Search

Severe premature birth (

This work is authored by a group of Ph.D. students and academics who attended a workshop on visual methodologies in the framework of the Scuola di alta formazione in geografia organised by AGeI (Association of Italian Geographers), 2022 edition. By visually reporting the workshop activities we aim at reflecting on the creative power of images in expanding geographical imaginations and its potential in the teaching of geography. The paper is shaped as a visual essay in which images and text do not refer directly to each other but rather aim at creating an imaginative reading flow.

Pictorial humanization is a useful intervention for the improvement of hospitalized patients’ affective states. Despite benefits in many hospital wards having been well documented, so far, no attention was paid to the Neonatal Intensive Care Unit (NICU). The aim of the present study was to evaluate the levels of distress and the affective perception of the environment experienced by parents of infants hospitalized in a NICU after the implementation of an intervention of pictorial humanization. A sample of 48 parents was recruited, 25 before the intervention was performed (Control Group), and 23 after its implementation (Pictorial Humanization Group). All parents completed the “Rapid Stress Assessment Scale” and “Scales of the Affective Quality Attributed to Place” questionnaires. Despite results showing no significant differences on parental distress, after implementation of pictorial intervention parents reported a perception of the NICU as significantly more pleasant, exciting, and arousing, and less distressing, unpleasant, gloomy, and sleepy. A higher level of distress and a perception of the environment as less relaxing was predicted for the Control Group condition. The present study suggests that the pictorial intervention represents a useful technique to create more welcoming hospital environments and to reduce the negative effects associated with infant hospitalization.

Neonatal nutritional supplements may improve early growth for infants born small, but effects on long-term growth are unclear and may differ by sex. We assessed the effects of early macronutrient supplements on later growth. We searched databases and clinical trials registers from inception to April 2019. Participant-level data from randomised trials were included if the intention was to increase macronutrient intake to improve growth or development of infants born preterm or small-for-gestational-age. Co-primary outcomes were cognitive impairment and metabolic risk. Supplementation did not alter BMI in childhood (kg/m2: adjusted mean difference (aMD) −0.11[95% CI −0.47, 0.25], p = 0.54; 3 trials, n = 333). Supplementation increased length (cm: aMD 0.37[0.01, 0.72], p = 0.04; 18 trials, n = 2008) and bone mineral content (g: aMD 10.22[0.52, 19.92], p = 0.04; 6 trials, n = 313) in infancy, but not at older ages. There were no differences between supplemented and unsupplemented groups for other outcomes. In subgroup analysis, supplementation increased the height z-score in male toddlers (aMD 0.20[0.02, 0.37], p = 0.03; 10 trials, n = 595) but not in females, and no significant sex interaction was observed (p = 0.21). Macronutrient supplementation for infants born small may not alter BMI in childhood. Supplementation increased growth in infancy, but these effects did not persist in later life. The effects did not differ between boys and girls.

Background: After preterm birth, infants are at high risk for delays in language development. A promising intervention to reduce this risk is represented by the exposure to parental voices through book-reading in Neonatal Intensive Care Units (NICU). This study investigated the possible advantages of book-reading to preterm neonates during their NICU stay on their subsequent language development. Methods: 100 families of preterm infants were recruited. The parents of 55 preterm infants (Reading Group) received a colored picture-book on NICU admission and were supported to read to their neonate as often as possible and to continue after hospital discharge. 45 infants (Control Group) were recruited before the beginning of the intervention. Infant language development was assessed with the Hearing and Language quotients of the Griffith Mental Development Scale at the corrected age of 3, 6, 9, 12, 18 and 24 months. Results: Regardless of group membership, Hearing and Language mean quotients decreased between 9 and 18 months; nevertheless, this decrease was considerably reduced in the Reading group, compared to the Control Group. Conclusions: Reading in NICUs represents a suitable intervention that could positively influence language development and parent-infant relationships in preterm children. Study findings support its implementation, as preventive measure.

