title: Mother-infant interaction improves with a developmental intervention for mother-preterm infant dyads.
abstract: While premature infants have a high need for positive interactions, both infants and their mothers are challenged by the infant's biological immaturity. This randomized clinical trial of 198 premature infants born at 29-34 weeks gestation and their mothers examined the impact of the H-HOPE (Hospital to Home: Optimizing the Infant's Environment) intervention on mother-premature infant interaction patterns at 6-weeks corrected age (CA). Mothers had at least 2 social environmental risk factors such as minority status or less than high school education. Mother-infant dyads were randomly assigned to the H-HOPE intervention group or an attention control group. H-HOPE is an integrated intervention that included (1) twice-daily infant stimulation using the ATVV (auditory, tactile, visual, and vestibular-rocking stimulation) and (2) four maternal participatory guidance sessions plus two telephone calls by a nurse-community advocate team. Mother-infant interaction was assessed at 6-weeks CA using the Nursing Child Assessment Satellite Training-Feeding Scale (NCAST, 76 items) and the Dyadic Mutuality Code (DMC, 6-item contingency scale during a 5-min play session). NCAST and DMC scores for the Control and H-HOPE groups were compared using t-tests, chi-square tests and multivariable analysis. Compared with the Control group (n = 76), the H-HOPE group (n = 66) had higher overall NCAST scores and higher maternal Social-Emotional Growth Fostering Subscale scores. The H-HOPE group also had significantly higher scores for the overall infant subscale and the Infant Clarity of Cues Subscale (p < 0.05). H-HOPE dyads were also more likely to have high responsiveness during play as measured by the DMC (67.6% versus 58.1% of controls). After adjustment for significant maternal and infant characteristics, H-HOPE dyads had marginally higher scores during feeding on overall mother-infant interaction (β = 2.03, p = 0.06) and significantly higher scores on the infant subscale (β = 0.75, p = 0.05) when compared to controls. In the adjusted analysis, H-HOPE dyads had increased odds of high versus low mutual responsiveness during play (OR = 2.37, 95% CI = 0.97, 5.80). Intervening with both mother and infant is a promising approach to help premature infants achieve the social interaction patterns essential for optimal development.
authors: Women, Children and Family Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, United States. Electronic address: rwt@uic.edu.
authors: Rosemary
authors: R
authors: White-Traut
authors: Kathleen F
authors: KF
authors: Norr
authors: Camille
authors: C
authors: Fabiyi
authors: Kristin M
authors: KM
authors: Rankin
authors: Zhyouing
authors: Z
authors: Li
authors: Li
authors: L
authors: Liu
mesh_terms: D000328:Adult; D003463:Cues; D004644:Emotions / Q000502:physiology*; D005190:Family; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature / Q000523:psychology*; D008297:Male; D009034:Mother-Child Relations; D009035:Mothers / Q000523:psychology*; D012931:Social Environment; D014110:Touch / Q000502:physiology*
keywords: Low-income mothers; Mother–infant interaction; Multisensory intervention; Preterm infants; Social interactive behaviors
references: MCN Am J Matern Child Nurs. 2011 Mar-Apr;36(2):91-7
references: 21350371
references: Pediatrics. 2006 Jul;118(1):e107-14
references: 16818525
references: Early Hum Dev. 2003 Aug;73(1-2):61-70
references: 12932894
references: Nurs Res. 1998 Nov-Dec;47(6):309-17
references: 9835486
references: Res Nurs Health. 2007 Jun;30(3):333-46
references: 17514707
references: Pediatrics. 2006 Jul;118(1):e9-19
references: 16818541
references: BMC Pregnancy Childbirth. 2012 Jun 29;12:62
references: 22748037
references: J Pediatr. 1991 May;118(5):751-60
references: 2019932
references: Pediatrics. 2010 Feb;125(2):313-9
references: 20100743
references: J Pediatr Nurs. 1994 Apr;9(2):91-7
references: 7518000
references: Br J Psychiatry. 1985 Mar;146:287-93
references: 3986438
references: J Obstet Gynecol Neonatal Nurs. 2003 Mar-Apr;32(2):161-71
