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1.
J Perinatol ; 37(5): 475-479, 2017 05.
Article in English | MEDLINE | ID: mdl-28252658

ABSTRACT

Longitudinal follow-up with assessment of developmental status at about 2 years of age is routine for high-risk newborns. The results of these assessments can be used for many purposes, including helping physicians, parents, and teachers plan educational or developmental interventions. These assessments also provide outcome measures for clinical research studies. Outcome results may also serve as a source of information for clinicians when counseling parents regarding provision of care for extreme preterm infants. Consideration should be given to use of different outcome metrics based on the purpose for testing. Categorization of composite cognitive, motor and neurosensory findings to define levels of impairment should be limited to research. Planning for individual interventions is better guided by descriptive findings. Current tools for assessing neurodevelopmental status at 2 years of age have important limitations. First, outcomes at early ages do not always predict function later in life. They are, at best, an estimate of longer-term outcomes, with important individual variation. For infants without severe neurologic injury, postnatal environmental factors play a predominant role in determining long-term cognitive and academic outcomes. Further investigations should assess quality of life and other considerations that are important for parents when making decisions about neonatal intensive care unit care for their infant.


Subject(s)
Central Nervous System/growth & development , Infant, Extremely Low Birth Weight/growth & development , Infant, Premature/growth & development , Neuropsychological Tests/standards , Child Development , Cognition , Humans , Infant , Infant, Newborn , Motor Activity , Prognosis , Quality of Life
3.
J Dent Res ; 91(9): 859-64, 2012 Sep.
Article in English | MEDLINE | ID: mdl-22821239

ABSTRACT

Few studies have investigated the role of early maternal enabling and psychosocial factors on subsequent adolescent caries experience. In this retrospective cohort study of 224 adolescents, we hypothesized that the causal pathway between early maternal enabling factors (education, cognitive abilities, psychological distress) and adolescent caries experience (DMFT) at age 14 yrs is mediated by maternal psychosocial factors (stress, coping, social support) and adolescent dental behavior/access. Maternal data on socio-demographic, medical, and psychosocial variables were measured when the child was 3, 8, and 14 yrs old. A structural equations model (SEM) evaluated the causal pathway, with latent variables for maternal enabling factors (MEF), stress, coping, and social support. Poor MEF was associated with increased stress and poorer coping when the child was 3 yrs old, which in turn affected adolescent dental visits and behavior. Greater social support at child's age 3 was directly associated with lower mean DMFT in adolescence. Maternal psychosocial factors measured when children are young are important mediators for adolescent mean DMFT, but these factors measured when children are adolescents are not. Better early and concurrent MEF, however, was associated directly/indirectly (through dental visits and insurance) with adolescent DMFT. Early maternal factors are important predictors for adolescent caries.


Subject(s)
Dental Caries/epidemiology , Dental Caries/psychology , Maternal Behavior , Models, Psychological , Mother-Child Relations , Adaptation, Psychological , Adolescent , Causality , Cohort Studies , DMF Index , Educational Status , Female , Forecasting , Humans , Male , Psychology , Retrospective Studies , Risk Factors , Social Support , Statistics, Nonparametric , Stress, Psychological , Surveys and Questionnaires
4.
Caries Res ; 44(6): 509-18, 2010.
Article in English | MEDLINE | ID: mdl-20975268

