title: Intervention effects on emotion regulation in preterm infants with very low birth weight: A randomize controlled trial.
abstract: Preterm infants are at risk for emotional difficulties and behavioral problems. This study was aimed to investigate the effects of a clinic-based intervention program (CBIP) and a home-based intervention program (HBIP) compared with a usual care program (UCP) on emotion regulation to stress in preterm infants with very low birth weight (VLBW, birth weight <1500 g). A total of 178 VLBW preterm infants had been previously randomly assigned to receive one of three interventions (57 in CBIP, 63 in HBIP and 58 in UCP). The CBIP and HBIP contained identical child-, parent- and dyad-focused interventions that were provided to infants during hospitalization and were respectively delivered at clinics and at home at PMA 36-38 and 40 weeks, and 1, 2, 4, 6, 9, 12 months of corrected age. All infants were prospectively observed for behavioral reactivity and regulation in response to experimentally evoke stress evoked by a toy-behind-barrier procedure at 12, 18, and 24 months of corrected age. Their cognitive and language abilities, and mothers' responsiveness were also assessed at 12 months as potential covariates. Compared to the UCP-group infants, the HBIP-group infants exhibited shorter durations of visual orientation to a toy (adjusted difference [95% CI]=-1.60 [-3.07 to -0.13], p=0.03), and the CBIP-group infants exhibited shorter durations of avoidance (adjusted difference [95% CI]=-0.84 [-1.57 to -0.10], p=0.03) from 12 to 24 months of corrected age. The CBIP and HBIP showed no difference in the stress reactivity from the UCP, however. These results suggest that comprehensive interventions incorporating child-, parent- and dyad-focused services enhanced VLBW preterm infants' emotion regulation in response to stress at toddler age.
authors.affiliation: School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.
authors.forename: Ying-Chin
authors.initials: YC
authors.lastname: Wu
authors.affiliation: Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Wu-Shiun
authors.initials: WS
authors.lastname: Hsieh
authors.affiliation: Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan.
authors.forename: Chyong-Hsin
authors.initials: CH
authors.lastname: Hsu
authors.affiliation: Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan.
authors.forename: Jui-Hsing
authors.initials: JH
authors.lastname: Chang
authors.affiliation: Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Hung-Chieh
authors.initials: HC
authors.lastname: Chou
authors.affiliation: Department of Child and Family Development, University of Georgia, GA, USA.
authors.forename: Hui-Chin
authors.initials: HC
authors.lastname: Hsu
authors.affiliation: Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan.
authors.forename: Nan-Chang
authors.initials: NC
authors.lastname: Chiu
authors.affiliation: Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Wang-Tso
authors.initials: WT
authors.lastname: Lee
authors.affiliation: Graduate Institute of Epidemiology, National Taiwan University, Taipei, Taiwan.
authors.forename: Wei-J
authors.initials: WJ
authors.lastname: Chen
authors.affiliation: School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.
authors.forename: Yu-Wen
authors.initials: YW
authors.lastname: Ho
authors.affiliation: School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan; Physical Therapy Center, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: jeng@ntu.edu.tw.
authors.forename: Suh-Fang
authors.initials: SF
authors.lastname: Jeng
mesh_terms: D000342:Affective Symptoms / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D032763:Behavior Control / Q000379:methods*; D000067289:Behavior Observation Techniques / Q000379:methods; D002675:Child, Preschool; D003071:Cognition; D000066498:Emotional Adjustment; D004644:Emotions; D005260:Female; D006801:Humans; D007223:Infant; D007224:Infant Care / Q000379:methods; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight / Q000254:growth & development / Q000523:psychology; D007804:Language Development; D008297:Male; D010287:Parent-Child Relations; D015397:Program Evaluation; D013624:Taiwan
keywords: Behavior; Development; Early intervention; Effectiveness; Emotion regulation; Preterm infants