Neonatal nutritional supplements are widely used to improve growth and development but may increase risk of later metabolic disease, and effects may differ by sex. We assessed effects of supplements on later development and metabolism. We searched databases and clinical trials registers up to April 2019. Participant-level data from randomised trials were included if the intention was to increase macronutrient intake to improve growth or development of infants born preterm or small-for-gestational-age. Co-primary outcomes were cognitive impairment and metabolic risk. Supplementation did not alter cognitive impairment in toddlers (13 trials, n = 1410; adjusted relative risk (aRR) 0.88 [95% CI 0.68, 1.13]; p = 0.31) or older ages, nor alter metabolic risk beyond 3 years (5 trials, n = 438; aRR 0.94 [0.76, 1.17]; p = 0.59). However, supplementation reduced motor impairment in toddlers (13 trials, n = 1406; aRR 0.76 [0.60, 0.97]; p = 0.03), and improved motor scores overall (13 trials, n = 1406; adjusted mean difference 1.57 [0.14, 2.99]; p = 0.03) and in girls not boys (p = 0.03 for interaction). Supplementation lowered triglyceride concentrations but did not affect other metabolic outcomes (high-density and low-density lipoproteins, cholesterol, fasting glucose, blood pressure, body mass index). Macronutrient supplementation for infants born small may not alter later cognitive function or metabolic risk, but may improve early motor function, especially for girls.

The collaboration between Bufalini Hospital’s NICU (Neonatal Intensive Care Unit), Cesena, and the Developmental Psychodynamics Laboratory of Bologna’s Psychology Department, Cesena branch, has led to a shared reflection regarding both the Care of preterm births under 1500 grams, from 3 to 24 months of corrected age, and of a multidisciplinary neuro and psychodevelopmental follow up procedure . The studies, published in international journals, have led to the formulation of new research hypotheses and clinical reflection.

This study contributes to the knowledge on the effects of the COVID-19 pandemic by examining a moderated mediation model in which the impact of job loss over quality of life (QoL) is mediated by hopelessness and moderated by trait emotional intelligence (trait EI). Data were collected from a large nationally representative Italian sample of adult workers (N = 1610), who completed a series of anonymous online questionnaires. Total, direct and indirect effects were estimated through bootstrapped mediated moderation analyses providing 95% bias corrected bootstrap confidence intervals. After controlling for the effects of gender and age range, job loss was found to be negatively associated with QoL, and hopelessness partially mediated such relationship. These relationships were in turn moderated by trait EI. Our study suggests that trait EI levels act as protective factor for a good QoL, mitigating the impact of both job loss and hopelessness over QoL levels during the COVID-19 pandemic. Identifying psychological protective and/or risk factors for a better QoL is crucial for the development of interventions aimed at reducing the emotional impact of the pandemic and of its negative real-life consequences.

Background: After preterm birth, infants are at high risk for delays in language development. A promising intervention to reduce this risk is represented by the exposure to parental voices through book-reading in Neonatal Intensive Care Units (NICU). This study investigated the possible advantages of book-reading to preterm neonates during their NICU stay on their subsequent language development. Methods: 100 families of preterm infants were recruited. The parents of 55 preterm infants (Reading Group) received a colored picture-book on NICU admission and were supported to read to their neonate as often as possible and to continue after hospital discharge. Forty-five infants (Control Group) were recruited before the beginning of the intervention. Infant language development was assessed with the Hearing and Language quotients of the Griffith Mental Development Scale at the corrected ages of 3, 6, 9, 12, 18 and 24 months. Results: Regardless of group membership, Hearing and Language mean quotients decreased between 9 and 18 months, nevertheless, this decrease was considerably reduced in the Reading group, compared to the Control Group. Conclusions: Reading in NICUs represents a suitable intervention that could positively influence language development and parent-infant relationships in preterm children. The study findings support its implementation as a preventive measure.