ABSTRACT

OBJECTIVES: The purpose of this study was to examine developmental enamel defects and dental caries in very low birth weight adolescents with high risk (HR-VLBW) and low risk (LR-VLBW) compared to full-term (term) adolescents. METHODS: The sample consisted of 224 subjects (80 HR-VLBW, 59 LR-VLBW, 85 term adolescents) recruited from an ongoing longitudinal study. Sociodemographic and medical information was available from birth. Dental examination of the adolescent at the 14-year visit included: enamel defects (opacity and hypoplasia); decayed, missing, filled teeth of incisors and molars (DMFT-IM) and of overall permanent teeth (DMFT); Simplified Oral Hygiene Index for debris/calculus on teeth, and sealant presence. A caregiver questionnaire completed simultaneously assessed dental behavior, access, insurance status and prevention factors. Hierarchical analysis utilized the zero-inflated negative binomial model and zero-inflated Poisson model. RESULTS: The zero-inflated negative binomial model controlling for sociodemographic variables indicated that the LR-VLBW group had an estimated 75% increase (p < 0.05) in number of demarcated opacities in the incisors and first molar teeth compared to the term group. Hierarchical modeling indicated that demarcated opacities were a significant predictor of DMFT-IM after control for relevant covariates. The term adolescents had significantly increased DMFT-IM and DMFT scores compared to the LR-VLBW adolescents. CONCLUSION: LR-VLBW was a significant risk factor for increased enamel defects in the permanent incisors and first molars. Term children had increased caries compared to the LR-VLBW group. The effect of birth group and enamel defects on caries has to be investigated longitudinally from birth.


Subject(s)
Dental Caries Susceptibility , Dental Caries/etiology , Dental Enamel/abnormalities , Infant, Low Birth Weight , Infant, Very Low Birth Weight , Tooth Abnormalities/complications , Adolescent , Binomial Distribution , Case-Control Studies , Cohort Studies , DMF Index , Dental Caries/pathology , Dental Enamel/growth & development , Dental Enamel/pathology , Dentition, Permanent , Female , Follow-Up Studies , Humans , Infant, Newborn , Male , Reference Values , Retrospective Studies , Risk Factors , Tooth Abnormalities/pathology
5.
J Perinatol ; 28(7): 498-504, 2008 Jul.
Article in English | MEDLINE | ID: mdl-18368061

ABSTRACT

OBJECTIVE: This retrospective analysis assessed the relationship between medical treatment (postnatal steroids, surfactant) received neonatally and outcomes at 3 and 8 years using a longitudinal sample of children with bronchopulmonary dysplasia (BPD). STUDY DESIGN: Four groups were formed retrospectively based on the type of neonatal medical treatment received: no drug intervention (n=37), surfactant only (n=29), postnatal steroids only (n=13) and combined surfactant and postnatal steroids (n=16). Groups were compared on neurological and medical outcomes. RESULT: Combined postnatal steroids and surfactant treatment was associated with more days on supplemental oxygen than no intervention or surfactant only. Surfactant replacement therapy alone was not associated with adverse consequences; however, postnatal steroid exposure appeared to be related. CONCLUSION: Although retrospective analyses make statements about causation impossible, the differential relationships of therapies with cognitive outcomes argues for careful monitoring of therapeutic agents with very low birth weight infants.


Subject(s)
Adrenal Cortex Hormones/adverse effects , Bronchopulmonary Dysplasia/drug therapy , Intelligence/drug effects , Psychomotor Performance/drug effects , Pulmonary Surfactants/adverse effects , Child , Child, Preschool , Drug Therapy, Combination , Female , Humans , Infant , Infant, Newborn , Infant, Premature , Infant, Very Low Birth Weight , Longitudinal Studies , Male , Prospective Studies , Retrospective Studies
6.
Nurs Res ; 50(6): 346-55, 2001.
Article in English | MEDLINE | ID: mdl-11725936

ABSTRACT

BACKGROUND: Effects of maternal employment for preschool children vary based on specific characteristics of the mother's employment, the family's economic status, and the mother's attitudes about employment. However, there is limited research on a growing group of children at developmental risk-those born prematurely and living in a single-parent family. OBJECTIVE: To examine the effects of maternal employment and prematurity on child cognition and behavior in single-parent families. METHODS: Sixty preterm and 61 full-term preschool children were recruited through NICU admission records and birth records. Data were collected with the Kaufmann Assessment Battery for Children, Peabody Picture Vocabulary Test, Child Behavior Checklist, Parenting Stress Index, and the Life History Calendar. RESULTS: Greater hours employed was related to higher achievement and mental processing scores only. Less discrepancy between actual and desired employment was related to higher achievement, mental processing, and language scores and lower behavior scores. Prematurity was not related to child cognitive and behavioral performance. Only the relationship between discrepancy and language remained after statistical control. CONCLUSIONS: The concerns about negative effects of maternal employment on young children may be overstated, especially in low-income, single-mother families. These findings are especially important in the context of welfare reform.