references: 12685667
references: Public Health Nurs. 1995 Jun;12(3):171-80
references: 7596966
references: J Dev Behav Pediatr. 2007 Feb;28(1):36-44
references: 17353730
references: BMJ. 2012 Mar 01;344:e896
references: 22381676
references: J Obstet Gynecol Neonatal Nurs. 2006 May-Jun;35(3):358-68
references: 16700685
references: Early Hum Dev. 2004 Sep;79(2):145-58
references: 15324994
references: Am J Epidemiol. 1977 Sep;106(3):203-14
references: 900119
references: Dev Med Child Neurol. 2002 Feb;44(2):91-7
references: 11848115
references: Pediatrics. 2006 Sep;118(3):e869-78
references: 16880249
references: J Psychiatr Res. 2011 Oct;45(10):1387-94
references: 21683371
references: J Affect Disord. 2008 May;108(1-2):101-11
references: 18001841
references: Early Hum Dev. 2011 Jun;87(6):427-31
references: 21497029
references: Psychol Bull. 2003 Mar;129(2):195-215
references: 12696839
references: Nurs Res. 1987 Jul-Aug;36(4):244-8
references: 3648699
references: J Obstet Gynecol Neonatal Nurs. 2003 May-Jun;32(3):402-9
references: 12774883
references: Depress Anxiety. 2008;25(9):793-800
references: 17397041
references: West J Nurs Res. 2000 Apr;22(3):320-34
references: 10804895
references: J Pediatr Nurs. 2012 Aug;27(4):299-309
references: 22703676
references: Pediatrics. 2012 Oct;130(4):e838-46
references: 22945414
references: J Perinat Neonatal Nurs. 2010 Oct-Dec;24(4):356-65
references: 21045616
references: Infant Behav Dev. 2009 Jan;32(1):17-26
references: 19026450
references: J Obstet Gynecol Neonatal Nurs. 1994 Sep;23(7):581-9
references: 7996309
references: Nurs Res. 2001 May-Jun;50(3):155-64
references: 11393637
references: Child Dev. 1985 Feb;56(1):15-27
references: 3987400
references: J Obstet Gynecol Neonatal Nurs. 2009 Jul-Aug;38(4):478-89; quiz 489-90
references: 19614884
references: J Am Acad Child Adolesc Psychiatry. 2004 Sep;43(9):1089-97
references: 15322412
references: J Health Soc Behav. 2001 Sep;42(3):258-76
references: 11668773
references: Pediatr Nurs. 1997 Mar-Apr;23(2):169-75, 193
references: 9165933
references: Res Nurs Health. 2005 Jun;28(3):252-67
references: 15884024
references: Infant Behav Dev. 2011 Apr;34(2):215-25
references: 21371754
references: Res Nurs Health. 2007 Feb;30(1):17-30
references: 17243105
references: J Dev Behav Pediatr. 2005 Feb;26(1):24-33
references: 15718880
references: J Pediatr Nurs. 1987 Apr;2(2):96-101
references: 3550039
references: J Pediatr. 2011 Jul;159(1):92-8
references: 21324481
references: Clin Perinatol. 1990 Mar;17(1):31-45
references: 2318015
references: J Obstet Gynecol Neonatal Nurs. 2011 Nov-Dec;40(6):719-31
references: 22092914
references: J Perinatol. 2007 Dec;27 Suppl 2:S48-74
references: 18034182
references: Arch Dis Child Fetal Neonatal Ed. 2003 Sep;88(5):F400-4
references: 12937044
references: Child Dev. 2000 May-Jun;71(3):752-71
references: 10953941
references: Infant Behav Dev. 2012 Jun;35(3):489-98
references: 22721747
references: J Abnorm Child Psychol. 2012 Jul;40(5):803-13
references: 22146899
references: Pediatrics. 1991 Nov;88(5):943-53
references: 1945635
references: Res Nurs Health. 2001 Jun;24(3):157-69
references: 11526615
references: Pediatrics. 2013 Apr;131(4):693-700
references: 23530177
references: Aust J Physiother. 2001;47(3):169-76
references: 11552873
references: Early Hum Dev. 2011 Jan;87(1):21-6
references: 20951514
references: Infant Ment Health J. 2005 Sep;26(5):423-441
references: 28682494
references: Pediatrics. 2004 Apr;113(4):846-57
references: 15060237
references: Child Dev. 1994 Apr;65(2 Spec No):346-60
references: 8013226
references: MCN Am J Matern Child Nurs. 2005 Jan-Feb;30(1):52-9
references: 15622150
references: Res Nurs Health. 1988 Feb;11(1):31-9
references: 3347763
references: J Perinat Educ. 2011 Summer;20(3):142-53
references: 22654463
references: Dev Psychopathol. 2003 Summer;15(3):613-40
references: 14582934
references: Dev Psychopathol. 2012 Feb;24(1):65-78
references: 22292994
references: J Pediatr. 1992 May;120(5):780-5
references: 1578316
references: Natl Vital Stat Rep. 2012 Aug 28;61(1):1-72
references: 24974589