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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Neonatal stress and behavior problems in preschool children born preterm
Rafaela Gm Cassiano1, Claudia M Gaspardo1, Maria Bm Linhares1
1Department of Neurosciences and Behavior, Ribeirão Preto Medical School, 54539University of São Paulo, Ribeirão Preto, SP, Brazil.
Insights
High neonatal stress and early behavior problems in preterm infants predict later behavioral issues. Early intervention and developmental care in the NICU are crucial for better outcomes.
Area of Science:
- Pediatrics
- Neonatology
- Developmental Psychology
Background:
- Preterm birth presents unique challenges for infant development.
- Neonatal acute stress and early behavioral patterns may influence long-term outcomes.
- Understanding these predictors is vital for targeted interventions.
Purpose of the Study:
- To investigate the impact of preterm birth, neonatal stress, and early behavior on later behavioral outcomes.
- To identify specific risk factors for behavioral problems in 4-5-year-old children born preterm.
- To inform the development of supportive care strategies for preterm infants.
Main Methods:
- Longitudinal study of 70 preterm children.
- Assessment of neonatal characteristics using the Neonatal Infant Stressor Scale.
- Maternal-reported behavior evaluation via the Child Behavior Checklist (1.5-5 years).
- Statistical analyses including multiple linear regression and repeated measures ANOVA.
Main Results:
- High neonatal acute stress during NICU hospitalization correlated with increased total and externalizing behavior problems at 4-5 years.
- More behavior problems at 18-36 months predicted increased total and externalizing behaviors later.
- Lower gestational age and more internalizing behaviors at 18-36 months predicted more internalizing problems at 4-5 years.
Conclusions:
- Neonatal conditions and early childhood behavior problems are significant predictors of later behavioral outcomes in preterm children.
- Implementing developmental care in the NICU and post-discharge follow-up programs are essential.
- Early identification and management of behavioral issues in preterm infants can improve long-term development.
Abstract:
The aim of the present longitudinal study was to examine the effect of preterm childbirth, acute neonatal stress, and child behavior at 18-36 months of age on later behavior outcomes in 4-5-year-old children. The sample comprised of 70 children who were born preterm. The neonatal characteristics of children were assessed during hospitalization by reviewing their medical records and utilizing the Neonatal Infant Stressor Scale. Behavior problems were evaluated by the maternal-report in the Child Behavior Checklist 1½-5 years. A multiple linear regression analysis was conducted. Also, the repeated measures analysis of variance and the McNemar test for paired samples were performed. Daily exposure of the infants to high neonatal acute stress during NICU hospitalization and more behavior problems at 18-36 months of age was associated with more total and externalizing behavior problems at 4-5 years of age. Lower gestational age at childbirth and more internalizing behavior problems at 18-36 months was associated with more internalizing problems at 4-5 years old. The present study showed the combination of predictors of neonatal conditions and behavioral problems at childhood, highlighting the relevance of the implementation of developmental care in the NICU and follow-up the preterm infants after discharge programs.
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