Maternal involvement and the language environment in the neonatal intensive care unit (NICU) - a cohort study

Preterm infants are at increased risk for language delays. Increased word exposure in the NICU is associated with increased child language skills at 2 years. Additionally, increased maternal involvement in infant care in the NICU is associated with improved outcomes.

To examine associations between maternal involvement in the NICU and early infant language exposures and vocalizations.

Outcome data were obtained for the control arm of a larger RCT at Women & Infant's Hospital NICU from January 2013 to August 2016 which enrolled infants < 32 weeks gestational age. Audio environment was captured and analyzed for adult word count (AWC), child vocalizations (CV) and conversational turns (CT) at 32-, 34- and 36-weeks PMA. Infant chart was reviewed for total hours of maternal involvement (visitation, skin-to-skin contact, holding, touching, bedside care and feeding participation) per recording day.

As infant gestational age increased, maternal feeding involvement and infant holding increased, while skin-to-skin care decreased. Aggregate counts of maternal involvements over all recording days showed 51 % of mothers participated in 5-6 involvements and 4 % in 0 involvements. Negative binomial model showed that for every stepwise increase in maternal involvement, there was a 116 % increase (rate ratio 2.16; 1.78-2.62; p < 0.0001) in AWCs and a subsequent 74 % increase (rate ratio 1.74; 1.47-2.05, p < 0.0001) in CTs over the 3 recordings.

Infants of mother with increased involvement experienced increased exposure to AWC and responded with increased CTs. Increasing opportunities and types of parental care involvement are ideal methods of fostering early language development.