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Published on: July 10, 2012
Developmental outcomes of infants with bronchopulmonary dysplasia: comparison with other medically fragile infants
D Holditch-Davis1, S Docherty, M S Miles
1School of Nursing and Frank Porter Graham Child Development Center University of North Carolina at Chapel Hill, 27599, USA.
Insights
Infants with bronchopulmonary dysplasia (BPD) show similar developmental outcomes and mother-infant interactions compared to other medically fragile infants. Chronic health issues, not BPD specifically, influence these behaviors.
Area of Science:
- Neonatal Medicine
- Developmental Psychology
- Pediatric Health
Background:
- Bronchopulmonary dysplasia (BPD) is a chronic lung disease affecting premature infants.
- Understanding developmental trajectories and mother-infant interactions is crucial for medically fragile infants.
- Previous research suggested unique challenges for infants with BPD, necessitating further investigation.
Purpose of the Study:
- To compare developmental outcomes and mother-infant interactions in infants with BPD versus other medically fragile infants.
- To identify factors influencing these outcomes, including maternal behaviors and home environment.
- To determine if observed differences are specific to BPD or related to broader chronic health issues.
Main Methods:
- Longitudinal behavioral observations of mother-infant dyads (n=62) with BPD (n=23) and without BPD (n=39).
- Assessments conducted during hospitalization, post-discharge, and at 6 and 12 months corrected age.
- Statistical analysis using multiple regressions to examine predictors of developmental outcomes (mental, adaptive, language, motor).
Main Results:
- No significant differences in developmental outcomes or interactive behaviors were found between infants with BPD and other medically fragile infants.
- Intraventricular hemorrhage (IVH) did not significantly affect developmental or interactive variables.
- Maternal positive attention and home environment positively correlated with mental development; maternal negative affect related to adaptive behavior.
Conclusions:
- Developmental and interactive differences observed in infants with BPD are likely attributable to chronic health problems, not BPD exclusively.
- Maternal interaction quality and the home environment are key factors in infant development for both groups.
- Findings suggest a need for supportive interventions focusing on maternal behaviors and home environment for all medically fragile infants.
Abstract:
The purpose of this study was to compare the developmental outcomes and mother-infant interactions of infants with bronchopulmonary dysplasia (BPD) and those of other medically fragile infants. One-hour behavioral observations were made of the interactions of mothers with two groups of infants (23 with BPD, 39 medically fragile without BPD or neurological problems) at enrollment, every 2 months during hospitalization, 1 month after discharge, and at 6 months' and 12 months' corrected age. Assessment of the home environment also was done at 6 and 12 months. Multiple regressions were calculated separately for child mental, adaptive, language, and motor outcomes. Predictors were: home environment assessment, measures of maternal interactive behaviors (positive attention, expression of negative affect, medicalized caregiving), infant group membership, and presence of intraventricular hemorrhage (IVH) in the infant. There were no significant differences between the two groups in any of the developmental outcomes or interactive variables, and the presence of IVH had no effect on these variables. Maternal positive attention and the home environment were correlated with mental development, and mother negative affect was related to adaptive behavior for both groups. Differences in developmental and interactive behaviors between infants with BPD and other prematurely born infants found in other studies appear to be a result of chronic health problems and, thus, are not unique to infants with BPD.
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