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Effects of Neonatal Pain and Temperament on Attention Problems in Toddlers Born Preterm
Claudia M Gaspardo1, Rafaela G M Cassiano1, Sofia M A Gracioli1,2
1Department of Neurosciences and Behavior, Ribeirao Preto Medical School, University of São Paulo.
Insights
Neonatal pain and stress impact attention problems in preterm toddlers, especially when they and their mothers have less self-regulation. Early developmental care and follow-up programs are recommended.
Area of Science:
- Developmental Psychology
- Neonatal Care
- Behavioral Science
Background:
- Preterm birth is associated with increased risk for behavioral problems.
- Neonatal pain and stress exposure can have long-term effects on neurodevelopment.
- Temperament plays a crucial role in modulating behavioral outcomes.
Purpose of the Study:
- To investigate the influence of neonatal pain-related stress on attention and externalizing behaviors in preterm toddlers.
- To examine the moderating role of infant and maternal temperament traits.
Main Methods:
- A cohort of 62 preterm toddlers (18-36 months) and their mothers participated.
- Mothers completed validated questionnaires assessing child and adult temperament and behavior problems.
- Neonatal pain-related stress was quantified from medical records using the Neonatal Infant Stressor Scale.
Main Results:
- High neonatal pain-related stress, low toddler Effortful Control, and high maternal Surgency predicted 23% of the variance in attention problems.
- Externalizing behavior problems were primarily associated with temperament, not neonatal pain stress.
Conclusions:
- Neonatal pain experiences and poorer self-regulation in toddlers and mothers are linked to attention problems in preterm infants.
- Interventions promoting regulated temperament in mother-infant dyads are recommended for NICU developmental care and post-discharge follow-up.
Objective:
To examine the effects of individual characteristics of neonates and neonatal pain-related stress on attention problems and externalizing behavior problems of toddlers born preterm, analyzing the moderating effects of the dispositional traits of temperament.
Methods:
The sample included 62 toddlers aged 18-36 months and their mothers. The mothers were interviewed using the Child Behavior Checklist 1.5-5 for toddlers' attention and externalizing behavior problems assessment, the Early Childhood Behavior Questionnaire for toddlers' temperament assessment, and the Adult Temperament Questionnaire for their temperament assessment. The Neonatal Infant Stressor Scale analyzed the number of pain-related stress events during neonatal intensive care unit (NICU) hospitalization recorded in the medical charts. Statistical descriptive, correlation, and multiple linear regression analyses were performed.
Results:
High neonatal pain-related stress total index, associated with toddler's temperament with less Effortful Control, and mother's temperament with high Surgency explained 23% variability of the attention problems. Otherwise, the externalizing behavior problems were explained by temperament, but not by neonatal pain-related stress.
Conclusions:
The findings support the impact of neonatal pain experiences, and current toddlers' and mothers' temperament characterized by poorer self-regulation on attention problems in toddlers born preterm. Developmental care in the NICU and follow-up programs after discharge are recommended to promote regulated temperament of the mother-child dyads, aiming to prevent attentional problems in toddlers born preterm.
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