Neurobehavioral development and early regulatory problem in very preterm and very low birth weight infants

Children born preterm have more neurodevelopmental difficulties compared with full-term peers, including difficulties with cognitive function, self-regulation, attention, executive function, and emotional regulation. Children born preterm have also been found to have regulatory difficulties (defined as excessive crying, sleeping, or feeding problems) in early childhood, which in turn are early warning signs of future problems. The aims of the study are 1) to investigate the specificity of neurobehavioral profile in very preterm/very low birth weight (VP/VLBW) and full-term (FT) infants; 2) to explore differences in regulatory problems expressed by infants born very preterm (VP; <32 wk gestation) or with very low birth weight (VLBW; <1500 g) and infants born at full term (FT) during the first month of life, and 3) to determine the influence of preterm neurobehavioral features at 36 wk gestation, and parental stress experienced in the NICU, on infant regulatory problems in the first month. This prospective longitudinal study will involve 40 VP/VLBW and 30 FT infants recruited in the Hospital Policlinico Umberto I of Rome, Sapienza University. Neurobehavioral features (orientation, habituation, hypertonicity, hypotonicity, excitability, arousal, lethargy, nonoptimal reflexes, asymmetric reflexes, stress, self-regulation, quality of movement, handling) will beassessed at 36 w gestational age for PT infants and at term for the FT infants with the NICU Network Neurobehavioral Scale (Lester & Tronick, 2004). Maternal and Paternal stress will be assessed with the Parental Stressor Scale: Neonatal Intensive Care Unit (Miles, Funk, Carlson, 1993). Regulatory Problem will be assessed at term and at 1 month of age (corrected age for PT) with a standard interview of mothers (Cry, Feed and Sleep Interview). Results will be discussed, with a specific focus on the neurobehavioral factors that might be associated with regulatory problems at birth and at 1 month. Clinical implication and future direction will be presented, also concerning early intervention for high risk infants and families in the NICU.