Subject(s)
Child Development , Developmental Disabilities/prevention & control , Employment , Infant, Premature , Single Parent , Achievement , Child Behavior , Child, Preschool , Cognition , Female , Humans , Infant, Newborn , Male , Mother-Child Relations , Multivariate Analysis , Regression Analysis , Risk Factors , Socioeconomic Factors
7.
Pediatrics ; 108(2): 372-81, 2001 Aug.
Article in English | MEDLINE | ID: mdl-11483802

ABSTRACT

OBJECTIVE: To evaluate the effects of dietary intake of the long-chain polyunsaturated fatty acids, arachidonic acid (AA), and docosahexaenoic acid (DHA) on multiple indices of infant growth and development. DESIGN: A double-masked, randomized, parallel trial was conducted with term infants fed formulas with or without AA+DHA for 1 year (N = 239). Reference groups of breastfed infants (N = 165) weaned to formulas with and without AA+DHA were also studied. Infants in the formula groups were randomized at

Subject(s)
Child Development/drug effects , Fatty Acids, Unsaturated/therapeutic use , Infant Nutritional Physiological Phenomena , Infant, Premature/growth & development , Arachidonic Acid/administration & dosage , Arachidonic Acid/pharmacology , Arachidonic Acid/therapeutic use , Breast Feeding , Child Development/physiology , Cohort Studies , Docosahexaenoic Acids/administration & dosage , Docosahexaenoic Acids/pharmacology , Docosahexaenoic Acids/therapeutic use , Double-Blind Method , Fatty Acids, Unsaturated/administration & dosage , Fatty Acids, Unsaturated/pharmacology , Female , Food, Fortified , Humans , Infant Food , Infant, Newborn , Infant, Premature/physiology , Milk, Human , Multivariate Analysis , Prospective Studies
9.
Early Hum Dev ; 64(2): 91-103, 2001 Sep.
Article in English | MEDLINE | ID: mdl-11440822

ABSTRACT

Fetal cocaine exposure may have differentially adverse effects on developmental outcomes of very low birthweight (VLBW) infants. As part of a longitudinal study, 31 cocaine-positive very low birthweight infants, and age, race and socioeconomic status matched VLBW controls enrolled at birth were followed. Neonatal maternal-child interactions, concurrent maternal psychological characteristics and environmental factors conceptualized as important for child outcome were assessed as well as standard developmental outcomes at 3 years. In the neonatal period, cocaine-exposed VLBW infants who remained in maternal custody tended to be rated as less responsive and their mothers as less nurturing, less emotionally available and with a tendency to use more maladaptive coping mechanisms than nonexposed VLBW infants. At follow-up, cocaine-exposed VLBW children were delayed in cognitive, motor and language development compared to controls. Almost half (45%) of the exposed children scored in the range of mental retardation compared to 16% of the comparison VLBW children. The persistent cognitive, motor and language delays of the cocaine-exposed VLBW children, combined with the poorer behavioral interactions of cocaine-using women with their infants in the neonatal period, indicate a need for increased developmental surveillance of cocaine-exposed VLBW infants with a focus on maternal drug treatment and parenting interventions.


