769 - Early parental structure supports language outcomes in formerly preterm infants

Publication Number: 769.4926

Mary Lauren Neel, Emory University School of Medicine, Atlanta, GA, United States; Caitlin P.. Kjeldsen, Emory University School of Medicine, Atlanta, GA, United States; Rachelle Srinivas, Michigan State University College of Human Medicine, Dublin, OH, United States; Paige Ryals, Emory University School of Medicine, Atlanta, GA, United States; Nathalie L. Maitre, Emory University and Children's Healthcare of Atlanta, Atlanta, GA, United States

Background: Heightened parental sensitivity has been consistently associated with improved developmental outcomes in preterm and other high-risk infants. Recent work has demonstrated the additional importance of parental structure to further support most optimal outcomes in this population. Language outcomes are of particular importance to parents of high-risk infants as they support communication into adulthood. Parent-infant transaction programs, containing elements of both parental sensitivity and structure, are among the only evidence-based early interventions to support speech/language outcomes in high-risk infants. However, to date, there are limited measures of early parenting characteristics.

Objective: We aimed to determine if early parenting characteristics as measured from NICU discharge to 1-year with a validated parenting questionnaire were associated with improved language outcomes at 1-year in formerly preterm infants.

Design/Methods: Primary caregivers completed the Baby Care Questionnaire (BCQ) at NICU discharge, 3-months corrected age (CA), and 1-year CA. The BCQ is validated from pregnancy through 2 years, and provides a score for parental attunement (akin to sensitivity, reliance on infant cues) and parental structure (reliance on routines and consistency). Bayley Scales of Infant Development (BSID) receptive and expressive language scales were performed by reliable examiners at 1-year CA. Predictive and concurrent associations were analyzed using multiple regression controlling for gestational age (GA).

Results: Our cohort (Table 1) included n=105 preterm infants with a mean GA of 28 weeks (range 24-34 weeks). Infants had receptive and expressive scores of 8.2 (SD 2.4) and 8.8 (SD 2.3), respectively. Consistent with previous work, lower GA was associated with lower 1-year BSID composite language score (r=0.19, p=0.02). Parental structure measured with BCQ at 3-months CA and 1-year CA was significantly associated with improved 1-year BSID receptive scaled scores adjusting for GA (beta=0.234, p=0.05; beta=0.257, p=0.03, respectively). There were no significant associations with expressive language outcomes or between parental attunement and any 1-year language outcomes.

Conclusion(s): This work supports the importance of parental structure for most optimal high-risk infant development, this time in the context of receptive language outcomes. Opportunities for early parenting interventions to support parental structure may support subsequent and concurrent language development in formerly preterm infants.

Table 1. Participant demographics and scores, mean (SD) *unless noted
BPD: bronchopulmonary dysplasia; BSID: Bayley Scales of Infant Development; NEC: necrotizing enterocolitis