Regulatory Problems in Very Preterm and Full-Term Infants Over the First 18 Months
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Published on: November 20, 2015
1*Department of Psychology, University of Warwick, Coventry, United Kingdom; †Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, United Kingdom.
Insights
Infants born very preterm (VP) or with very low birth weight (VLBW) show increased regulatory problems (RPs) like sleeping and feeding issues by 18 months. Persistent RPs in early infancy predict later issues in both VP/VLBW and full-term infants.
Area of Science:
- Neonatal development
- Infant regulatory problems
- Developmental pediatrics
Background:
- Regulatory problems (RPs) such as crying, sleeping, and feeding difficulties are common in infancy.
- Infants born very preterm (VP) or with very low birth weight (VLBW) may face unique developmental challenges.
- Understanding the trajectory of RPs in these infants is crucial for early intervention.
Purpose of the Study:
- To investigate differences in regulatory problems (RPs) between very preterm/very low birth weight (VP/VLBW) infants and full-term (FT) infants.
- To examine the prevalence, persistence, and early predictors of RPs up to 18 months of age.
Main Methods:
- A prospective longitudinal study involving 73 VP/VLBW infants and 105 FT infants.
- Mothers were interviewed at term, 3, 6, and 18 months to assess infant regulatory problems.
- Statistical analysis was used to compare groups and identify predictors of persistent RPs.
Main Results:
- Few differences in RPs were observed between VP/VLBW and FT infants in the first 6 months.
- At 18 months, VP/VLBW infants exhibited higher rates of sleeping, feeding, and multiple RPs compared to FT infants.
- RPs identified as early as 3 months in VP/VLBW infants and 6 months in FT infants predicted RPs at 18 months.
Conclusions:
- VP/VLBW infants are at a slightly increased risk for regulatory problems at term and in the second year of life.
- Persistent RPs within the first 6 months are indicative of a higher likelihood of ongoing issues into toddlerhood for both VP/VLBW and FT infants.
- Clinical awareness of persistent early RPs is important for identifying infants at risk for continued regulatory difficulties.
Objective:
This study is an investigation of differences in regulatory problems (RPs; crying, sleeping, feeding) expressed by infants born very preterm (VP; <32 wk gestation) or with very low birth weight (VLBW; <1500 g) and infants born at full term (FT) during the first 18 months of life. It investigates the prevalence of single and multiple RPs, their persistence and how early in infancy RPs still found at 18 months of age can be predicted.
Method:
This prospective longitudinal study of 73 VP/VLBW and 105 FT infants utilized a standard interview of mothers to assess regulatory problems among the infants at term, 3, 6, and 18 months of age.
Results:
Few differences were found between VP/VLBW and FT infants in the first 6 months. At 18 months, VP/VLBW infants had more single sleeping (RR = 2.2, CI = 1.3-3.7), feeding (RR = 1.4, CI = 1.03-1.8), and multiple RPs (RR = 1.7, CI = 1.02-2.8) than FT infants. In VP/VLBW infants, RPs as early as 3 months and in FT infants RPs as early as 6 months predicted RPs at 18 months. Those infants who had persistent RPs in the first 6 months of life were more likely to still have RPs at 18 months.
Conclusion:
VP/VLBW children are at slightly increased risk for RPs at term and in the second year of life. Clinicians should be aware that RPs that persist across the first 6 months point to increased risk of continuing RPs into toddlerhood in both VP/VLBW and FT infants.
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