Extremely low birth weight preterm infants lack vasomotor response in relationship to cold body temperatures at birth

ObjectiveThis study evaluated peripheral vasoconstriction in ELBW infants when body temperature decreased during the first 12-hours of life.DesignAn exploratory, within-subjects design with 10 ELBW infants. Abdominal and foot temperatures were measured every minute. Peripheral vasoconstriction (abdominal > peripheral temperature by 2° C) and abdominal-peripheral temperature difference were also evaluated.ResultsAbdominal and peripheral temperatures were significantly correlated within each infant. One 880 g infant exhibited isolated peripheral vasoconstriction; a 960 g infant had abdominal temperatures more than 1° C higher than peripheral temperatures. Eight smaller infants exhibited no peripheral vasoconstriction and spent most of their observations with peripheral greater than abdominal temperatures. In 8 infants, mean temperature difference was significantly higher when abdominal temperature was less than 36.5° C.ConclusionMost ELBW infants did not exhibit peripheral vasoconstriction during their first 12-hours of life, despite low temperatures. ELBW infants’ vasomotor control may be immature during this period

Comparative Network Analysis of Preterm vs. Full-Term Infant-Mother Interactions

Several studies have reported that interactions of mothers with preterm infants show differential characteristics compared to that of mothers with full-term infants. Interaction of preterm dyads is often reported as less harmonious. However, observations and explanations concerning the underlying mechanisms are inconsistent. In this work 30 preterm and 42 full-term mother-infant dyads were observed at one year of age. Free play interactions were videotaped and coded using a micro-analytic coding system. The video records were coded at one second resolution and studied by a novel approach using network analysis tools. The advantage of our approach is that it reveals the patterns of behavioral transitions in the interactions. We found that the most frequent behavioral transitions are the same in the two groups. However, we have identified several high and lower frequency transitions which occur significantly more often in the preterm or full-term group. Our analysis also suggests that the variability of behavioral transitions is significantly higher in the preterm group. This higher variability is mostly resulted from the diversity of transitions involving non-harmonious behaviors. We have identified a maladaptive pattern in the maternal behavior in the preterm group, involving intrusiveness and disengagement. Application of the approach reported in this paper to longitudinal data could elucidate whether these maladaptive maternal behavioral changes place the infant at risk for later emotional, cognitive and behavioral disturbance

Improving the outcome of infants born at <30 weeks' gestation - a randomized controlled trial of preventative care at home

Background: Early developmental interventions to prevent the high rate of neurodevelopmental problems in very preterm children, including cognitive, motor and behavioral impairments, are urgently needed. These interventions should be multi-faceted and include modules for caregivers given their high rates of mental health problems

Psychological distress among postpartum mothers of preterm infants and associated factors: a neglected public health problem

Objective: The aim of the present study was to determine the prevalence of psychological distress, depression, anxiety, and stress among postpartum Arab mothers of preterm or low birth weight (LBW) infants and to identify maternal characteristics that can predict psychological distress among mothers of preterm infants. Methods: A hospital-based study was conducted. A representative sample of 2,091 postpartum mothers was surveyed and 1,659 women (79.3%) gave their consent to participate in the study. The study was based on a face-to-face interview with a designed questionnaire covering sociodemographic characteristics, anthropometric measures, medical history, and maternal characteristics. Depression, anxiety, and stress were measured using the Depression Anxiety Stress Scale (DASS-21). Results: In the study sample, 10.2% of the postpartum mothers had preterm/LBW infants. Depression (29.4 vs. 17.3%) and anxiety (26.5 vs. 11.6%) were significantly more common among mothers of preterm births compared to mothers of full term infants (p < 0.001). The risk of depression in mothers of preterm/LBW infants was two times the risk in mothers of full term infants, while the risk of anxiety was 2.7 times in mothers of preterm/LBW infants than in mothers of full term infants. Young mothers and those who had less than secondary education (42.0 vs. 21.7%; p = 0.007) and lower monthly household income (72.0 vs. 53.3%; p = 0.024) were more depressed and anxious after the preterm birth when compared with mothers of full term infants. Psychological distress was higher in mothers with history of preterm birth (30.0 vs. 21.7%) and delivery complications (52.0 vs. 33.3%). Conclusions: We found a greater risk of depression and anxiety in mothers of preterm births than in mothers of full term infants. Our analysis revealed that depressed and anxious women of preterm infants were younger, less educated, had a lower body weight and low household income than non-depressed and non-anxious women

