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This longitudinal study investigated associations between language environment and parent-infant close contact in the neonatal intensive care unit (NICU), and preterm children's lexical abilities.NICU language environment of 43 very preterm infants (born 32 gestational weeks) was measured with the Language Environment Analysis system (LENA; variables: number of adult words, conversational turns, and child vocalizations). Parent-infant close contact (holding and skin-to-skin contact) in the NICU was reported using parental closeness diaries. At 15 and 18 months' corrected age, lexical development was measured with screening methods, and eye tracking-based lexical processing was assessed at 18 months. N varied between 29 and 38 in different outcome measures.LENA measured conversational turns and child vocalizations, and parent-infant close contact associated positively with lexical development (r=0.35--0.57). High numbers of NICU adult words associated negatively with lexical processing (r=-0.38---0.40). In regression models, conversational turns and parent-infant close contact explained 34--35% of receptive development.Findings suggest that adult-infant turn taking and parent-infant close contact in the NICU are positively associated with lexical development. High numbers of overheard words in the NICU may not favor later lexical processing. Further research is warranted on the significance of NICU language environment on later lexical abilities.

Background: Associations between lexical processing and lexical development during the second year of life have been little studied in preterm children. Aims: To evaluate associations between lexical processing at 18 months and lexical development between 12 and 18 months in very preterm children. Study design: Correlational study. Subjects: 25 Finnish-speaking children born

Aim: To evaluate the validity of the Language Environment Analysis (LENA) system's automatic measures in two neonatal intensive care units supporting parent-infant closeness, and in two Finno-Ugric languages: Finnish and Estonian. Methods: The sound environment of 70 very preterm infants was recorded for 16 h in the neonatal intensive care units with the LENA system roughly at the gestational age of 32 (+2) weeks. Of these, the recordings of 14 infants (20%, two 5-min samples with a high percentage of speech, totally 140 min) were analysed in detail and in two different ways. Parental closeness diaries were used to document the presence of the parents. Agreements between LENA system and human coder estimates were analysed. Results: Findings showed a high variation in agreements. The highest agreements were found in female and adult word counts (r = 0.91 and 0.95). The agreements for child vocalisation count, conversational turns and silence were modest or low (r = −0.03 to 0.64). Conclusion: Our study provides novel information on the validity of the LENA system in the neonatal intensive care unit. Findings show that the LENA system provides valid information on adult words, but LENA estimates for child vocalisations were less valid at this early age. publishedVersion