Subject(s)
Child Development/drug effects , Cocaine-Related Disorders/complications , Developmental Disabilities/chemically induced , Infant, Very Low Birth Weight , Maternal Behavior/drug effects , Mother-Child Relations , Adult , Child, Preschool , Cocaine-Related Disorders/psychology , Female , Gestational Age , Humans , Infant, Newborn , Longitudinal Studies , Male , Maternal Behavior/psychology , Maternal Exposure/adverse effects , Maternal-Fetal Exchange , Pregnancy , Prenatal Exposure Delayed Effects
10.
Pediatrics ; 107(5): 1057-64, 2001 May.
Article in English | MEDLINE | ID: mdl-11331686

ABSTRACT

OBJECTIVE: To assess whether there is an association of level of fetal cocaine exposure to developmental precursors of speech-language skills at 1 year of age, after controlling for confounding factors. DESIGN: In a prospective, longitudinal, quasi-experimental, matched cohort design, 3 cocaine exposure groups were defined by maternal self-report and infant meconium assay: nonexposure (n = 131), heavier exposure (n = 66), >the 75th percentile for maternal self-report and >the 70th percentile of benzoylecgonine concentration, and all others as lighter exposure (n = 68). At 1 year of age, the Preschool Language Scale-3 was administered by examiners unaware of infant drug status. RESULTS: Independent of confounding drug, medical, and environmental factors, more heavily exposed infants had lower auditory comprehension scores than nonexposed infants and lower total language scores than lighter and nonexposed infants. More heavily exposed infants were also more likely to be classified as mildly delayed by total language score than nonexposed infants. There were positive linear relationships between the concentration of benzoylecgonine in meconium and all outcomes and between maternal report of severity of prenatal cocaine use with poorer auditory comprehension indicating a relationship between amount of exposure and poorer outcomes. CONCLUSIONS: This study documents significant behavioral teratogenic effects of fetal cocaine exposure on attentional abilities underlying auditory comprehension skills considered to be precursors of receptive language. Pediatricians are in a unique position to monitor early development of cocaine-exposed infants and make timely referrals for intervention.


Subject(s)
Cocaine-Related Disorders/physiopathology , Cocaine/analogs & derivatives , Language Development Disorders/etiology , Pregnancy Complications/physiopathology , Prenatal Exposure Delayed Effects , Analysis of Variance , Cocaine/analysis , Female , Humans , Infant , Infant, Newborn , Language Development Disorders/diagnosis , Language Development Disorders/epidemiology , Language Tests , Longitudinal Studies , Male , Meconium/chemistry , Pregnancy , Regression Analysis , Statistics, Nonparametric
11.
J Dev Behav Pediatr ; 22(1): 19-26, 2001 Feb.
Article in English | MEDLINE | ID: mdl-11265919

ABSTRACT

A prospective follow-up of very low birth weight (VLBW) infants with and without bronchopulmonary dysplasia (BPD) and term control infants was conducted. The effects of BPD and VLBW on speech-language development and specific language impairment at 3 years of age were investigated, controlling for the effects of sociodemographic and other medical risk factors. Groups were compared on cognitive and speech-language outcomes using the Battelle Language and Bayley Mental Scales of Infant Development. Children with a history of BPD had lower receptive language skills than VLBW children without BPD, who in turn had lower receptive skills than term children. Children with a history of BPD also had lower expressive skills than the two comparison groups, whereas VLBW children without BPD did not differ in expressive language from term children. When IQ score was controlled, children with BPD demonstrated specific language impairment in receptive language. The presence of patent ductus arteriosis (PDA) was the best predictor of language deficits and the combined occurrence of PDA and BPD resulted in differentially lower language scores. Neurologic complications, low socioeconomic status, and minority race were also significant predictors of language delay. The findings emphasize the importance of considering both medical and sociodemographic factors in evaluating the risk of VLBW infants for poorer speech-language outcomes.