Although preterm birth constitutes a risk factor for postpartum depressive symptomatology, perinatal depression (PND) has not been investigated extensively in fathers of very low (VLBW) and extremely low birth weight (ELBW) infants. This study explored paternal depression levels at 3, 9, and 12 months of infant corrected age, investigating also the predictive role played by the severity of prematurity, maternal and paternal PND levels, and parenting stress. We recruited 153 fathers of 33 ELBW, 42 VLBW, and 78 full-term (FT) infants, respectively. Depression was investigated by the Edinburgh Postnatal Depression Scale (EPDS) and distress by the Parenting Stress Index-Short Form-PSI-SF (Total and subscales: Parental Distress, Parent–Child Dysfunctional Interaction, and Difficult Child). ELBW fathers showed a significant decrease (improvement) in EPDS, total PSI-SF, and Parental Distress mean scores after 3 months. Paternal EPDS scores at 12 months were significantly predicted by VLBW and FT infants’ birth weight categories, fathers’ EPDS scores at 3 and 9 months, Parent–Child Dysfunctional Interaction subscale at 3 months, and Difficult Child subscale at 9 months. This study strengthens the relevance of including early routine screening and parenting support for fathers in perinatal health services, with particular attention to fathers who might be more vulnerable to mental health difficulties due to severely preterm birth.

Behavioral Inhibition (BI) is a temperamental trait characterized by fear and wariness in reaction to new and unfamiliar stimuli, both social and non-social. BI has been recognized as possible forerunner of anxiety disorders, especially social anxiety and phobia, therefore, its assessment is clinically relevant. The present study aimed to examine the psychometric properties of the Italian adaptation of the Behavioral Inhibition Questionnaire (BIQ), which measures BI in preschool children. The BIQ was completed by 417 Italian parents (230 mothers, 187 fathers) of 270 preschoolers aged 3–5. Confirmatory factor analysis showed a good internal validity: the factorial structure was corresponding to the original six-factor version. Results showed excellent internal consistency, significant item-total correlations, good inter-rater reliability, convergent validity (by correlating the BIQ with the Italian Questionnaires of Temperament-QUIT, the Anxiety-Shy Conner’s Scale and the Laboratory Temperament Assessment Battery) and discriminant validity (i.e., no correlation with Conners’ ADHD scale). Significant correlations emerged between BI indexes and total BIQ scores of parents and maternal (but not paternal) versions of the questionnaire. Altogether, the results are promising and consistent with previous validation studies, suggesting the BIQ as a reliable and valid measure for evaluating parents’ perception of BI in Italian preschoolers.

Aim of this study was to investigate whether parental mental representations during pregnancy and after delivery differed between parents who conceived after Assisted Reproductive Treatments (ART) and spontaneous conceiving (SC) parents. Effects of specific ART variables (previous ART attempts, treatment type and cause of infertility) were also taken into account. Seventeen ART couples and 25 SC couples were recruited at Santa Maria Nuova Hospital (Reggio Emilia, Italy). At both 32 weeks of gestation (T1) and 3 months postpartum (T2) participants completed the Semantic Differential of the IRMAG, a self-report tool which measures specific domains of mental representations pertaining either individual (Child, Self-as-woman/man, and Partner) or parental (Self-as-parent, Own parent) characteristics. Results showed that ART parents had significantly more positive representations of the child compared to SC parents, while the scores at Partner dimension improved from T1 to T2 for SC parents only. With regards to ART history, scores at the Self-as-woman/man dimension were significantly less positive for ICSI than IVF parents and improved substantially from T1 to T2 only in case of mothers with previous ART attempts and of fathers at the first ART cycle. The representation of own parents increased from T1 to T2 in case of infertility diagnosis due to male factors, while a decrease emerged when infertility was due to female factors. Findings suggest the need to investigate parental mental representations after ART, in order to improve the understanding on the transition to parenthood of infertile couples and to target more specific intervention for parenting support.

Background: Perinatal depression (PND) in mothers and fathers of very low and extremely low birth weight (VLBW and ELBW) infants has not been studied extensively. In particular, no studies investigated the reciprocal influence of depressive symptoms during the first 12 months postpartum. This study aimed at exploring the impact of the severity of prematurity on maternal and paternal PND during the first postpartum year; specifically, we used an Actor–Partner Interdependence Model (APIM) to test the interdependence of both partners on depressive symptoms.Methods: A total of 177 mothers and 177 fathers were recruited, divided into 38 couples with ELBW infants, 56 with VLBW, and 83 of full-term (FT) infants. PND was evaluated by the Edinburgh Postnatal Depression Scale (EPDS) at 3, 9, and 12 months postpartum (corrected age for preterm infants).Results: Maternal depressive symptoms at 3 months were positively related to those at 9 and 12 months in the 3 groups. Conversely, paternal depressive symptoms assessed at 3 months were positively related to those measured at 9 months for the ELBW group, 12 months for the VLBW group, 9 and 12 months for FT condition. Furthermore, a significantly positive partner effect was observed regarding the influence of 3 month maternal depressive symptoms on paternal depressive symptoms at 9 months, but only in the case of the VLBW group.Conclusion: Prematurity represents a very specific scenario in the transition to parenthood, leading to specific reactions in mothers and fathers, especially in high-risk conditions. Results should be deepened given the relevance of their clinical implications.

