Frontiers of Infant Psychiatry - Vol. 2

By Justin D. Call; Eleanor Galenson et al. | Go to book overview

15
Experience Following Premature Birth:
Stresses and Opportunities for Infants,
Parents, and Professionals

Peter A. Gorski, M.D.

Many individuals live or work in a stressful environment. Few persons are born into such settings loaded with constant noise, activity and crowds. This paper will attempt to illustrate this social experience and consider the consequences endured by more than 200,000 infants (one in twelve live births) and their parents in the United States each year as a result of premature birth (Perelman and Farrell, 1982).

Even in 1983, the magnitude of physical, cognitive, and psychological disabilities following prematurity remains high. While the vast majority of premature neonates survive infancy (from 35 percent of infants born weighing under 750 grams to over 90 percent

born over 1,500 grams [Britton et al., 1981; Cohen et al., 1982; Driscoll et al., 1982; Horwood et al., 1982; Kiely et al., 1981]), the price of survival is too often expressed through a range of sensory, motor, or behavioral handicaps including blindness, hearing deficits, movement disorders, expressive and receptive language communication blocks, mental subnormality, school underachievement, and behavior problems. Up to one third of the large population of children who survive prematurity suffer minor dysfunction in the areas cited above. Another 15 percent to 30 percent remain moderately to severely disabled. (Britton et al., 1981; Driscoll et al., 1982; Horwood et al., 1982; Kiely et al., 1981; Knobloch et al., 1982; Ruiz et al., 1981). Morbidity has remained relatively unchanged when compared with the progress in lowering mortality rates over the last decade (Horwood et al., 1982; Kiely et al., 1981; Knobloch et al., 1982; Ruiz et al., 1981).

Subsumed within these categories of developmental risk are psychological morbidities that are often functionally crippling beyond any real physical impairment. The awful fears parents retain from the initial life threat can

____________________
This work was supported in part by Social and Behavioral Sciences Research Grant No. 12-93 from the March of Dimes Birth Defects Foundation and a Mount Zion Hospital and Medical Center General Research Support Grant.

The following members of our research team are gratefully acknowledged for their devoted contribution to our ongoing project: Carol H. Leonard, Ph. D., John A. Martin, Ph.D., Pamela C. High, M.D., Margaret D. Lang, P.N.P., Robert E. Piecuch, M.D., Mr. David M. Sweet, and Sally A. Sehring, M.D. Special gratitude is acknowledged for the sustaining support of Roberta A. Ballard, M.D.

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