title: Brief report: birth status, medical complications, and social environment: individual differences in development of preterm, very low birth weight infants.
abstract: OBJECTIVE
  To assess whether medical complications mediate the relationship between birth status (i.e., birth weight and gestational age) and developmental outcome of preterm, very low birth weight (VLBW) infants, as well as the role of the early social environment (maternal distress and social support) in infant development.
  
  
  METHODS
  Birth status and medical complication information was collected during the child's NICU stay. Maternal distress was assessed with the Beck Depression Inventory and the Parenting Stress Index at 4 months corrected infant age. Social support was measured with the Dunst Scales at 4 months corrected age. Child development measures were collected at 4 and 13 months corrected age (Bayley MDI and PDI), and at 36 months chronological age (PPVT-R and Achenbach CBCL).
  
  
  RESULTS
  Medical complications mediated the birth status-outcome relationship at 4 and 13 months, but not at 36 months. The 36-month outcomes were predicted by 4-month maternal distress and social support.
  
  
  CONCLUSIONS
  Prematurity and VLBW are indirectly related to early developmental outcome through their association with medical complications. However, by 36 months, developmental outcomes are more closely related to aspects of the early social environment than to early physiological factors.
authors.affiliation: Department of Psychology, University of Notre Dame, Indiana 46556, USA. miceli.3@nd.edu
authors.forename: P J
authors.initials: PJ
authors.lastname: Miceli
authors.forename: M C
authors.initials: MC
authors.lastname: Goeke-Morey
authors.forename: T L
authors.initials: TL
authors.lastname: Whitman
authors.forename: K S
authors.initials: KS
authors.lastname: Kolberg
authors.forename: C
authors.initials: C
authors.lastname: Miller-Loncar
authors.forename: R D
authors.initials: RD
authors.lastname: White
mesh_terms: D000328:Adult; D002657:Child Development; D005260:Female; D006304:Health Status; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000523:psychology*; D007234:Infant, Premature / Q000254:growth & development* / Q000523:psychology*; D019102:Infant, Very Low Birth Weight / Q000254:growth & development* / Q000523:psychology*; D008297:Male; D009035:Mothers / Q000523:psychology; D017063:Outcome Assessment, Health Care / Q000379:methods; D011446:Prospective Studies; D012720:Severity of Illness Index; D012944:Social Support; D013997:Time Factors