The impact of the COVID-19 pandemic on global healthcare workers’ (HCWs) mental health has been well documented in the last two years; however, little is known regarding HCWs working in specific healthcare fields. During two subsequent periods of national lockdown in Italy (June–July 2020, T1, and November–December 2020, T2), a total sample of 47 HCWs working in a reproductive medicine hospital unit completed an ad hoc questionnaire for assessing emotional reactions to the pandemic, stress symptoms, and ways of coping. Moderate–high levels of anger and sadness were experienced by 65.9% and 68.1% of the HCWs, respectively, while moderate–high levels of anxiety and fear were experienced by 51.1% and 56.8%, respectively. Higher stress symptoms experienced by HCWs were hypervigilance, avoidance of thoughts and memories, and tiredness/low energy. At T2, levels of hypervigilance, irritability, intrusive thoughts, and detachment were higher than at T1, while avoidance of external triggers decreased. Moderate–high levels of anxiety resulted significantly associated with several symptoms of stress: irritability/fearfulness, depression/hopelessness, tiredness/low energy, problems with concentration, and intrusive thoughts. Regarding coping strategies, HCWs tended to adopt more problem-focused coping (e.g., contributing to improving a situation) and this tendency was higher at T2. Overall findings suggest a risk for the persistence of stress symptoms and, therefore, a risk for a chronic course, which might interfere with the global quality of mental health at work and the care provided to patients. Clinical implications highlight the relevance of implementing support programs for this category of HCWs focused on the elaboration of negative emotions and on fostering adaptive coping strategies.

Background The literature has recognized premature birth as a risk factor for infant development and maternal anxiety. This study investigated the impact of the severity of birth weight, as well as of maternal anxiety at 3 months of infants' corrected age, on infants' outcomes during the 1st year postpartum. Moreover, it described the longitudinal trajectories of developmental outcomes, additionally exploring the impact of anxiety. Methods The study compared 147 mothers and their 147 newborns, differentiated in 25 Extremely Low Birth Weight (ELBW), 41 Very Low Birth Weight (VLBW), and 81 Full-Term (FT) infants. At 3, 9, and 12 months (corrected age in the case of preterm infants) the level of infants' development was investigated according to the 5 quotients (Locomotor, Personal and Social, Hearing and Language, Eye-hand Co-ordination and Performance) of the Griffiths Mental Development Scales (GMDS-R). During the assessment of 3 months, mothers fulfilled Penn State Worry Questionnaire (PSWQ) to evaluate the presence of generalized anxiety. Results Among the 5 GMDS-R quotients, significant effect of severity of birth weight emerged only for Performance quotient: preterm infants (ELBW at 3 months; VLBW at 12 months) showed lower scores than FT ones. Moreover, this quotient decreased from 3 to 9 and to 12 months for VLBW and FT infants, while it was stable for ELBW ones. A significant interaction between severity of birth weight and maternal anxiety emerged for Hearing and Language and Locomotor quotients. In the first case, scores for ELBW infants, independently from maternal anxiety, decreased from 9 to 12 months. The same results emerged for VLBW infants, in the case of non-anxious mothers. Regarding Locomotor quotient, mean scores decreased from 3 to 9 and to 12 months for all groups in the case of non-anxious mothers. Conversely, when mothers were anxious, this decrease emerged only for VLBW infants. Lastly, ELBW, VLBW and FT showed difference in the growth and slope of the trajectories of different quotients. Conclusion The severity of birth weight for preterm infants, also in interaction with maternal anxiety, had significant and specific impact on different dimensions of infants' development. Clinical implications of these results underline the need for individualized interventions.

