Prematurity Flashcards
1
Q
preterm/premature
A
- Delivery before 36/37 weeks
- 8-12% of births
- Very preterm = less than 32 weeks
- Boys are more likely to be born preterm
- Prematurity is associated with SES (people with low SES more likely to give birth preterm)
2
Q
Low birth weight
A
- Weight under 5.5lbs
- Very low birth weight = under 2.5/3.5lbs
3
Q
NICU
A
- Standard of care for preterm infants
- Primary goal = maintain and enhance physical well-being of child, often through artificial means (ex. Surgery, chemical/drug intervention)
- Problems: limited parent-child bonding; not a natural environment (lights, noises, not like womb or home environment); parents feel overwhelmed/unimportant
4
Q
preterm birth outcomes
A
- Survivability: Youngest age of survivability around 22 weeks, smallest around .5lbs
- Health problems
- Developmental delays: Motor delays, lower IQ/cognitive abilities, learning/school disabilities
- Behaviour problems, social difficulties: Higher behavioural symptoms and lower adaptive skills (esp. For boys)
5
Q
health problems associated with prematurity
A
- Immediate difficulty breathing, lung disease, brain complications, seizures, feeding difficulties, gastrointestinal issues
- Long-term frequent hospital stays, continued issues with breathing, eyesight issues
6
Q
parents and pre-term infants (challenges)
A
- Difficulty with hospital environment
- Preterm infants seen as less attractive; cry less, less arousing cries; less likely to trigger automatic parenting responses
- Delays in reaching developmental milestones (because they’re gestationally less old than full-term babies -> difference between gestational age and chronological age)
- “prematurity stereotype”: parents react differently to pre-term babies
- different parent-infant interactions
7
Q
prematurity stereotype study
A
- moms watch video of same baby, but some are told that the baby is pre-term while others are told it’s full-term. Moms then rate baby on variety of measures (social, competency, cuddly, etc.). “Pre-term” baby receives less positive ratings
- Parents think of preterm babies as less advanced, may give them less advanced toys
8
Q
parent-infant interactions
A
- Parents unsure; may be worried/afraid of what to do with baby
- Infants more passive, less reactive -> incites mothers to respond in a more active, more directive, providing more stimulation (less socially competent parenting -> overstimulating)
9
Q
interventions for preterm infants
A
- Kangaroo care
- Infant massage
- Music
- Parent training/support
- Goal: support the best medical care for infants, while also supporting the best parent-child relationships
10
Q
Kangaroo Care
A
- Parent-infant skin-to-skin contact
- Initially developed for premature infants in areas where there was a shortage of incubators and healthcare workers
11
Q
Outcomes of kangaroo care study (discharge, 3 months, 6 months)
A
- Are there long-term benefits associated with kangaroo care vs standard care?
- at discharge: improved mother-infant interactions (ex. mom had more positive affect, touch, etc; infant was more alert)
- at 3 months: more stimulating home environments (both mothers and fathers); lower maternal depression
- at 6 months: Infants who had KC were more developmentally advanced (mental and psychomotor); Mothers who had done KC were engaging in more sensitive parenting
- Conclusions: Parents who engage in kangaroo care are more sensitive/warm, provide more nurturing/stimulating home environments, and have lower rates of depression; Pre-term infants who receive kangaroo care show more advanced development
12
Q
why are there benefits to kangaroo care?
A
- Effects of parent proximity vs. Separation after birth
- Heat, touch, smell, nursing, etc.
- Skin to skin contact releases oxytocin in mother
- Transactional model -> kangaroo care impacts both mother and child, who then impact each other
- Parent: feelings of effectiveness, importance
13
Q
History of Preterm Care
A
- Used to be born/raised at home
- Early incubators created in late 1800s
- Parental contact initially discouraged (fear of germs)
- 70s was first time mothers allowed into NICU to handle babies
14
Q
Conditions unique to preterm infants and parents
A
- the timing of birth (before parents are truly prepared, before parents can care for baby on their own)
- the nature of the hospital experience (intimidating for parents)
- behavioral characteristics of preterm behavior and development (going home can be stressful/overwhelming; parents become overprotective due to their view that the child is vulnerable)
15
Q
theories of parent-child relationships and their respective interpretations of prematurity
A
- Social interaction approaches (ex. Infant cues determine parents’ competence)
- Bonding theory (ex. Critical period exists for optimal mother-infant bonding)
- Attachment theory (ex. Prematurity may disrupt parental responsiveness)
- Transactional approach (ex. Baby shapes parent and vice versa)
16
Q
parent-infant relationships (in hospital, interaction, attachment)
A
- In hospital: many factors influence parental visitation and engagement (ex. SES, what hospital mom is in); hospital policies play a role in encouraging it (ie. Weekly “appointments” led to more positive expectations)
- Infant-parents interaction: fathers are initially more engaged than those of full-term infants, mothers sometimes overstimulate; prematurity, immaturity, and illness affect interactions; long-term continuities in mother-child interaction style -> linked to positive outcomes
- Prematurity typically does not affect attachment (most form secure)
17
Q
interventions designed to improve parent-child relationships
A
- Infant-focused: providing experiences similar to those in utero or in home; tailoring to needs of individual infants
- Parent-focused: encouraging caregiving opportunities, contact with veteran parents/support groups
- Parent-infant focused: kangaroo care; training in rocking/massaging procedures