Parental role conflict: the nursing diagnosis in mothers of hospitalized newborns

OBJECTIVE: To verify if mothers of newborns hospitalized recognize the defining characteristics of parental role conflict as representative of that experience. METHODS: A cross-sectional and descriptive study, developed in a neonatal unit of a public teaching hospital in the state of São Paulo. The sample consisted of 100 women who assigned scores of 1 to 5 to the defining characteristics of the diagnosis, where 1 meant not at all characteristic and 5 meant completely characteristic of what I am experiencing. RESULT: Of the total sample, 96 women self-identified with the diagnosis. The most prevalent defining characteristics were: anxiety, mother expresses concern(s) in relation to changes in maternal role; verbalizes feelings of frustration, reports concern about family and fear. Women who were with their children less often during hospitalization had a higher number of defining characteristics. CONCLUSION: There was a high prevalence of the defining characteristics of the studied diagnosis, suggesting the relevance of the topic and the need for further studies to be developed in the neonatal unit.OBJETIVO: Verificar si las madres de los recién nacidos hospitalizados reconocen las características definitorias de conflicto de rol parental como representativas de esa experiencia. MÉTODOS: Estudio transversal y descriptivo realizado en una unidad neonatal de un hospital de enseñanza pública en el estado de São Paulo. La muestra consistió en 100 mujeres que le asignaron puntuaciones de 1 a 5 para las características que definen el diagnóstico, en la que 1 significa nada característico y 5 significa completamente característico de lo que estoy viviendo. RESULTADOS: De la muestra total, 96 mujeres se auto-identificaron con el diagnóstico. Las características más comunes que definen fueron: ansiedad,expresa preocupación por los cambios en el rol parental,expresa sentimientos de frustración,expresa preocupación sobre la familia (p. ej., funcionamiento, comunicación, salud),y temor. Las mujeres que estaban con sus hijos con menor frecuencia durante la hospitalización tenían un mayor número de características definitorias. CONCLUSIÓN: Se observó una alta prevalencia de las características definitorias del diagnóstico estudiado, lo que sugiere la relevancia del tema y la necesidad de nuevos estudios que se desarrollarán en la unidad neonatal.OBJETIVO: verificar se mães de recém-nascidos hospitalizados reconhecem as Características Definidoras do conflito no desempenho do papel de mãe como representativas do que vivenciam. MÉTODO: estudo transversal e descritivo, desenvolvido em uma unidade neonatal de um hospital público de ensino do Estado de São Paulo. A amostra foi constituída por 100 mulheres que atribuíram escores de 1 a 5 às características definidoras do diagnóstico, em que 1 significava absolutamente não característico e 5 totalmente característico do que estou vivenciando. RESULTADO: do total da amostra, 96 mulheres identificaram-se com o diagnóstico. As características definidoras mais prevalentes foram: ansiedade; mãe expressa preocupação(ões) em relação a mudanças no papel materno; verbaliza sentimentos de frustração; mãe expressa preocupação(ões) em relação à família e medo. As mulheres que estiveram menos vezes com os filhos, durante a internação, apresentaram maior número de características definidoras. CONCLUSÃO: verificou-se alta prevalência de características definidoras do diagnóstico estudado, o que sugere a pertinência da temática e a necessidade de que mais estudos sejam desenvolvidos na unidade neonatal.Universidade Estadual de Campinas, Campinas Faculdade de EnfermagemUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de EnfermagemUNIFESP, EPESciEL