This study aims to describe parents&rsquo, and infant&rsquo, s interactive styles after assisted reproduction treatments (ART), to compare them with parent&ndash, infant interactions after spontaneous conception (SC), and to assess the effect of specific ART variables (cause of infertility, treatment type, and previous ART attempts) on interaction quality. The sample included 25 ART conceiving couples and 31 SC couples with their 3-months-old babies. Free parent&ndash, infant interactions (3&ndash, 5 min) were coded using the CARE-Index, a video-based assessment scale that gives both dimensional (e.g., sensitivity, control, passivity) and categorical scores (sensitive, inept, at-risk) for parents and infants. Results showed a global similarity between groups in CARE-Index dimensions. Nevertheless, differences emerged in categorical scores, as the interactive patterns of ART parents were more frequently classified as &ldquo, inept&rdquo, and &ldquo, at-risk&rdquo, compared to SC parents. With regards to ART dyads only, infants conceived through intracytoplasmic sperm injection scored significantly lower to the dimension compulsivity and higher to passivity, compared to infants conceived through in vitro fertilization. Yet, infants conceived at the first ART cycle had significantly lower levels of difficulty than infants conceived after one ART attempt. These results speak about the existence of important parent&ndash, infant interactive differences related to conception modality and ART technique and suggest the need to implement support programs to promote more sensitive parenting styles.

Objective: In the 1st year of the post-partum period, parenting stress, mental health, and dyadic adjustment are important for the wellbeing of both parents and the child. However, there are few studies that analyze the relationship among these three dimensions. The aim of this study is to investigate the relationships between parenting stress, mental health (depressive and anxiety symptoms), and dyadic adjustment among first-time parents. Method: We studied 268 parents (134 couples) of healthy babies. At 12 months post-partum, both parents filled out, in a counterbalanced order, the Parenting Stress Index-Short Form, the Edinburgh Post-natal Depression Scale, the State-Trait Anxiety Inventory, and the Dyadic Adjustment Scale. Structural equation modeling was used to analyze the potential mediating effects of mental health on the relationship between parenting stress and dyadic adjustment. Results: Results showed the full mediation effect of mental health between parenting stress and dyadic adjustment. A multi-group analysis further found that the paths did not differ across mothers and fathers. Discussion: The results suggest that mental health is an important dimension that mediates the relationship between parenting stress and dyadic adjustment in the transition to parenthood.

Objective: The aim of this observational study was to evaluate the effects of two different protein intake regimes on feeding tolerance, in-hospital growth, anthropometric data and psychomotor outcome up to 24 months corrected age (CA) in extremely low birth-weight (ELBW; birth weight < 1000 g) infants.Methods: During the period 2008-2013, 52 ELBW infants admitted at birth to two Neonatal Intensive Care Units of Emilia Romagna (Italy) were fed according to different protocols of protein fortification of human milk: an estimated protein intakes at maximum fortification levels of 3.5 gr/kg/day in the Standard Nutrition Population-SNP group (n = 26) and 4.8 g/kg/day in the Aggressive Nutrition Population-ANP group (n = 26). During hospitalization, infants' growth, biochemical indices of nutritional status, enteral intake, feeding tolerance, clinical history and morbidity were evaluated. After discharge, anthropometric data and psychomotor outcome, evaluated by Revised Griffiths Mental Development Scales (GMDS-R) 0-2 years, were assessed up to 24 months CA.Results: During hospitalization, the ANP group showed significantly higher weight (18.87 vs. 15.20 g/kg/day) and head circumference (0.70 vs. 0.52 cm/week) growth rates compared to SNP, less days of parenteral nutrition (7.36 +/- 2.7 vs. 37.75 +/- 29.6) and of hospitalization (60.0 +/- 13.3 vs. 78.08 +/- 21.32). After discharge, ANP infants had a greater head circumference compared to SNP (45.64 +/- 0.29; 46.80 +/- 0.31). Furthermore, the General Quotient of GMDS-R mean scores in the SNP group significantly decreased from 12 to 24 months CA, while no difference was seen in the ANP group.Conclusions: Increased protein intake may provide short and long term benefits in terms of growth and neurodevelopment in human milk-fed ELBW infants.

