Effect of early intervention on social interaction between mothers and preterm infants at 12 months of age: A randomized controlled trial
Research highlights
► Preterm infants-Randomized controlled trial-Early intervention-Videoobservation ► Effects on social interaction between mothers and preterm infants at 12 months ► Intervention mothers scored higher on maternal sensitivity/responsiveness ► Being first-time mother was a moderator that enhanced the effects of intervention. ► More positive mood was observed among infants of First-time mothers.
Section snippets
Background
Preterm birth is associated with a variety of social and cognitive delays and risk factors for adverse medical, psychosocial and behavioral outcomes (Minde, 2005, Kiechl-Kohlendorfer et al., 2009). The quality of early social interactions between parents and infants can impact later development (Beckwith and Rodning, 1996, Forcada-Guex et al., 2006, Smith et al., 2006), but to achieve social interaction of sufficient quality with preterm infants might be difficult. Preterm infants are less
Design, sample and setting
This study compared the effects of the MITP on different maternal and infant behaviors in a preterm intervention group and a preterm and randomized control group in a Level 3 hospital in Norway. Parents of preterm infants with ultrasound GA ≥ 30.0 and <36 weeks were consecutively recruited between January 2005 and December 2006. They were eligible if they could speak, read and write Norwegian, had no history of drug or alcohol abuse or severe psychiatric disorders, and if a hospital stay of
Observations of mother–infant interactions at 12 months
A total of 46 video observations in the intervention group and 47 observations in the control group were coded. When comparing the preterm groups the intervention mothers scored significantly higher on sensitivity/responsiveness (p = .048) (Table 4). Group differences of borderline statistical significance were found on maternal intrusiveness (p = .06), child positive mood (p = .07) and dyadic mutuality (p = .06), all in favor of the intervention group. No significant group differences were found on
Discussion
The developmental prognosis among preterm infants is influenced by the quality of early mother–infant interactions. In this randomized, controlled trial a significant effect of the Mother Infant Transaction Program was found in mothers’ sensitivity and responsiveness to preterm infant cues observed at 12 months. A similar but non-significant trend on some of the other variables also favoured the intervention group. The results suggest that being a first-time mother may be a condition that
Conclusion
Effective interventions may increase maternal sensitivity and contribute to a more optimal caretaking environment for fragile preterm infants. The present results showed a positive effect of MITP on important qualities of social interaction between mothers of moderately and late preterm infants at 12 months. Being a first-time mother seems to be a moderator that enhances the effects of the intervention. The intervention method has been assessed on differential populations in differential
Acknowledgments
Thanks to the research nurse Kari S. Halle for enrollment, allocation and assistance in data collecting, and the following neonatal nurses delivering the intervention: Signe Bandlien, Cecilie Braaten, Lars Erik Engen, Lene Grønvold, Gunn Inger Hoffart, Anne Marie Krokedal, Tonje Rød, Vigdis Skaug, Elin Storvik and Inger Johanne Tølløfsrud. Ph.D. Glenys A. Hamilton for statistical advice and Nihal Perera and Irene Syse for data management and monitoring. The study was approved by the Regional
References (46)
- et al.
Prematurity, maternal stress and mother–child interactions
Early Human Development
(2004) - et al.
Effectiveness of a modified mother–infant transaction program on outcomes for preterm infants from 3 to 24 months of age
Infant Behavior & Development
(2009) - et al.
Joint attention in term and preterm infants at 12 months corrected age: the significance of gender and intervention based on a randomized controlled trial
Infant Behavior & Development
(2006) - et al.
Parent-infant interaction as a mediator of the relation between neonatal risk status and 12-month cognitive development
Infant Behavior & Development
(2001) - et al.
The mother–infant transaction program. The content and implications of an intervention for the mothers of low-birthweight infants
Clinics in Perinatology
(1990) - et al.
Nine-year outcome of the Vermont intervention program for low birth weight infants
Pediatrics
(1993) Patterns of infant-mother attachment: Antecedents and effects of development
Bulletin of the New York Academy of Medicine
(1985)- et al.
The behavior of the full-term but underweight newborn infant
Developmental Medicine and Child Neurology
(1976) - et al.
Less is more: meta-analyses of sensitivity and attachment interventions in early childhood
Psychological Bulletin
(2003) - et al.
Assessment of parent–child interaction
Dyadic processes between mothers and preterm infants: Development at ages 2 to 5 years
Infant Mental Health Journal
Focus on maternal behavior in infant intervention
American Journal of Orthopsychiatry
Infant, mother, and contextual predictors of mother-very low birth weight infant interaction at 9 months of age
Journal of Developmental and Behavioral Pediatrics
Early interactions and interaction coaching of high-risk infants and parents (vol. 16 ed., pp. 1–34)
Early dyadic patterns of mother–infant interactions and outcomes of prematurity at 18 months
Pediatrics
More than maternal sensitivity shapes attachment: infant coping and temperament
Annals of the New York Academy of Sciences
Maternal adjustment to the birth of a child: Primiparity versus multiparity. [References]
Journal of Reproductive and Infant Psychology
Lack of preparedness: experiences of first-time mothers
MCN The American Journal of Maternal Child Nursing
Randomised trial of a parenting intervention during neonatal intensive care
Archives of Disease in Childhood. Fetal and Neonatal Edition
Methods to improve reliability of video-recorded behavioral data
Research in Nursing and Health
Correlates of mother–premature infant interactions
Research in Nursing and Health
Supporting insensitive mothers: The Vilnius randomized control trial of video-feedback intervention to promote maternal sensitivity and infant attachment security
Child: Care, Health and Development
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