Neonatal neurobehavior associated with developmental changes from age 2 to 3 in very preterm infants.

OBJECTIVE: Understand how high-risk infants' development changes over time. Examine whether NICU Network Neurobehavioral Scale (NNNS) profiles are associated with decrements in developmental outcomes between ages 2 and 3 years in infants born very preterm. STUDY DESIGN: The Neonatal Outcomes for Very preterm Infants (NOVI) cohort is a multisite prospective study of 704 preterm infants born <30 weeks' gestation across nine university and VON affiliated NICUs. Data included infant neurobehavior measured by NNNS profiles at NICU discharge and the Bayley Scales of Infant and Toddler Development (BSID-III) at ages 2 and 3 years. Generalized estimating equations tested associations between NNNS profiles and BSID-III composite score changes between ages 2 and 3 years. RESULTS: The final study sample included 433 infants with mean gestational age of 27 weeks at birth. Infants with dysregulated NNNS profiles were more likely to have decreases in BSID-III Cognitive (OR = 2.66) and Language scores (OR = 2.53) from age 2 to 3 years compared to infants with more well-regulated neurobehavioral NNNS profiles. Further, infants with more well-regulated NNNS profiles were more likely to have increases in BSID-III Cognitive scores (OR = 2.03), rather than no change, compared to infants with dysregulated NNNS profiles. CONCLUSIONS AND RELEVANCE: Prior to NICU discharge, NNNS neurobehavioral profiles identified infants at increased risk for developing later language and cognitive challenges. Findings suggests that neonatal neurobehavior provides a unique, clinically significant contribution to the evaluation of very preterm infants to inform treatment planning for the most vulnerable.

Parental Conflict in the Context of Multiethnoracial Relationships.

The percent of families with parents from different racial or ethnic backgrounds has risen exponentially in the last decades. Approximately 14% of children were born into multiethnoracial (MER) families in the United States in 2015, more than double the rate from 1980. Studies show that MER couples are more likely to separate or divorce than their monoethnoracial (MoER) counterparts. With the growing rates of MER couples, there has been increased interest and research addressing the unique benefits and challenges of being in a MER relationship. It is likely that the challenges that arise in MER families peak across the transition to parenthood when couples must negotiate how to merge their respective values, behaviors, and beliefs into a new family unit. Our study examines how the ethnoracial composition of couples (i.e., same versus different racial/ethnic backgrounds) predicts levels and increases in coparental conflict across early parenthood; and, in addition, the role of familial support as both a mediator and moderator of this relationship. We found that mothers in MER dyads report more coparenting conflict and lower familial support than their MoER counterparts across early parenthood. Additionally, fathers in MER dyads had marginally lower family support than their MoER counterparts predicting greater coparenting conflict across early parenthood. Identifying the processes linking couples' ethnoracial composition to the quality of family relationships could help inform parent interventions to better support MER parents across the transition to parenthood.

The Implications of Early Marital Conflict for Children's Development.

Although negative associations between the frequency and intensity of marital conflict and children's adjustment are well documented, less is known about how parents' conflict styles are related to children's developmental outcomes. The present study examines whether exposure to different types of parents' conflict styles, during a child's first year of life, is related to children's behavioral outcomes in the first grade. Parents' conflict resolution styles (CRSs) and child outcomes were examined in a sample of 150 working-class, first-time parents and their children. It was hypothesized that infants' exposure to more conflictual conflict resolution styles would predict poorer child outcomes over time. Results revealed that parents' unique conflict styles mattered in unique ways for children's development, but also that the interaction of parents' styles, their dyadic conflict patterns, was also related to child outcomes. Results revealed that higher levels of parents' depressive or angry CRSs in the first year predicted more internalizing problems for children, while constructive CRS was related to fewer externalizing problems. However, gender effects showed that higher rates of parental compliance during conflict were related to more internalizing problems in girls. Furthermore, dyadic results revealed that having one parent angrily engage in conflict and the other parent - withdraw, comply or angrily engage - was related to more externalizing problems for boys. Overall, results showed that parents' different conflict resolution styles, during a child's first year of life, are related to their children's developmental outcomes 6 years later. These results emphasize children's early vulnerability to parental conflict and hold implications for clinicians and practioners.

Parents' Nonstandard Work and Children's Sleep: The Mediating Role of Bedtime Routines.

OBJECTIVE: The present study examined if caregivers' long work hours or shift work are related to children's sleep duration through the disruption of bedtime routines. METHOD: Work hours and schedules, bedtime routines and sleep (actigraph assessments) were examined in a sample of 250 caregivers and their preschool children. RESULTS: Results revealed that consistent bedtime routines mediated the relationship between caregiver's work and children's sleep, such that longer hours and shift work predicted fewer routines that, in turn, predicted less child sleep. CONCLUSION: These results point to the crucial role of bedtime routines as a promising point of intervention for working parents. While caregivers may not be able to change their work hours or schedules, they can create more stable and consistent bedtime routines to mitigate the negative effects of their work on children's sleep.