Early Risk Identification and Neural Mechanisms of Parent-Infant Interactions in Preterm Infants
Mary Lauren Neel, MD, MSCI
BACKGROUND: One in ten infants in the US is born preterm, with increased risk for neurodevelopmental impairment. Controlling for infant medical and family social factors, parenting characteristics explain 18% variance in outcomes. Parenting approaches are modifiable using high quality interventions.
GAP: The stability of parenting characteristics is uncertain in early months, when NICU-based interventions are potentially most beneficial. Absent mechanistic data explaining relationships between parenting characteristics and infant responses render designing targeted interventions challenging. Finally, few quantitative parenting domain measures in young infants are available, delaying early identification of at-risk dyads.
HYPOTHESES: Parental attunement (infant cues and physical connection) and structure (routine) assessed by validated Baby Care Questionnaires are stable (pre-NICU discharge to 3-4 months corrected age [CA]), accounting for illness severity and prematurity.
Cortical processing measures of connection are most pronounced in response to mother’s voice (infant-directed speech).
Parents demonstrating high attunement and structure before discharge will have highest synchrony and emotional connection (3-4 months CA).
METHODS: Prospective observational cohort study, 111 infants (330/7-360/7 weeks postmenstrual age) at large regional NICU followed longitudinally (NICU discharge – 3-4 months CA).
NICU assessed parental attunement and structure, and infant cortical processing measures of connection during different speech/sound conditions. Neural and behavioral markers of emotional mother/infant connection during interaction (3-4 months CA). Covariates: infant medical factors, socio-economic status, maternal depression, maternal perception of bonding.
IMPACT: Pilot/background data critical to design/testing early, mechanistically sound, neurally-based parenting interventions in preterm populations with the potential to enhance neuroprotective or therapeutic interventions in multimodal approach. Help to identify at-risk dyads who may benefit most from targeted NICU-based parenting interventions.