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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Temperament at 9 months of very preterm infants born at less than 29 weeks' gestation: the Epipage study
Béatrice Larroque1, Sylvie N'guyen The Tich, Antoine Guédeney
1INSERM U149, 16 avenue Paul Vaillant Couturier, 94807 Villejuif Cedex, France. larroque@vjf.inserm.fr
Insights
Premature infants born before 29 weeks gestation show similar temperaments to full-term babies at 9 months. Neurological issues in preterm infants are linked to more difficult temperaments.
Area of Science:
- Neonatalogy
- Developmental Psychology
- Pediatrics
Background:
- Very preterm infants (born before 29 weeks' gestation) face developmental challenges.
- Temperament differences between preterm and full-term infants require investigation.
- Understanding neurological sequelae's impact on infant temperament is crucial.
Purpose of the Study:
- To compare the temperament of very preterm infants with full-term infants at 9 months corrected age.
- To investigate the influence of neurological sequelae on the temperament of very preterm infants.
- To identify specific neurological factors affecting infant temperament.
Main Methods:
- Longitudinal study comparing 266 very preterm infants (<29 weeks gestation) with 546 full-term infants.
- Infant Characteristics Questionnaire administered to parents at 9 months corrected age.
- Analysis included neonatal ultrasound findings and developmental assessments.
Main Results:
- No significant differences in Difficult, Unadaptable, or Unpredictable temperament scales between groups.
- Very preterm infants showed slightly higher scores on the Dull scale, which became non-significant after controlling for covariates.
- Neurological insults (cerebral lesions, developmental delays) were associated with higher Dull, Unadaptable, and Unpredictable scores in very preterm infants.
Conclusions:
- Gestational age alone does not significantly alter infant temperament at 9 months.
- Neurological insults in very preterm infants are associated with altered temperament profiles.
- Neonatal ultrasound and developmental assessments can identify preterm infants at risk for temperamental difficulties.
Abstract:
The objective was to determine whether the temperament of very preterm singleton infants born before 29 weeks' gestation differs from their full-term counterparts at 9 months and to examine the influence of neurological sequelae on temperament in very preterm infants. The parents of very preterm infants from nine French regions and a group of full-term infants were sent the Infant Characteristics Questionnaire when the infants were 9 months old. The analysis included 266 singleton very preterm infants from the same regions born before 29 weeks' gestation and 546 full-term singleton infants. There were no significant differences for the Difficult, Unadaptable, and Unpredictable scales between very premature and term infants. Very preterm infants had a slightly higher Dull scale score than term infants. After taking into account mother's age, duration of hospitalization, and cerebral lesions found on neonatal ultrasound scans, this difference was no longer significant. Among very premature infants, those with cerebral lesions as diagnosed by neonatal ultrasound scan were rated higher on the Dull and Unadaptable scales. Delays in development at 9 months were also related to higher Dull and Unpredictable scales. These data suggest that prematurity does not affect temperament ratings at 9 months as assessed by the mother. However, very preterm infants with neurological insults, documented by the neonatal cerebral ultrasound or by a delay in development, are rated higher by their mothers on the Dull, Unadaptable, and Unpredictable scales.
