Does early skin-to-skin contact have a long-term effect on the emotional and behavioral development of very preterm infants?

Objectives: The present study aimed to explore the effect of risk factors associated with the COVID-19 outbreak experience on parents' and children's well-being. Methods: Parents of children aged between 2- and 14-years-old completed an online survey reporting their home environment conditions, any relation they had to the pandemic consequences, their difficulties experienced due to the quarantine, their perception of individual and parent-child dyadic stress, and their children's emotional and behavioral problems. Results: Results showed that the perception of the difficulty of quarantine is a crucial factor that undermines both parents' and children's well-being. Quarantine's impact on children's behavioral and emotional problems is mediated by parent's individual and dyadic stress, with a stronger effect from the latter. Parents who reported more difficulties in dealing with quarantine show more stress. This, in turn, increases the children's problems. Living in a more at-risk area, the quality of the home environment, or the relation they have with the pandemic consequences, do not have an effect on families' well-being. Conclusions: Dealing with quarantine is a particularly stressful experience for parents who must balance personal life, work, and raising children, being left alone without other resources. This situation puts parents at a higher risk of experiencing distress, potentially impairing their ability to be supportive caregivers. The lack of support these children receive in such a difficult moment may be the reason for their more pronounced psychological symptoms. Policies should take into consideration the implications of the lockdown for families' mental health, and supportive interventions for the immediate and for the future should be promoted. Show more

The cognitive and behavioral outcomes of school-aged children who were born preterm have been reported extensively. Many of these studies have methodological flaws that preclude an accurate estimate of the long-term outcomes of prematurity. To estimate the effect of preterm birth on cognition and behavior in school-aged children. MEDLINE search (1980 to November 2001) for English-language articles, supplemented by a manual search of personal files maintained by 2 of the authors. We included case-control studies reporting cognitive and/or behavioral data of children who were born preterm and who were evaluated after their fifth birthday if the attrition rate was less than 30%. From the 227 reviewed studies, cognitive data from 15 studies and behavioral data from 16 studies were selected. Data on population demographics, study characteristics, and cognitive and behavioral outcomes were extracted from each study, entered in a customized database, and reviewed twice to minimize error. Differences between the mean cognitive scores of cases and controls were pooled. Homogeneity across studies was formally tested using a general variance-based method and graphically using Galbraith plots. Linear meta-analysis regression models were fitted to explore the impact of birth weight and gestational age on cognitive outcomes. Study-specific relative risks (RRs) were calculated for the incidence of attention-deficit/hyperactivity disorder (ADHD) and pooled. Quality assessment of the studies was performed based on a 10-point scale. Publication bias was examined using Begg modified funnel plots and formally tested using the Egger weighted-linear regression method. Among 1556 cases and 1720 controls, controls had significantly higher cognitive scores compared with children who were born preterm (weighted mean difference, 10.9; 95% confidence interval [CI], 9.2-12.5). The mean cognitive scores of preterm-born cases and term-born controls were directly proportional to their birth weight (R(2) = 0.51; P<.001) and gestational age (R(2) = 0.49; P<.001). Age at evaluation had no significant correlation with mean difference in cognitive scores (R(2) = 0.12; P =.20). Preterm-born children showed increases in externalizing and internalizing behaviors in 81% of studies and had more than twice the RR for developing ADHD (pooled RR, 2.64; 95% CI, 1.85-3.78). No differences were noted in cognition and behaviors based on the quality of the study. Children who were born preterm are at risk for reduced cognitive test scores and their immaturity at birth is directly proportional to the mean cognitive scores at school age. Preterm-born children also show an increased incidence of ADHD and other behaviors. Show more

Parenting stress and child behavior problems have been posited to have a transactional effect on each other across development. However, few studies have tested this model empirically. The authors investigated the relationship between parenting stress and child behavior problems from ages 3 to 9 years old among 237 children, 144 of whom were typically developing and 93 who were identified as developmentally delayed. Behavior problems and parenting stress covaried significantly across time for both groups of children. Cross-lagged panel analyses generally supported a bidirectional relationship between parenting stress and child behavior problems for mothers and fathers. Show more