Subject(s)
Bronchopulmonary Dysplasia/complications , Language Disorders/complications , Language Disorders/diagnosis , Verbal Behavior , Child, Preschool , Cognition Disorders/complications , Cognition Disorders/epidemiology , Ductus Arteriosus, Patent/epidemiology , Female , Follow-Up Studies , Humans , Infant, Newborn , Infant, Very Low Birth Weight/physiology , Language Disorders/epidemiology , Male , Motor Skills Disorders/complications , Motor Skills Disorders/epidemiology , Prospective Studies , Risk Factors , Socioeconomic Factors
12.
Semin Neonatol ; 6(5): 393-401, 2001 Oct.
Article in English | MEDLINE | ID: mdl-11988029

ABSTRACT

Randomized clinical trials of early nutritional interventions in infants are necessary to establish safety and efficacy of supplementation of infant formulas with LCPUFAS for term and preterm infants. Such trials pose significant methodologic difficulties when applied to infants because of the rapidly changing development of the infant's central nervous system and its interdependence with multiple environmental factors. Current assessments of infant cognitive development in the first year of life lack stability and predictive relationships to later outcomes. Thus, intervention trials need to extend beyond the first two years of life. Small sample sizes, high attrition rates, and lack of attention to confounding variables known to be related to child outcomes are additional problems in the majority of studies to date, especially for preterm populations. Attention to selection and attrition biases and the roles of mediating and moderating factors in affecting intervention effects are also necessary to determine the benefits vs risks of LCPUFA supplementation of infant formula.


Subject(s)
Dietary Supplements , Fatty Acids, Unsaturated/administration & dosage , Infant Food , Infant Nutritional Physiological Phenomena , Randomized Controlled Trials as Topic , Breast Feeding , Cognition , Confounding Factors, Epidemiologic , Humans , Infant, Newborn , Reproducibility of Results , Selection Bias , Sensitivity and Specificity
13.
Neurotoxicol Teratol ; 22(5): 653-66, 2000.
Article in English | MEDLINE | ID: mdl-11106858

ABSTRACT

The present study investigated the neurobehavioral outcomes of fetal cocaine exposure. Attempts were made to control, by design or statistical analysis, for significant confounders. Timing and amount of drug exposures were considered, and biologic measures of exposure were quantified to classify exposure severity. One hundred sixty-one non-cocaine and 158 cocaine-exposed (82 heavily and 76 lightly exposed) infants were seen at a mean-corrected age of 43 weeks post-conception and administered the Neurobehavioral Assessment (NB Assessment). Heavily cocaine-exposed infants had more jitteriness and attentional problems than lightly and non-exposed infants. They also had more movement and tone abnormalities, and sensory asymmetries than non-exposed infants. Heavily exposed infants were more likely to be identified with an abnormality than non-exposed infants and there was a trend toward heavily exposed infants being more likely to be identified with an abnormality than lightly exposed infants. Furthermore, there was a trend for heavily exposed infants to be less likely to be testable than non-exposed infants. After the confounding and mediating factors were considered, heavily cocaine-exposed infants were four times as likely to be jittery and nearly twice as likely to demonstrate any abnormality than lightly and non-exposed infants, but all other effects were no longer significant. Higher concentrations of the cocaine metabolites of cocaine, cocaethylene, and benzoylecgonine (BZE) were related to higher incidence of movement and tone abnormalities, jitteriness, and presence of any abnormality. Higher cocaethylene levels were related to attentional abnormalities and higher meta-hydroxybenzoylecgonine (m-OH-BZE) was related to jitteriness. Drug effects on attention were mediated by maternal psychological distress, suggesting that this factor should be considered in future studies of drug exposure effects.


Subject(s)
Cocaine/adverse effects , Prenatal Exposure Delayed Effects , Psychomotor Performance/drug effects , Adolescent , Adult , Birth Weight/drug effects , Cocaine/metabolism , Dose-Response Relationship, Drug , Female , Gestational Age , Humans , Infant, Newborn , Male , Maternal Age , Meconium/chemistry , Neuropsychological Tests , Pregnancy
14.
Crit Care Nurs Clin North Am ; 12(2): 227-35, 2000 Jun.
Article in English | MEDLINE | ID: mdl-11249368

ABSTRACT

Severe pediatric head injury has negative consequences for children of all ages. Even mild and moderate head injury results in residual impairment for school-age children and adolescents. Data are needed on the effects of these less severe insults, especially for preschoolers. Although research on the impact of the child's head injury on the parent-child relationship and family functioning is limited, the experience is likely to be very stressful for the parent and the family. Indeed, family integrity may be at risk. Research is needed that examines the effects of a child's head injury for the parent and the family over time and identifies factors related to these outcomes.


