Effect of intensive care unit exposure on temperament in low birth weight preterm infants.

This study examined the hypothesis that low birth weight, preterm infants, owing to their severe illness and exposure to intensive care units (ICU), are predisposed to a more difficult temperament. Temperament was compared among three groups (n = 92): high-risk (HR) preterm infants (mean birth weight 1244 g), low-risk (LR) preterm infants (mean birth weight 2050 g), and full-term (FT) infants (mean birth weight 3159 g). Mothers completed the Infant Temperament Questionnaire (ITQ) when infants were 6 months (adjusted) old. The most striking differences were in mothers' subjective ratings of their infants: 21% of the HR mothers rated their infants as more difficult than average, compared to 4% of full-term and 0% of low-risk preterm mothers. By contrast, according to objective rating, HR infants met none of the ITQ criteria for the diagnostic category of "difficult." However, HR infants did have less favorable scores in mood, adaptability, persistence, and distractibility than LR and FT. When the HR group was further analyzed, differences in mothers' objective ratings were accounted for by length of hospitalization, while differences in mothers' subjective ratings were accounted for by severity of disease. Results suggest that, in our sample, exposure to ICU may have led to some temperament differences, but its effect was more pervasive on parents' perceptions of their infants.

The very low birth weight transport goes home: impact on the family.

Very low birth weight (VLBW) infants are known to experience more health problems after discharge from the hospital, but the effects of such problems in terms of the demand for medical care and of the effect of this on the family are only just beginning to be described. A survey of the families of 132 children who were born weighing less than 1750 g at mostly suburban hospitals and transported to a Children's Hospital, who were 1-4 years old at the time of the survey, has revealed that these children continue to experience health problems to the extent that 35% are limited in one or more activities of daily living. They also incur greater use of health care services (17% hospitalized in the prior year; 54% with a doctor's visit in the prior month). The most important predictors of high perceived impact of these problems on the family is related to the number of activities limited by health, the age of the child, and the financial resources the family could bring to coping with the child's care. These findings provide further characterization of the families which may be most vulnerable to the ongoing health problems of the VLBW infant.