Global Care of Preterm Children: The Role of Individual, Family and Environmental Factors

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Perinatal and Neonatal Medicine".

Deadline for manuscript submissions: closed (30 November 2024) | Viewed by 5683

Special Issue Editor

Department of Psychology, University of Bologna, 40127 Bologna, Italy
Interests: developmental psychopathology; parental perinatal psychopathology; early parent-infant interactions; preterm birth and parenting; transition to parenthood
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Preterm birth occurs when infants are born before the 37th gestational week, and constitutes an important risk factor for the survival, health, and development of the newborn. The vulnerability of preterm babies requires specific practices and attention during the entire perinatal period (maintaining reasonable sleep, cheerful and relaxed state of mind, proper nutrition, etc.).

Furthermore, it is widely recognized that consequences of prematurity could impact the whole social environment around the preterm child. In particular, the traumatic experience of prematurity could negatively influence maternal and paternal emotional states, presenting an obstacle to the process of transition to parenthood and the onset of relationship between preterm infants and their parents.

Recently, the higher implementation of interdisciplinary approaches has contributed to the reduction of an infant-centered bias in the practices of health services, emphasizing a systemic perspective where the whole individual, dyadic and familiar levels could play an essential role in sustaining preterm development and health. Therefore, in order to reduce the negative impact of premature birth, there is a need of research that empirically supports the relevance of practices driven by a longitudinal and multidisciplinary perspective, involving the many professional figures caring for preterm infants and their families.

This Special Issue aims to deepen the knowledge concerning the most recent advances in the global care of preterm children, including the individual, family, and environmental factors. We are especially interested in papers that explore new approaches aiming to improve preterm child health as well as papers that investigate new intervention models that may include caregivers as well as children. Research areas may include (but are not limited to) the keywords listed below.

Dr. Erica Neri
Guest Editor

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Keywords

  • preterm birth
  • preterm children
  • parent–child interaction
  • parental distress
  • nursing
  • preterm nutrition
  • environmental factors

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Published Papers (4 papers)

