Brain development/Law/Policy Medicine

Stable home lives improve prospects for preemies

Cynthia Rogers, MD, visits Abel Stanart in the NICU at St. Louis Children's Hospital on August 21, 2019. Abel, four days old, and his parents Katie Turek and Trask Stanart are in the neonatal intensive care unit. (Photo: Matt Miller, WUSM)

As they grow and develop, children who were born at least 10 weeks before their due dates are at risk for attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder and anxiety disorders. They also have a higher risk than children who were full-term babies for other neurodevelopmental issues, including cognitive problems, language difficulties and motor delays.

Researchers at Washington University School of Medicine in St. Louis who have been trying to determine what puts such children at risk for these problems have found that their mental health may be related less to medical challenges they face after birth than to the environment the babies enter once they leave the newborn intensive care unit (NICU).

In a new study, the children who were most likely to have overcome the complications of being born so early and who showed normal psychiatric and neurodevelopmental outcomes also were those with healthier, more nurturing mothers and more stable home lives.

The findings are published Aug. 26 in The Journal of Child Psychology and Psychiatry.

“Home environment is what really differentiated these kids,” said first author Rachel E. Lean, PhD, a postdoctoral research associate in child psychiatry. “Preterm children who did the best had mothers who reported lower levels of depression and parenting stress. These children received more cognitive stimulation in the home, with parents who read to them and did other learning-type activities with their children. There also tended to be more stability in their families. That suggests to us that modifiable factors in the home life of a child could lead to positive outcomes for these very preterm infants.”…

…“The children with psychiatric problems also came from homes with mothers who experienced more ADHD symptoms, higher levels of psychosocial stress, high parenting stress, just more family dysfunction in general,” said senior investigator Cynthia E. Rogers, MD, an associate professor of child psychiatry. “The mothers’ issues and the characteristics of the family environment were likely to be factors for children in these groups with significant impairment. In our clinical programs, we screen mothers for depression and other mental health issues while their babies still are patients in the NICU.”

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