potential influences of social change on individuals' psychological development.     

父母差别对待与青少年问题行为的关系：一个有调节的中介模型

通过问卷调查的方式,采用同胞不同经历问卷、关系网络问卷和问题行为量表对开封市1179名初高中学生进行研究。研究结果显示：（1）父母差别对待与外/内化问题行为呈显著正相关;同胞关系与外/内化问题行为呈显著负相关;父母差别对待和同胞关系呈显著负相关。（2）同胞关系在父母差别对待与外/内化问题行为之间起部分中介作用。（3）“父母差别对待→同胞关系→外/内化问题行为”这一中介路径的前半段受出生顺序调节;与年幼个体相比,父母差别对待对年长个体的同胞关系影响更大。出生顺序会调节父母差别对待对同胞关系的影响,提示二胎家庭要更关注年长个体的变化。     

The effect of preterm birth on infant negative affect and maternal postpartum depressive symptoms: A preliminary examination in an underrepresented minority sample

ObjectiveTo examine the effect of preterm birth on maternal postpartum depressive symptoms and infant negative affect in an underrepresented minority sample.MethodParticipants were 102 mothers and their 3- to 10-month-old infants. Mothers completed the Edinburgh Postnatal Depression Scale and the Infant Behavior Questionnaire-Revised.ResultsRelative to normative samples, the current underrepresented minority sample of mostly Hispanics and Blacks displayed high rates of preterm birth (30%) and maternal postpartum depressive symptoms (17%). Preterm birth had a significant direct effect on postpartum depressive symptoms and infant negative affect. Additionally, there was an indirect effect of postpartum depressive symptoms on the relation between preterm birth and infant negative affect. Specifically, lower birth weight and gestational age predicted higher levels of depressive symptoms in the mother, and higher levels of depressive symptoms in the mother, in turn, predicted higher levels of infant negative affect.ConclusionFindings emphasize the importance of screening for postpartum depressive symptoms and infant negative affect among mothers and their preterm infants, especially among families from underrepresented minority backgrounds.     

Still cautious: Personality characteristics of extremely low birth weight adults in their early 30s

Extremely low birth weight survivors (ELBW; <1000 g) display a personality style characterized by cautiousness, shyness, and risk aversion in their 20s. We examined whether non-impaired ELBW survivors were still more cautious than their normal birth weight (NBW) peers at ages 30–35 and assessed the stability of this personality characteristic across approximately a decade in the oldest known cohort of ELBW survivors. Of the 154 participants tested at ages 22–26, 111 (i.e., 72%) of them returned approximately 10 years later [i.e., 69% (49/71) ELBW and 75% (62/83) NBW], and once again they completed the Eysenck Personality Questionnaire-Revised (EPQ-R). We created the same theoretically and empirically derived composite measure of cautiousness at each visit by summing the EPQ-R psychoticism scale (reverse scored) and the EPQ-R lie scale. We found that ELBW adults reported higher cautiousness than their NBW counterparts at ages 30–35. We also found that levels of cautiousness remained stable over approximately 10 years in both groups. Our findings suggest that individuals born at ELBW were more cautious than NBW peers and that this personality characteristic remained stable into their early 30s. The present study appears to be the first empirical demonstration of personality stability among adult ELBW survivors.     

The impact of parents’ mental health on parent–baby interaction: A prospective study

The aims of the current study were to examine the effect of fathers’ and mothers’ pre and postnatal mental health on mother–infant and father–infant interactions. Mental health was broadly defined to include anxiety, depression and PTSD. A community sample of 44 mothers and 40 fathers from 45 families completed questionnaire measures of mental health in late pregnancy and three months postpartum. Mother–infant and father–infant interactions were observed and videoed three months postpartum and analysed using the CARE-index. Results showed that prenatal mental health, in particular anxiety, was associated with parent–infant interactions to a greater extent than postnatal mental health. Fathers’ prenatal symptoms were associated with higher paternal unresponsiveness and infant passivity whilst fathers’ postnatal symptoms were associated with higher levels of infant difficulty in the father–baby interaction. The results also indicated that mothers and fathers interaction with their babies were similar, both on average and within the couples, with 34% being inept or at risk. These findings highlight the need for early detection and prevention of both mental health and parent–infant relationship problems in fathers as well as mothers. However, further prospective and longitudinal studies are needed to understand the influences of parental mental health on the parent–infant interactions further. Also it should be noted that the mental health scores were low in this sample, which may reflect the sample characteristics. Future studies therefore would benefit from focusing on more vulnerable groups of parents.     

Complementary assessments of executive function in preterm and full-term preschoolers

Executive functions (EFs) are interrelated cognitive processes that have been studied in relation to behavior, attention, academic achievement, and developmental disorders. Studies of EF skills assessed through parent report and performance-based measures show correlations between them ranging from none to modest. Few studies have examined the relationship between EF skills measured through parent report and performance-based measures in relation to adaptive function. The present study included preschool children born preterm as a population at high risk for EF impairments. Preschool children (N = 149) completed a battery of EF tasks that assess working memory, response inhibition, idea generation, and attention shifting or cognitive flexibility. Parents reported on children’s EF and adaptive skills. Preterm children showed more parent-rated and performance-based EF impairments than did full-term children. The combined use of either parent report or performance-based measures resulted in the identification of a large number of children at risk for EF impairment, especially in the preterm group. Both parent report and performance-based EF measures were associated with children’s adaptive function. EF skills are measurable in young child'ren, and we suggest that EF skills may serve as targets for intervention to improve functional outcomes. We recommend the use of both parent report and performance-based measures to characterize children’s EF profiles and to customize treatment.     

Birth Order Position and Prosocial Tendencies

This study investigated the relationship between psychological birth order position and different types and levels of prosocial tendencies. An ex postfacto, between-family research design was used. Data on prosocial tendencies were obtained from 888 college students (females = 80.4%, mean age = 20.94 yrs, SD = 2.83; males = 19.6%, mean age = 21.62 yrs, SD = 2.44). Participants completed a biographical questionnaire as well as the Prosocial Tendencies Measure (Carlo & Randall, 2002). Data were analysed to compare and contrast prosocial tendencies between demographics using parametric ANOVAs, t tests and the Mann-Whitney Test. Significant differences in prosocial tendency scores were only found between middle-borns and last-borns on altruism, with middle-borns scoring significantly higher in prosocial tendencies than last-borns. There is no evidence to suggest that a definitive link between prosocial tendencies and birth order exists in this study.