Cystic fibrosis newborn screening: impact of early screening results on parenting stress.

Newborn screening for cystic fibrosis (CF) is currently available through dried blood analysis for immunoreactive trypsinogen (IRT). The possible parenting stress associated with false-positive results or the early diagnosis of an asymptomatic infant has yet to be systematically addressed. This exploratory study examined levels of parenting stress among mothers of these infants. Results indicated significantly less total parenting stress but greater defensiveness in responding among families of false-positive screened children relative to their healthy comparison families. Parents of children diagnosed with CF through newborn screening did not show significantly higher stress scores than their healthy or "traditionally-diagnosed" CF comparison families. They did however have high frequencies of "at-risk scores" warranting referral based on clinical cut-off levels for Total Parenting Stress scores (45%) and Child Demandingness subscale score (50%). As the possibility for expanding CF neonatal screening to other states is considered, the need for further exploration of psychosocial sequelae affecting parenting will be increasingly important.

Bayley's infant behavior record ratings of infants with recurrent apnea: behavioral profile and correlates with apnea, age, and developmental status.

The goal of this study was to provide a behavioral profile of apneic infants and to examine relationships between behavioral ratings, apnea frequency, age, and concurrent developmental status. Two samples of previously apneic infants were included in this exploratory analysis using the Infant Behavior Record (IBR) as a measure of temperament. Frequency of IBR suspect ratings was more than twice those reported for the Bayley standardization sample for tension, object orientation, attention, and reactivity. Apnea frequency, age, and developmental status were significantly related to a number of IBR ratings with relationships remaining significant for apnea and decreased responsiveness to persons and sensory interest after controlling for age and developmental status in the combined samples. These findings are consistent with a behavioral profile described as a lethargic temperament but may reflect early physiologic instability rather than inherent behavioral style.

Apparent life-threatening events during infancy: a follow-up study of subsequent growth and development.

This research was an exploratory follow-up study of 51 infants who had experienced an "apparent life-threatening event" (ALTE) characterized by apnea and subsequent home cardiorespiratory monitoring. The purpose was to (1) describe relationships among perinatal characteristics, birth status, recurrent apnea, and ratings of the home environment, and (2) relate these measures to infant growth and developmental outcomes. The method included home visits and assessments of infant outcomes at 10 to 14 months, followed by retrospective review of obstetric and infant medical records. Perinatal characteristics, birth status, and recurrent apnea were interrelated correlates of both growth and developmental outcomes. The ratings of the home environment (HOME [Home Observation for Measurement of the Environment] Scale) were related to developmental outcomes and to a lesser extent to physical growth status. Hierarchical regression analysis entering gestational age, obstetric and postnatal complications, apnea, and HOME subscale 4 (provision of appropriate play materials) significantly enhanced the predictability of mental and psychomotor development. Future longitudinal research is necessary to explore whether the association between apnea and specific infant outcomes attenuates over time and whether the relationship is direct or mediated by parental perception of infant vulnerability and altered caregiving style.