The Impact of Factors of Neonatal Inpatient Care on Stress Regulation and Development in Toddlers Born Preterm
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The study aims at exploring which factors of neonatal inpatient care affect a) the stress regulation and b) the development of one to two years old preterm infants (N=47) and, in a second step, at identifying the relationship between these factors. Moreover, the significance of the observed effects is considered by taking into account the differences in development between preterm and mature born children (N=51; 1-2a). This approach contributes to a more detailed picture of the early programming hypothesis of the hypothalamic-pituitary-axis by focusing on the sensitive period of brain development in the last trimester of pregnancy.
A newly developed retrospective applicable stress scale was used to determine stressful events that are experienced by preterm babies during the hospital treatment. The stress score was calculated using the clinic's electronic documentation databases. This allows for flexible calculation of weighted cumulative stress values regarding different periods of hospitalization. Furthermore, the known risk factors gestational age at birth, Clinical Risk Index for Babies (CRIB-II) and (as a potential protective factor) length of Kangaroo Mother Care (KMC) was extracted from the databases. These factors' effects on development (operationalized by the Bayley Scales of Infant and Toddler Development - Third Edition) and stress regulation (measured with salivary cortisol diurnal profiles) were tested by multiple regression analysis.
In addition, this study compares the developmental outcome and the stress regulation in a sample of children born very preterm with those of children born term (by u-tests).