Subject(s)
Caregivers/psychology , Craniocerebral Trauma/psychology , Craniocerebral Trauma/rehabilitation , Family Health , Adult , Child , Cost of Illness , Craniocerebral Trauma/nursing , Humans , Parents/psychology , Professional-Family Relations
15.
Alcohol Clin Exp Res ; 23(3): 487-93, 1999 Mar.
Article in English | MEDLINE | ID: mdl-10195823

ABSTRACT

BACKGROUND: Fetal alcohol syndrome, fetal alcohol effects, alcohol-related neurodevelopmental disorder, and alcohol-related birth defects, all terms referring to the spectrum of consequences of in utero exposure to ethanol, are a major public health burden. There is currently no laboratory test to identify newborns exposed to ethanol in utero. Meconium was analyzed for ethyl linoleate, a metabolite of ethanol, as a biological marker for fetal ethanol exposure. METHODS: Samples of meconium were obtained from 248 infants and analyzed for fatty acid ethyl esters. Detailed maternal alcohol, tobacco, and drug use histories were obtained within 1 month of giving birth. RESULTS: The detection of ethyl linoleate in meconium was called a positive test. The mean number of drinks reported per week in the month before pregnancy, the first trimester, and overall were significantly higher in the positive group (unadjusted: 9.2 +/- 1.9 vs. 4.3 +/- 1.4, p = 0.004; 7.3 +/- 1.7 vs. 3.8 +/- 1.2, p = 0.03; and 6.1 +/- 1.3 vs. 3.0 +/- 1.0, p = 0.006). A positive test was not associated with marijuana, cocaine, or tobacco use. Sensitivity and specificity of the test were 72% and 51% to distinguish women who reported 1 or more drinks/week in the third trimester from women who denied use, and 68% and 48% to distinguish women who used > or =1 drink/week from women who used <1 drink/week in the month before pregnancy. CONCLUSIONS: The presence of ethyl linoleate in meconium is the first reported biological marker for maternal ethanol use during pregnancy. Because of the inherent inaccuracy associated with the use of self-reporting, the establishment of true values of sensitivity and specificity will require validation where the presence, quantity, and timing of exposure to alcohol is known. Further validation of this marker will permit identification and intervention of at-risk infants.


Subject(s)
Alcohol Drinking/metabolism , Ethanol/metabolism , Linoleic Acids/analysis , Meconium/chemistry , Adult , Biomarkers/analysis , Chromatography, Gas , Female , Humans , Infant, Newborn , Linoleic Acids/metabolism , Meconium/metabolism , Pregnancy , Pregnancy Trimesters , Prenatal Exposure Delayed Effects , Sensitivity and Specificity , Substance-Related Disorders/metabolism
16.
JAMA ; 281(9): 799-805, 1999 Mar 03.
Article in English | MEDLINE | ID: mdl-10071000

