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Updated: Jul 16, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Effect of intensive care unit exposure on temperament in low birth weight preterm infants
Insights
High-risk preterm infants, often exposed to intensive care units (ICU), may exhibit temperament differences. Parental perception, influenced by illness severity and hospitalization, plays a significant role.
Area of Science:
- Neonatal development
- Infant psychology
- Pediatric intensive care
Background:
- Preterm infants, particularly those with low birth weight, face significant health challenges.
- Exposure to intensive care units (ICU) may impact infant development and temperament.
- Understanding temperament differences is crucial for early intervention and parental support.
Purpose of the Study:
- To test the hypothesis that high-risk preterm infants have more difficult temperaments.
- To compare temperament between high-risk preterm, low-risk preterm, and full-term infants.
- To explore the influence of illness severity and ICU exposure on infant temperament and parental perception.
Main Methods:
- Temperament assessment using the Infant Temperament Questionnaire (ITQ) at 6 months adjusted age.
- Comparison of three infant groups: high-risk preterm (HR), low-risk preterm (LR), and full-term (FT).
- Analysis of maternal subjective and objective ratings, correlated with hospitalization length and disease severity.
Main Results:
- Mothers of HR infants reported significantly more difficult temperaments compared to FT and LR infants.
- Objective ITQ ratings showed HR infants had less favorable scores in mood, adaptability, persistence, and distractibility.
- Maternal subjective ratings were linked to disease severity, while objective ratings correlated with hospitalization length.
Conclusions:
- While ICU exposure may contribute to some objective temperament differences in preterm infants, its effect is more pronounced on parental perceptions.
- Parental perception of infant temperament is significantly influenced by the infant's illness severity and duration of hospitalization.
- Further research is needed to understand the long-term implications of these findings on infant development and parent-infant bonding.
Abstract:
This study examined the hypothesis that low birth weight, preterm infants, owing to their severe illness and exposure to intensive care units (ICU), are predisposed to a more difficult temperament. Temperament was compared among three groups (n = 92): high-risk (HR) preterm infants (mean birth weight 1244 g), low-risk (LR) preterm infants (mean birth weight 2050 g), and full-term (FT) infants (mean birth weight 3159 g). Mothers completed the Infant Temperament Questionnaire (ITQ) when infants were 6 months (adjusted) old. The most striking differences were in mothers' subjective ratings of their infants: 21% of the HR mothers rated their infants as more difficult than average, compared to 4% of full-term and 0% of low-risk preterm mothers. By contrast, according to objective rating, HR infants met none of the ITQ criteria for the diagnostic category of "difficult." However, HR infants did have less favorable scores in mood, adaptability, persistence, and distractibility than LR and FT. When the HR group was further analyzed, differences in mothers' objective ratings were accounted for by length of hospitalization, while differences in mothers' subjective ratings were accounted for by severity of disease. Results suggest that, in our sample, exposure to ICU may have led to some temperament differences, but its effect was more pervasive on parents' perceptions of their infants.
