Neurobehaviour between birth and 40 weeks' gestation in infants born <30 weeks' gestation and parental psychological wellbeing: predictors of brain development and child outcomes.
BACKGROUND
Infants born <30 weeks' gestation are at increased risk of long term neurodevelopmental problems compared with term born peers. The predictive value of neurobehavioural examinations at term equivalent age in very preterm infants has been reported for subsequent impairment. Yet there is little knowledge surrounding earlier neurobehavioural development in preterm infants prior to term equivalent age, and how it relates to perinatal factors, cerebral structure, and later developmental outcomes. In addition, maternal psychological wellbeing has been associated with child development. Given the high rate of psychological distress reported by parents of preterm children, it is vital we understand maternal and paternal wellbeing in the early weeks and months after preterm birth and how this influences the parent-child relationship and children's outcomes. Therefore this study aims to examine how 1) early neurobehaviour and 2) parental mental health relate to developmental outcomes for infants born preterm compared with infants born at term.


METHODS
This prospective cohort study will describe the neurobehaviour of 150 infants born at <30 weeks' gestational age from birth to term equivalent age, and explore how early neurobehavioural deficits relate to brain growth or injury determined by magnetic resonance imaging, perinatal factors, parental mental health and later developmental outcomes measured using standardised assessment tools at term, one and two years' corrected age. A control group of 150 healthy term-born infants will also be recruited for comparison of outcomes. To examine the effects of parental mental health on developmental outcomes, both parents of preterm and term-born infants will complete standardised questionnaires related to symptoms of anxiety, depression and post-traumatic stress at regular intervals from the first week of their child's birth until their child's second birthday. The parent-child relationship will be assessed at one and two years' corrected age.


CONCLUSIONS
Detailing the trajectory of infant neurobehaviour and parental psychological distress following very preterm birth is important not only to identify infants most at risk, further understand the parental experience and highlight potential times for intervention for the infant and/or parent, but also to gain insight into the effect this has on parent-child interaction and child development.
Victorian Infant Brain Studies, Murdoch Childrens Research Institute, 4th Floor, Flemington Road, Parkville, Victoria 3052, Australia. alicia.spittle@mcri.edu.au.
Alicia J
AJ
Spittle
Deanne K
DK
Thompson
Nisha C
NC
Brown
Karli
K
Treyvaud
Jeanie L Y
JL
Cheong
Katherine J
KJ
Lee
Carmen C
CC
Pace
Joy
J
Olsen
Leesa G
LG
Allinson
Angela T
AT
Morgan
Marc
M
Seal
Abbey
A
Eeles
Fiona
F
Judd
Lex W
LW
Doyle
Peter J
PJ
Anderson
D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism; D001921:Brain / Q000254:growth & development* / Q000378:metabolism; D016022:Case-Control Studies; D002657:Child Development; D002794:Choline / Q000378:metabolism; D005865:Gestational Age; D018698:Glutamic Acid / Q000378:metabolism; D005973:Glutamine / Q000378:metabolism; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D019344:Lactic Acid / Q000378:metabolism; D008279:Magnetic Resonance Imaging / Q000379:methods; D009682:Magnetic Resonance Spectroscopy; D008603:Mental Health; D009460:Neurologic Examination; D009483:Neuropsychological Tests; D010287:Parent-Child Relations; D016487:Parenting; D010290:Parents / Q000523:psychology*; D047928:Premature Birth / Q000523:psychology*; D011446:Prospective Studies; D047929:Term Birth
D015415:Biomarkers; D005973:Glutamine; D001224:Aspartic Acid; D019344:Lactic Acid; D018698:Glutamic Acid; C000179:N-acetylaspartate; D002794:Choline