Objective: Although there is an established link between parenting stress, postnatal depression, and anxiety, no study has yet investigated this link in first-time parental couples. The specific aims of this study were 1) to investigate whether there were any differences between first-time fathers’ and mothers’ postnatal parenting stress, anxiety, and depression symptoms and to see their evolution between three and 6 months after their child’s birth; and 2) to explore how each parent’s parenting stress and anxiety levels and the anxiety levels and depressive symptoms of their partners contributed to parental postnatal depression. Method: The sample included 362 parents (181 couples; mothers’ MAge = 35.03, SD = 4.7; fathers’ MAge = 37.9, SD = 5.6) of healthy babies. At three (T1) and 6 months (T2) postpartum, both parents filled out, in a counterbalanced order, the Parenting Stress Index-Short Form, the Edinburgh Postnatal Depression Scale, and the State-Trait Anxiety Inventory. Results: The analyses showed that compared to fathers, mothers reported higher scores on postpartum anxiety, depression, and parenting stress. The scores for all measures for both mothers and fathers decreased from T1 to T2. However, a path analysis suggested that the persistence of both maternal and paternal postnatal depression was directly influenced by the parent’s own levels of anxiety and parenting stress and by the presence of depression in his/her partner. Discussion: This study highlights the relevant impact and effects of both maternal and paternal stress, anxiety, and depression symptoms during the transition to parenthood. Therefore, to provide efficacious, targeted, early interventions, perinatal screening should be directed at both parents.

Introduction: Although preterm birth represents a risk factor for early mother-infant interactions, few studies have focused on toddlerhood, an important time for the development of symbolic play, autonomous skills, and child's socialization competences. Moreover, no study has looked at the effect of birth weight on mother-child interactions during this period. Expanding on the available literature on prematurity, the main objective of this study was to explore the quality of mother-toddler interactions during play, using a longitudinal research design, as well as taking into account the effect of birth weight. Method: 16 Extremely Low Birth Weight (ELBW), 24 Very Low Birth Weight (VLBW), 25 full-term children, and their mothers were recruited for the present study. Mother-child dyads were evaluated at 18, 24, and 30 months of child age. Ten minutes of mother-child play interaction were recorded and later coded according to the Emotional Availability Scales (EAS). Furthermore, the child's level of development was assessed through the Griffiths Scale, and its contribution controlled for. Results: ELBW dyads showed an overall lower level of emotional availability, compared to VLBW and full-term dyads, but no main effect of birth weight was found on specific EA dimensions. Moreover, a significant effect of child age emerged. Overall scores, and Child Responsiveness and Involvement scores improved over time, independently of birth weight. Lastly, a significant effect of the interaction between birth weight and child age was found. Between 18 and 30 months, the overall quality of the interaction significantly increased in ELBW and VLBW dyads. Additionally, between 18 and 30 months, VLBW children significantly improved their responsiveness, while their mothers' sensitivity, structuring, and non-intrusive behaviors improved. In contrast, no change emerged in full-term dyads, although scores were consistently higher than those of the other groups. Discussion: Birth weight affects the quality of mother-toddler interactions. Monitoring the relational patterns of preterm dyads during toddlerhood is important, especially in the case of ELBW children.

Literature on mother-child feeding interactions during the transition to self-feeding in preterm populations is lacking, particularly through observational methods. The present research study aims to look at the longitudinal patterns of mother-toddler feeding interactions, comparing preterm and full term dyads. To this end, a multi-method approach was used to collect data from 27 preterm to 20 full-term toddlers and their mothers. For each dyad, mother-child interactions were observed during the snack time at 18 and 24 months of age and then assessed through the Italian version of the Feeding Scale. Higher scores on the scale indicate a less healthy pattern of interaction. Additionally, at both points in time, mothers completed the BDI-II questionnaire as a screen for maternal depression and the child's developmental stage was assessed using the Griffiths Scales. A series of repeated measures Analysis of Variances were run to detect differences in feeding interactions between the two groups at the time of assessment. Our results show that preterm dyads report overall higher levels of maternal negative affection, interactional conflicts, and less dyadic reciprocity during the meal compared to full-term dyads. Additionally, longitudinal data show that dyadic conflict decreases in both groups, whereas the child's food refusal behaviors increase in the preterm group from 18 to 24 months. No differences were reported for both the BDI-II and the child's development for the two groups. The results reveal that regardless of maternal depression and the child's developmental stage, the two groups show different trajectories in the pattern of feeding interactions during the transition to self -feeding, at 18 and 24 months, with overall less positive interactions in preterm mother-child dyads.

