Academic journal article International Journal of Child Health and Human Development

Parental Emotional Availability Moderates the Relationship between Neonatal Pain-Related Stress and Internalizing Behaviors in Children Born Very Preterm at 18 Months

Academic journal article International Journal of Child Health and Human Development

Parental Emotional Availability Moderates the Relationship between Neonatal Pain-Related Stress and Internalizing Behaviors in Children Born Very Preterm at 18 Months

Article excerpt

Children born very preterm show a higher prevalence of internalizing (anxiety/depressive) behaviors compared to term-born peers as early as 18 months corrected age (CA). In animal studies, early stress leads to greater anxiety behaviors later in life, however the role of stress in the etiology of internalizing problems in preterm children is unknown. Our aim was to examine whether: 1) neonatal pain-related stress in infants born very preterm is associated with greater internalizing at 18 months CA, and 2) caregiver behavior and stress moderate the relationship between early pain and internalizing behavior. N=97 children born very preterm (≤32 weeks GA) were seen at 18 months CA. Neonatal data (e.g. illness severity, number of skin breaking procedures, days of mechanical ventilation and morphine exposure) were obtained from medical chart review. Neonatal pain was defined as the number of skin breaking procedures, adjusted for medical confounders. At 18 months CA, the primary caregiver parent completed the Parenting Stress Index, and carried out a videotaped 5-min semistructured play session with their child, later coded for quality of mother-child interaction using the Emotional Availability Scale. The parent completed the Child Behavior Checklist for Ages 1.5-5 to measure child internalizing. Using generalized linear modeling to adjust for multiple medical confounders, higher child Internalizing at 18 months CA was associated with greater neonatal pain (χ2= 3. …

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