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  • Original Article
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Developmental care, neonatal behavior and postnatal maternal depressive symptomatology predict internalizing problems at 18 months for very preterm children

Abstract

Objective:

To provide a prospective developmental model for behavioral outcomes in preterm infants in relation to developmental care (DC) practices and postnatal maternal depression.

Study design:

A longitudinal, multicenter, follow-up study conducted in 25 Italian tertiary neonatal intensive care units (NICUs). Participants were 162 healthy very preterm infants and their mothers. The level of quality of DC was assessed for each hospital. Infant’s neurobehavioral profile was evaluated twice: at discharge (T1) and at 18 months for behavioral problems (T3). Maternal depressive symptomatology was measured at T1 and at 6 months (T2).

Results:

Low-quality DC in NICUs was associated with lower levels of infant neurobehavioral adaptability and higher levels of maternal depressive symptoms. Maternal depressive symptomatology in conjunction with higher infant dysregulation predicted more internalizing problems at 18 months of age.

Conclusion:

DC interventions and postnatal maternal depression, as well as infant behavior have an impact on short- and long-term infant outcomes.

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Acknowledgements

The NEO-ACQUA project was supported by an advisory group whose membership consisted of the following people: Roberto Bellù, Renato Borgatti, Alberto Del Prete, Guido Calciolari, Maria Caterina Cavallo, Rosario Montirosso, Rinaldo Zanini. We thank the MediData Studi e Ricerche staff in Modena for their organizational, technical and scientific support. We are very grateful to the staff of all NICUs. We would also like to thank participating children and their parents for their involvement in this study. The NEO-ACQUA project was supported by an unrestricted educational grant from Chiesi Farmaceutici SpA, Parma, Italy. Preparation of this manuscript was partially supported by funds from the Italian Health Ministry Grant RC01-04-2013 to RM.

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Correspondence to R Montirosso.

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The authors declare no conflict of interest. The first author wrote the first version of the draft and no honorarium, grant or other form of payment was given to anyone to produce the manuscript.

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THE NEO-ACQUA STUDY GROUP

The NEO-ACQUA Study Group are listed as follows:

Fabio Mosca6, Odoardo Picciolini6, Roberto Bellù7, Alberto Del Prete7, Rinaldo Zanini7, Stefano Visentin8, Nadia Battajon8, Maria Lucia Di Nunzio9, Fiorina Ramacciato9, Laura Barberis10, Emmanuele Mastretta10, Giovanna Carli11, Michela Alfiero Bordigato11, Valeria Chiandotto12, Cristiana Boiti12, Rosangela Litta13, Giovanna Minelli13, Marcello Napolitano14, Alessandro Arco15, Palma Mammoliti16, Cinzia Fortini17, Paolo Tagliabue18, Lorenzo Quartulli19, Giuliana Motta20, Paola Introvini21, Rosetta Grigorio22, Paola Mussini23, Giulia Pomero24, Carlo Poggiani25, Ananda Bauchiero26

6NICU, Department of Maternal and Pediatric Sciences, University of Milan Fondazione IRCCS Ca’ Granda, Milan, Italy; 7Department of Neonatal Care and NICU, Manzoni Hospital, Lecco, Italy; 8Neonatology and NICU, Ca' Foncello Hospital, Treviso, Italy; 9NICU, Cardarelli Hospital, Campobasso, Italy; 10Division of Neonatology and NICU, S Anna Hospital, Turin, Italy; 11NICU, Hospital of Camposampiero, Camposampiero, Italy; 12Department of Neonatology, University Hospital SMM, Udine, Italy; 13Division of Neonatology and NICU, Ospedali Riuniti, Foggia, Italy; 14NICU, Evangelic Hospital Villa Betania, Napoli, Italy; 15NICU, University Hospital G Martino, Messina, Italy; 16NICU, Ospedale degli Infermi, Rimini, Italy; 17NICU, Pediatric University Hospital, Ferrara, Italy; 18Division of Neonatology, San Gerardo Hospital, Monza, Italy; 19NICU, Perrino Hospital, Brindisi, Italy; 20NICU, Niguarda Hospital Ca' Granda, Milan, Italy; 21NICU, Buzzi Hospital, Milan, Italy; 22NICU, Umberto I Hospital, Siracusa, Italy; 23NICU, C Poma Hospital, Mantova, Italy; 24NICU, Santa Croce e Carle Hospital, Cuneo, Italy; 25NICU, Istituti Ospitalieri, Cremona, Italy; 26Department of Neonatology, S Anna University Hospital, Turin, Italy.

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Montirosso, R., Giusti, L., De Carli, P. et al. Developmental care, neonatal behavior and postnatal maternal depressive symptomatology predict internalizing problems at 18 months for very preterm children. J Perinatol 38, 191–195 (2018). https://doi.org/10.1038/jp.2017.148

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