Maternal depression and anxiety represent risk factors for the quality of early mother-preterm infant interactions, especially in the case of preterm birth. Despite the presence of many studies on this topic, the comorbidity of depressive and anxious symptoms has not been sufficiently investigated, as well as their relationship with the severity of prematurity and the quality of early interactions. The Aim of this study was to evaluate the quality of early mother-infant interactions and the prevalence of maternal depression and anxiety comparing dyads of extremely low birth weight (ELBW) and very low birth weight (VLBW) preterm infants with full-term ones. Seventy seven preterm infants (32 ELBW; 45 VLBW) and 120 full term (FT) infants and their mothers were recruited. At 3 months of corrected age, 5 min of mother-infant interactions were recorded and later coded through the Global Ratings Scales. Mothers completed the Edinburgh Postnatal Depression Scale and Penn State Worry Questionnaire. Infant levels of development were assessed through the Griffiths Mental Development Scales. A relation emerged among the severity of prematurity, depression, anxiety, and the quality of interactions. When compared with the FT group, the ELBW interactions were characterized by high maternal intrusiveness and low remoteness, while the VLBW dyads showed high levels of maternal sensitivity and infant communication. Depression was related to maternal remoteness and negative affective state, anxiety to low sensitivity, while infant interactive behaviors were impaired only in case of comorbidity. ELBW’s mothers showed the highest prevalence of depressive and anxious symptoms; moreover, only in FT dyads, low maternal sensitivity, negative affective state and minor infant communication were associated to the presence of anxious symptoms. The results confirmed the impact of prematurity on mother–infant interactions and on maternal affective state. Early diagnosis can help to plan supportive interventions.

Atopic dermatitis (AD) is a common childhood chronic inflammatory skin condition that greatly affects the quality of life (QoL) of affected children and their families. The aim of our study was to assess QoL and family QoL of children with AD from 4 different countries and then compare the data, evaluating the effects of AD severity and age of children. Data on the Children’s Dermatology Life Quality Index (CDLQI) and the Dermatitis Family Impact (DFI) questionnaires and the SCORAD index of 167 AD children 5-16 years old from Ukraine, Czech Republic, Singapore, and Italy was used for the study. SCORAD correlated with the CDLQI in all 4 countries and with DFI in all countries except Singapore. Only in Czech children did the CDLQI correlate with their age. No significant correlations between age and DFI results were found. AD symptoms and expenditures related to AD were highly scored in all countries. Impact of AD on friendship and relations between family members were among the lower scored items, and family problems did not increase proportionately with duration of AD in any of the four countries. Self-assessed health-related QoL of children with AD in our study correlated better in most cases with disease severity than family QoL results. Parents of school children with AD were generally less stressed, tired, and exhausted than parents of preschool children. These data together with results showing that duration of AD in children does not affect relations between parents and other family members is optimistic news for families with children with AD who did not recover until adolescence.

To contribute to the application of the Childhood Atopic Dermatitis Impact Scale (CADIS), 135 Italian parents of children with atopic dermatitis (AD) aged birth to 6 years completed: CADIS, Infants Dermatitis Quality of Life Index (IDQOL) or Children's Dermatology Life Quality Index (CDLQI), and Dermatitis Family Impact 10-item questionnaire (DFI). A subsample of 66 caregivers completed the CADIS again, 48 hours later. Disease severity was measured with the Severity Scoring of Atopic Dermatitis (SCORAD) index. Exploratory factor analyses almost replicated the general factor structure of the original CADIS, established on a US sample. However, some differences emerged, probably due to cultural differences. A reduced version of the original CADIS was also obtained, based on the exploratory factor analyses, to facilitate use in clinical settings. The original and the shorter versions were tested for reliability: overall Cronbach's α and test-retest reliability for the child- and parent-related scales were acceptable. Regarding concurrent validity, estimates showed the CADIS to correlate adequately with SCORAD, IDQOL-CDLQI, and DFI. Multiple comparison tests for discriminant validity revealed significant differences between extreme groups based on AD severity for all five domains of CADIS. The original CADIS showed adequate validity and reliability in Italy as well, and the shorter version showed promising psychometric properties.