ABSTRACT

CONTEXT: Few studies document how parents adapt to the experience of a very low-birth-weight (VLBW; <1500 g) birth despite societal concerns about the ethics and justification of intensive care for these infants. OBJECTIVE: To determine the degree and type of stress experienced over time by mothers whose infants vary in degree of prematurity and medical and developmental risk. DESIGN: Longitudinal prospective follow-up study of a cohort of mothers of high- and low-risk VLBW and term infants from birth to 3 years. SETTING: All level III neonatal intensive care units from a large midwestern metropolitan region. PARTICIPANTS: Mothers and infants prospectively and consecutively enrolled in a longitudinal study between 1989 and 1991. High-risk VLBW infants were diagnosed as having bronchopulmonary dysplasia, and comparison groups were low-risk VLBW infants without bronchopulmonary dysplasia and term infants (>36 weeks, >2500 g). MAIN OUTCOME MEASURES: Standardized, normative self-report measures of maternal psychological distress, parenting stress, family impact, and life stressors. RESULTS: Mothers of VLBW infants (high risk, n = 122; low risk, n = 84) had more psychological distress than mothers of term infants (n=123) at 1 month (13% vs 1%; P = .003). At 2 years, mothers of low-risk VLBW infants did not differ from term mothers, while mothers of high-risk infants continued to report psychological distress. By 3 years, mothers of high-risk VLBW children did not differ from mothers of term children in distress symptoms, while parenting stress remained greater. Severity of maternal depression was related to lower child developmental outcomes in both VLBW groups. CONCLUSIONS: The impact of VLBW birth varies with child medical risk status, age, and developmental outcome. Follow-up programs should incorporate psychological screening and support services for mothers of VLBW infants in the immediate postnatal period, with monitoring of mothers of high-risk VLBW infants.


Subject(s)
Infant, Very Low Birth Weight , Maternal Behavior/psychology , Mothers/psychology , Parenting/psychology , Stress, Psychological , Adult , Child, Preschool , Depression , Developmental Disabilities , Female , Humans , Infant , Infant, Newborn , Infant, Premature , Longitudinal Studies , Male , Prospective Studies
17.
Nurs Res ; 47(2): 114-21, 1998.
Article in English | MEDLINE | ID: mdl-9536195

ABSTRACT

BACKGROUND: The influence of premature birth of an infant in female-headed, single-parent families together or in conjunction with family environment factors, such as employment of the mother, on the mother-premature child relationship has not been considered in past studies. OBJECTIVES: To explore differences in parent-child and family relationships for employed and nonemployed single mothers of low-birth-weight (LBW) and full-term preschool children and to describe the relationships of the mother's employment status, employment history, and employment attitude-behavior consistency to parent-child and family relationships. METHODS: Single mothers with LBW (n = 60) and full-term (n = 61) preschool children provided data on their employment situation, the Parenting Stress Index, the Feetham Family Functioning Survey, and the Home Observation for Measurement of the Environment. RESULTS: Employed mothers had more positive perceptions and provided more enriching home environments for their children. Greater attitude-behavior consistency was associated with more positive perceptions of the parental role. CONCLUSION: Thus, in single-parent families, employment and consistency are positive influences on the mother-child relationship.


Subject(s)
Infant, Low Birth Weight/psychology , Mother-Child Relations , Single Parent/psychology , Women, Working/psychology , Adaptation, Psychological , Adult , Attitude , Child, Preschool , Employment/psychology , Family Health , Female , Humans , Male , Personal Satisfaction , Self Concept , Stress, Psychological/psychology , Surveys and Questionnaires
18.
J Dev Behav Pediatr ; 17(2): 69-76, 1996 Apr.
Article in English | MEDLINE | ID: mdl-8727839

ABSTRACT

Infants with very low birth weight (VLBW) are at increased risk for feeding disorders that can affect growth and development. One hundred and forty one mother-infant pairs were compared [55 with infants with high medical risk due to infant VLBW and bronchopulmonary dysplasia (BPD), 34 VLBW without BPD, and 52 term infants] on operationally defined measures of feeding behaviors and maternal self-report of depression and anxiety. Mothers of VLBW infants with and without BPD spent more time prompting their infants to feed when their infants engaged in nonfeeding behavior. Despite increased maternal efforts, infants with BPD took in less formula, spent less time sucking, and spent a greater proportion of time nonfeeding. VLBW infants without BPD were equivalent to term infants in percentage of time sucking and in volume of formula ingested and were more likely to take in higher calories than infants with BPD. Mothers of VLBW infants with and without BPD were also more likely to report clinically significant symptoms of depression and anxiety than mothers of term infants. Because mothers of VLBW infants who were more depressed or anxious were less likely to verbally prompt their infants to eat, maternal psychological symptoms should be considered in assessing interactions of VLBW mother-infant dyads.


