Neonatal stress and behavior problems in preschool children born preterm

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.