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

Clinical assessment of language development in children at age 3 years that were born preterm Avaliação da evolução dos aspectos linguísticos em crianças que nasceram prematuras aos 3 anos de idade

OBJECTIVE: To evaluate the influence of gestational age and birth weight on language development and neurodevelopmental outcome at age 3 years in children born preterm. METHOD: Cross sectional study including 69 children followed in our developmental outpatient clinic. Patients were consecutively included at the time of the 3 years of age appointment and stratified for birth weight (<1500 grams and between 1500-2500 grams). All patients were assessed for receptive and expressive language , Denver II and Bayley II tests and clinical neurological examination. For analysis patients were divided in two groups normal language acquisition (NLA) and delay in language acquisition (DLA). RESULTS: NLA children had higher scores on mental and psychomotor (p=<0.01, p=0.012) indexes of Bayley II. Newborns with less than 1500 grams had lower scores on all Bayley scale at age 36 months (p=0.002, p=0.007 and p<0.001). Multivariate analysis suggests an association between gestational age (p=0.032), abnormal behavior (p<0.001) and delay in language acquisition. Denver test at 12 and 24 months of age was a good predictor of delayed receptive and expressive language at three years of age (p=<0.01 and p=<0.01). CONCLUSION: Children born prematurely with low birth weight had an increased risk of language acquisition delay, and those had also lower cognitive and behavior scores when compared to NLA.<br>OBJETIVO: Avaliar influência da idade gestacional (IG) e peso ao nascimento na aquisição da linguagem e neurodesenvolvimento em crianças de 3 anos que nasceram prematuras. MÉTODO: Estudo transversal incluindo 69 crianças acompanhadas no Ambulatório de Seguimento Neonatal. Pacientes incluídos tinham 3 anos e foram estratificados por peso ao nascimento (>1500 gramas e entre 1500-2500 gramas). Todos foram avaliados com relação ao neurodesenvolvimento incluindo avaliação neurológica clínica, Denver II, Bayley II e avaliação da linguagem. Para a analise dividimos em dois grupos com e sem alteração na aquisição de linguagem. RESULTADOS: Crianças com DAL apresentam melhores índices nos escores de desenvolvimento no Bayley II (p=<0.01 e p=0.012). Crianças que nasceram com peso >1500 gramas tiveram escores menores no Bayley II na idade de 36 m (p=0.002, p=0.007 e p<0.001). Análise multivariada sugere uma associação da IG (p=0,032) e alteração comportamental (p=0,001) com atraso na aquisição da linguagem. Denver II alterado tanto aos 12 m quanto aos 24 m, correlaciona-se com significância estatística a atraso na aquisição de linguagem receptiva e expressiva aos 3 anos de idade (p=<0.01 e p=<0.01). CONCLUSÃO: Crianças nascidas prematuras e com baixo peso ao nascimento, apresentam maior risco de ter um atraso no desenvolvimento da linguagem. Sendo que as crianças que tem atraso no desenvolvimento de linguagem apresentaram um desempenho cognitivo e psicomotor inferior ao das com desenvolvimento normal