Subject(s)
Bottle Feeding/psychology , Bronchopulmonary Dysplasia/psychology , Infant Care/psychology , Infant, Very Low Birth Weight/psychology , Mother-Child Relations , Sucking Behavior , Adult , Anxiety/psychology , Bronchopulmonary Dysplasia/rehabilitation , Depression/psychology , Energy Intake , Female , Humans , Infant, Newborn , Male , Maternal Behavior , Mothers/psychology , Personality Assessment , Verbal Behavior , Weight Gain
19.
MD Comput ; 12(3): 200-5, 1995.
Article in English | MEDLINE | ID: mdl-7596250

ABSTRACT

We developed a research database for a five-year prospective investigation of the medical, social, and developmental correlates of chronic lung disease during the first three years of life. We used the Ingres database management system and the Statit statistical software package. The database includes records containing 1300 variables each, the results of 35 psychological tests, each repeated five times (providing longitudinal data on the child, the parents, and behavioral interactions), both raw and calculated variables, and both missing and deferred values. The four-layer menu-driven user interface incorporates automatic activation of complex functions to handle data verification, missing and deferred values, static and dynamic backup, determination of calculated values, display of database status, reports, bulk data extraction, and statistical analysis.


Subject(s)
Data Interpretation, Statistical , Database Management Systems , Medical Records Systems, Computerized , Software , Bronchopulmonary Dysplasia/diagnosis , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Longitudinal Studies , Male , Prospective Studies
20.
J Pediatr ; 124(5 Pt 1): 765-71, 1994 May.
Article in English | MEDLINE | ID: mdl-7513757

ABSTRACT

This study sought to determine whether very low birth weight (VLBW) infants (< 1500 gm) with fetal cocaine exposure differed from non-cocaine-exposed VLBW infants in incidence of neonatal medical complications and in later developmental outcome. Forty-one cocaine-exposed, VLBW infants, followed in a longitudinal study, were compared with 41 non-cocaine-exposed, VLBW infants of comparable race, social class, age, and incidence of bronchopulmonary dysplasia. Cocaine-exposed infants were identified on the basis of combined findings of maternal and/or infant urine immunoassay and on the basis of maternal self-report. At birth, groups did not differ on medical risk factors except that cocaine-exposed infants had a higher incidence of mild (grades I to II) intraventricular hemorrhage. Cocaine-using women were also more likely to use other drugs, especially alcohol, marijuana, and tobacco. At follow-up, at mean corrected ages of 16.5 +/- 8 months for 30 cocaine-exposed infants and 18.5 +/- 7 months for 37 non-cocaine-exposed infants, standardized assessments of cognitive (Mental Development Index) and motor (Psychomotor Development Index) development were administered. Cocaine-exposed infants had lower mean cognitive (83 +/- 27 vs 91 +/- 19), and motor (85 +/- 25 vs 96 +/- 18) scores; the incidence of developmental delay was significantly higher even after control for the effects of intraventricular hemorrhage and chronologic age. Cocaine-exposed VLBW infants were also more likely to be living with relatives or in foster homes. We conclude that these VLBW, cocaine-exposed infants were at increased risk of intraventricular hemorrhage, were more likely to be placed outside maternal care, and had higher incidences of cognitive and motor delays at follow-up.


Subject(s)
Cerebral Hemorrhage/chemically induced , Cocaine/adverse effects , Developmental Disabilities/chemically induced , Infant, Low Birth Weight , Prenatal Exposure Delayed Effects , Adult , Female , Humans , Infant, Newborn , Male , Pregnancy , Pregnancy Complications , Prospective Studies , Regression Analysis , Substance-Related Disorders/complications
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