Background The impact of atopic dermatitis (AD) on children's quality of life (QoL) in US and European countries is relatively well known, though rarely evaluated in the Italian population. Moreover, the association between child age and QoL has not been enough investigated, even though few studies detected a worse QoL in youngest AD children. The aim of the study was to evaluate the QoL in an Italian sample of atopic children and their families, also exploring a possible association with child age. Methods 60 AD children aged between 1-12 years and their mothers completed specific QoL questionnaires (IDQoL/CDLQI, DFI) and a clinician completed a measure of AD severity (SCORAD). Results AD severity (Objective SCORAD) significantly correlated with QoL measures. Severe AD children showed higher IDQoL/CDLQI and DFI scores compared to mild and moderate AD groups (P = 0.006 and P < 0.0005, respectively), but only DFI scores differed in these last two conditions (P = 0.014). DFI scores negatively correlated with children's age (P = 0.046), but did not differ when considering child age ranges. Multiple linear regression analyses revealed a significant association between Objective SCORAD and QoL measures. Conclusions A strong association between severe AD and poor QoL, both in children and mothers, was found in the Italian sample, in line with the international literature. Family's QoL scores were sensitively related to AD severity, more than the child's QoL, emphasising that the disease has a deep impact on the family. A significant association between age and QoL was only partially found and needs further investigation.

Aim : The goal of this study is to verify whether the Locomotor quotient of Griffiths Mental Development Scales (GMDS) can be considered a useful tool of screening for neurological disabilities in conjunction with objective tests. We explored whether there exists an association between the specialized medical examination and the GMDS Locomotor score at 6 and 12 months, and subsequently if it is possible to identify predictive factors at the birth of motor disability development. Materials and Methods : The sample includes 35 children born before the 32 nd gestational week with a birth weight less than 1500 g. The neurological examination was performed by an experienced physician using the criteria outlined by Milani-Comparetti and Amiel-Tison, while infant level of development was assessed using GMDS. Results : Significant correlation was found between the medical diagnosis and the GMDS at 6 and 12 months. The intraventricular hemorrhage of III-IV degree and periventricular leukomalacia were confirmed to be predictive risk factors for the development of motor disability. Conclusion: Locomotor quotient of GMDS could be used in conjunction with the standard neurological assessment to screen for motor disabilities.

El estudio explora, en el parto prematuro, la relación entre el estrés de los padres, la percepción maternal del temperamento del niño y el nivel de desarrollo del niño. Para la evaluación de una muestra de 78 niños prematuros a los 3 meses exactos de edad, en comparación con 73 nacidos a término, se han usado: Parenting Stress Index-Short Form (PSI-SF), para el estrés parental; cuestionarios italianos para el temperamento (QUIT, 1-12 meses), para el temperamento; las escalas de desarrollo mental de Griffiths (GMDS; 0-2 años), para el desarrollo del niño. Los resultados muestran que las madres de prematuro experimentan un estrés paternal significativamente mayor y sienten una reducción de la actividad motora en sus hijos, que tienen un menor nivel de desarrollo en la escala de Oído-Lenguaje, performance y cociente general. Los predictores significativos de estrés materno son los siguientes: nacimiento pre término, disminución en el desarrollo locomotor y personal-social y la percepción materna de una alta emocionalidad positiva y una baja emocionalidad negativa. El nacimiento prematuro tiene un profundo impacto estresante en las madres, agravado por la percepción de la disparidad entre las exigencias de la atención neonatal y los recursos disponibles

Background and aim of the study: Extrauterine growth restriction and failure to thrive remain a major problem in Extremely Low Birth Weight infants. Nutritional support in preterm babies has the objective to improve the achieve rate of growth similar to those of the fetus in utero at the equivalent gestational age. The aim of the study was to evaluate feeding tolerance, intrahospital growth, neurological outcome and anthropometric data until 24 months of corrected age (mca) from different protein intake assumed by preterm babies