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Research

11 pages, 445 KiB  
Article
Likelihood of Preterm Birth in Patients After Antenatal Corticosteroid Administration in Relation to Diagnosis and Confounding Risk Factors: A Retrospective Cohort Study
by Jan Pauluschke-Fröhlich, Richard Berger, Harald Abele, Claudia F. Plappert and Joachim Graf
Healthcare 2025, 13(1), 87; https://doi.org/10.3390/healthcare13010087 - 6 Jan 2025
Viewed by 824
Abstract
Background: In the case of threatened preterm birth (PTB) before the 34th week of pregnancy, the application of antenatal corticosteroids (ACSs) for the maturation of the fetal lung is a standard procedure in perinatal medicine. Common diagnoses for ACS use in pregnancy [...] Read more.
Background: In the case of threatened preterm birth (PTB) before the 34th week of pregnancy, the application of antenatal corticosteroids (ACSs) for the maturation of the fetal lung is a standard procedure in perinatal medicine. Common diagnoses for ACS use in pregnancy are the preterm rupture of membranes (PPROMs), placental bleeding, premature labor, preeclampsia, oligohydramnios, amniotic infection syndrome (AIS), and cervical insufficiency. The aim of this study was to investigate whether the current diagnosis, which results in ACS, and the patient’s risk factors influence the risk of PTB events. Methods: The data of all affected women were extracted, who were hospitalized in 2016 due to a threatening PTB and administered corticosteroids in the German federal state Rhineland-Palatinate (n = 1544), so the study was conducted as a retrospective cohort trial. Frequency analyses, Friedman tests, Chi square tests, logistic regressions, Spearman correlation, and moderation analysis were performed to determine the Odds ratio (OR) for PTB in ACS patients in relation to diagnosis and risk factors. Results: Only 60% of all patients with PTB risk delivered prematurely, whereby patients with different diagnoses differ in terms of the PTB risk; the highest risk could be found in AIS (OR = 16.12) or preeclampsia (OR = 5.46). For prior PTB, stillbirth, or abortion, there is a moderation effect (based on the confounders), while multiple pregnancies influence the PTB risk irrespective of diagnosis (OR = 6.45). In the whole collective, the OR for PTB was 6.6 in relation to all pregnant women in Germany. Conclusions: A higher risk of PTB could be found in patients with a diagnosis of AIS, preeclampsia, as well as in multiple pregnancies. Prior PTB, stillbirth, or abortion act as a relevant confounder. Full article
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24 pages, 362 KiB  
Article
Relational “Dance” Between Mother and Moderately Preterm Infant at 6 and 9 Months of Correct Age: Possible Risk and Protective Factors
by Concetta Polizzi, Serena Iacono Isidoro, Maria Maddalena Di Pasqua, Valentina Fontana, Susanna Marotta, Giovanna Perricone and Margherita Spagnuolo Lobb
Healthcare 2024, 12(22), 2231; https://doi.org/10.3390/healthcare12222231 - 8 Nov 2024
Viewed by 951
Abstract
Background/Objectives: This study explores the characteristics of the early mother–infant relationship in a sample of 30 mother–preterm infant dyads between 6 and 9 months, using a phenomenological observational tool called “Dance Steps”. This tool examines the configuration and reciprocity of mother–infant interactions. The [...] Read more.
Background/Objectives: This study explores the characteristics of the early mother–infant relationship in a sample of 30 mother–preterm infant dyads between 6 and 9 months, using a phenomenological observational tool called “Dance Steps”. This tool examines the configuration and reciprocity of mother–infant interactions. The study also investigates how sociodemographic factors and maternal functioning variables, such as postnatal depression and perceived social support, may serve as risk or protective factors in the development of these interaction “Steps”. Methods: Observations were conducted through video recordings of face-to-face caregiver–infant interactions during unstructured play sessions at neonatal follow-up visits. The data focused on identifying specific characteristics of reciprocity in the “dance steps”. Results: The results reveal certain features of reciprocity are stable over time, demonstrating synchronicity and attunement in many of the “dance steps”. Other “steps” evolve in response to the child’s developing competence. Sociodemographic factors, particularly the mother’s educational level and the infant’s sex, significantly influence the “Dance”. Postnatal depression negatively affected reciprocity in several steps, especially impacting the infant, whereas perceived social support had a lesser effect. Conclusions: The findings emphasize the importance of supporting mothers of preterm infants to adjust their interactions in ways that promote the child’s developmental competence. This support is essential for fostering physical and emotional closeness during critical developmental transitions. Full article
14 pages, 888 KiB  
Article
Perinatal Outcomes of Immigrant Mothers and Their Infants Born Very Preterm across Germany
by Britta M. Hüning, Julia Jaekel, Nils Jaekel, Wolfgang Göpel, Egbert Herting, Ursula Felderhoff-Müser, Juliane Spiegler and Christoph Härtel
Healthcare 2024, 12(12), 1211; https://doi.org/10.3390/healthcare12121211 - 17 Jun 2024
Cited by 1 | Viewed by 1373
Abstract
Background: In Germany, more than 40% of infants are born to immigrant parents. Increased survival rates of very preterm (below 32 weeks gestation at birth; VP) infants have not resulted in equally improved life chances and quality of life. More information on perinatal [...] Read more.
Background: In Germany, more than 40% of infants are born to immigrant parents. Increased survival rates of very preterm (below 32 weeks gestation at birth; VP) infants have not resulted in equally improved life chances and quality of life. More information on perinatal variations in outcomes according to social inequalities, migration background, and language barriers is needed. We tested whether mothers’ immigrant status and language barriers are associated with perinatal health and short-term neonatal outcomes. Methods: The data are from the national multi-centre German Neonatal Network (GNN) cohort, including VP births from 2009 onwards. In total, 3606 (n = 1738 female) children were assessed, and 919 (n = 449 female) of these children had immigrant backgrounds. Immigrant status was operationalised as a binary variable based on the children’s mothers’ countries of birth (born in Germany vs. foreign-born). Self-reported home language (L1) was used to calculate the average linguistic distance to German as one continuous variable. Results: Mixed-effects models showed that two out of fourteen effects of interest survived the adjustment for known confounders and accounting for the nestedness of data within birth hospitals. Linguistic distance from mothers’ L1s to German was independently associated with diagnoses of preeclampsia (OR = 1.01, 95% CI = [1.00, 1.01]). Infants of foreign-born mothers had higher odds for amniotic infection syndrome (AIS; OR = 1.45 [1.13, 1.86]) than infants of German mothers. Conclusions: Our findings from this large multi-centre longitudinal cohort of VP-born children indicate that maternal immigrant status and language barriers have limited impact on perinatal health and severe neonatal outcomes. This suggests that, regardless of background or language skills, there may be few inequalities in the perinatal health of pregnant women and their newborn preterm infants. Full article
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18 pages, 1067 KiB  
Article
Infant-Directed Speech to Preterm Infants during the First Year Postpartum: The Influence of Preterm Birth Weight and Maternal Parenting Stress
by Alessandra Provera, Erica Neri and Francesca Agostini
Healthcare 2024, 12(3), 401; https://doi.org/10.3390/healthcare12030401 - 4 Feb 2024
Cited by 2 | Viewed by 1644
Abstract
Premature birth can increase the level of parenting stress (PS), especially in the case of parents of high-risk infants (extremely low birth weight (ELBW) and very low birth weight (VLBW)). Though published research has explored how maternal PS influences early dyadic interactions, limited [...] Read more.
Premature birth can increase the level of parenting stress (PS), especially in the case of parents of high-risk infants (extremely low birth weight (ELBW) and very low birth weight (VLBW)). Though published research has explored how maternal PS influences early dyadic interactions, limited research has focused on infant-directed speech (IDS), and no studies have investigated the link between prematurity severity based on birth weight and maternal IDS. This study, involving 100 mother–infant dyads, categorized into 30 ELBW premature infants, 30 VLBW premature infants, and 40 full-term (FT) ones, examined the impact of preterm birth weight and maternal parenting stress on IDS features during early interactions at 3 and 9 months postpartum. Maternal input was assessed using the CHILDES system, while parenting stress was evaluated using the Parenting Stress Index-Short Form. The results revealed that high-risk conditions (ELBW preterm birth and high parenting stress) at 3 months were associated with reduced affect-salient speech and increased questioning. IDS functional patterns, specifically the proportion of affect-salient speech and questions, were influenced by both birth weight groups and parenting stress levels at 3 months but not at 9 months. These findings highlight the need to assess, within the context of prematurity, both birth weight and parenting stress in clinical practice, offering insights for developing interventions supporting positive parent–infant interactions and facilitating infant development. Full article
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