NEURODEVELOPMENT OF VERY AND LATE PRETERM INFANTS AND CORRELATION WITH MATERNAL STRESS AT 12 MONTHS OF CORRECTED AGE

Background. 'Late preterm" newborns (34-36 weeks of gestation) represent more than 70% of all preterm labors. Despite the high prevalence and increased medical risk, little is known on early and long-term neurodevelopmental outcome of these children and data are controversial. To our knowledge there are no studies on the parental stress of late preterm infants (LPI) compared with parents of very preterm infants (VPI). This study aimed to asses the outcomes of VPI and LPI at 1 years of corrected age (CA) and to examine correlation with maternal stress. Methods. Seventy-three subjects, LPI (N=34) and VPI (N=39) born from January 2010 to December 2011 admitted to our NICU of the Children's Hospital Bambino Gesù of Rome, Italy, and their mothers, took part in the study. Congenital malformation, genetic syndrome, severe neurological and sensorial deficits were excluded. Children were evaluated at 12 months CA with the Bayley Scales of Infant and Toddler Development-Third Edition (Bayley III). Their mothers (mean age=35.8±5.9) completed a questionnaire on parenting stress (Italian version of Parenting Stress Index-short form, PSI-SF) during the same session. Neonatal and socio-demographic data were collected. Results:. 63 preterm infants (25 LPI and 38 VPI) completed the Cognitive, Language and Motor Scales of Bayley III. Mean Cognitive composite Score (Cog; 104±10; p<.001) was significantly higher than Language (Lang; 97±10) and Motor composite score (Mot; 91±10). Mean Bayley scores were in the normal range in LPI e VPI without significant differences between groups. The mean Total Parenting Stress score (N=26 of LPI mothers and N=36 of VPI mothers) was significantly higher (p<.05) in VPI (68.89±20.3) than LPI mothers (59.23±12.2), accounted primarily for the Difficult Child subscale (mean was 23.83±8.8 and 19±4.8 respectively; p<.05). Bivariate correlations showed that for both LPI and VPI, Language score at Bayley III was significantly related to gestational age (r=.44, p<.05 and r=.43, p<.01 respectively); while for VPI only, the Parent-Child Difficult Interaction score of PSI-SF was negatively related to Language score of Bayley III (r=-.33, p<.05). Conclusion. Our study showed that the mean neurodevelopment outcome of VPI and LPI groups at 12 months of corrected age corresponded to the normative and that language development and motor skills were weaker than cognitive domain. Mothers of VPI exhibited greater psychological fragility compared to the others in daily management and understanding of child's behavior. These data, although preliminary, suggest the need of specialized and individualized multidisciplinary follow-up which includes a systematic assessment of parental concerns and of mother/child interaction.