The aim of the study was to analyze which maternal factors (depressive symptoms, effect of life events, maternal sensitivity and structuring) and infant characteristics (temperament, social withdrawal symptoms, interactive behavior, genotype, gender) contribute to shared pleasure (SP) in parent-infant interaction. Participants were 113 mother-infant dyads. The mothers filled in the Edinburgh Postnatal Depression Scale, the Infant Behavior Questionnaire, and the Life Events Questionnaire. The dyads were videotaped in a free-play situation, and the videos were analyzed using the Alarm Distress Baby Scale and the Emotional Availability Scales. The infants were genotyped for four genes involved in emotion regulation. The occurrence and duration of SP (SP-MD) in mother-infant interactions were analyzed from the videotapes. Higher maternal sensitivity and depressive symptoms, better infant responsiveness, and the infant having the GG variant of the gene tryptophan hydroxylase isoform 2 (TPH2) -307 were associated with the occurrence of SP. Lower level depressive symptoms, better maternal structuring, and greater infant involvement were associated with the longer duration of SP. Those dyads where the mother and infant were best able to read each other's positive cues and to respond to them were more likely to experience mutual positive affect, as seen in SP.El propósito de este estudio fue analizar cuáles factores maternos (síntomas depresivos, efectos de eventos vividos, sensibilidad y estructuración maternas) y características del infante (temperamento, síntomas de despego social, comportamiento interactivo, genotipo, género sexual) contribuyen al placer compartido (SP) en la interacción progenitor-infante. En el estudio participaron 113 díadas madre-infante. Las madres completaron la Escala de Depresión Postnatal de Edimburgo, el Cuestionario de Comportamiento del Infante y el Cuestionario de Eventos de Vida. A las díadas se les grabó en video durante una sesión de juego libre y los videos se analizaron usando la Escala de Alarma de la Angustia del Bebé y las Escalas de Disponibilidad Emocional. A los infantes se les determinó el genotipo en el caso de cuatro genes que tienen que ver con la regulación emocional. Con base en las videograbaciones, se analizó la incidencia y duración de SP (SP-MD) en las interacciones madre-infante. Una más alta sensibilidad materna y síntomas depresivos, mejor sensibilidad por parte del infante, y el hecho de que el infante tenía la variante GG del gen TPH2 -307 se asociaron con la incidencia de SP. Síntomas depresivos de bajo nivel, una mejor estructuración materna y una mayor participación del infante se asociaron con una más larga duración de SP. Aquellas díadas en que la madre y el infante eran más capaces de comprender las señales positivas de cada uno y de responder a las mismas, estaban en mejor condición de experimentar un mutuo afecto positivo, como el que se ve en SP.Le but de cette étude était d'analyser quels facteurs maternels (symptômes dépressifs, effet d’événements de la vie, sensibilité maternelle et structuration maternelle) et quelles caractéristiques du nourrisson (tempérament, symptômes de retrait social, comportement interactif, génotype, genre) contribuent au plaisir partagé (abrégé ici en français PP) dans l'interaction parent-nourrisson. Les participants ont consisté en 113 dyades mère-nourrisson. Les mères ont rempli l'Echelle de Dépression Postnatale d'Edinbourg, le Questionnaire du Comportement du Nourrisson, et le Questionnaire d'Evénements de la Vie. Les dyades ont été filmées à la vidéo pendant une situation de jeu libre et les vidéos ont été analysées en utilisant l'Echelle d'Alarme de Détresse du Bébé et les Echelles de Disponibilité Emotionnelle. Les nourrissons ont été génotypés pour quatre gènes impliqués dans la régulation de l’émotion. L'apparition et la durée du PP (en anglais SP-MD) dans les interactions mère-nourrisson ont été analysées à partir des vidéos. Une sensibilité maternelle plus élevée et des symptômes dépressifs, une meilleure réaction du nourrisson, le nourrisson ayant la variante GG du gène TPH2 -307 étaient liés à l'apparition du PP. Des niveaux plus bas de symptômes dépressifs, une meilleure structuration maternelle et un engagement plus important du nourrisson étaient liés à une durée plus longue du PP. Les dyades où la mère et le nourrisson étaient le plus capables de lire leurs signaux positifs réciproques et d'y répondre étaient moins à même de faire l'expérience d'une affect positif mutuel, comme on le voit dans le PP.Ziel der Studie war es, zu analysieren, welche mütterlichen Faktoren (depressive Symptome, Auswirkungen von Lebensereignissen, mütterliche Sensitivität und Strukturierung) und kindlichen Eigenschaften (Temperament, soziale Rückzugssymptome, interaktives Verhalten, Genotyp, Geschlecht) zur geteilten Freude (SP) in der Eltern-Kind-Interaktion beitragen. Die Teilnehmer waren 113 Mutter-Kind-Dyaden. Die Mütter füllten die Edinburgh-Postnatale-Depressions-Skala, den „Infant Behavior Questionnaire“ und den „Life Events Questionnaire“ aus. Die Dyaden wurden in einer freien Spielsituation per Video aufgenommen und anhand der „Alarm Distress Baby Scale“ und den „Emotional Availability Scales“ analysiert. Die Säuglinge wurden für vier Gene, die an der Emotionsregulation beteiligt sind, genotypisiert. Das Auftreten und die Dauer von SP (SP-MD) in den Mutter-Kind-Interaktionen wurden anhand der Videoaufnahmen analysiert. Höhere mütterliche Sensitivität und depressive Symptome, eine bessere Reaktionsfähigkeit des Säuglings und die GG-Variante des Gens TPH2 -307 beim Säugling waren mit dem Auftreten von SP assoziiert. Ein geringeres Ausmaß an depressiven Symptomen, eine bessere mütterliche Strukturierung und eine stärkere Beteiligung der Säuglinge waren mit einer längeren Dauer von SP assoziiert. Diejenigen Dyaden, bei denen die Mutter und der Säugling am besten in der Lage waren, die positiven Signale des anderen zu lesen und darauf zu reagieren, erlebten eher gemeinsame positive Affekte, wie sie in der SP zu sehen waren.二者の関わり合いにおいて分かち合う喜びに関連する母子の特性 本研究の目的は、どの母親の要因 （抑うつ症状、ライフイベントの影響、母親の感受性および行動様式） と乳児の特性 （気質、社会的引きこもり症状、相互作用的な行動、遺伝子型、性別） が親ー乳幼児の関わり合いにおいて、分かち合う喜び （SP） に寄与するかを分析することである。参加者は 113 組の母子であった。母親たちは、エジンバラ産後うつ病尺度、乳児行動アンケートとライフイベントアンケートに記入した。母子ペアは自由遊びの状況をビデオ録画され、そのビデオは Alarm Distress Baby Scale （乳児不安困難評価）とEmotional Availability Scale （感情適正評価） を使って分析された。乳幼児は、感情調節に関与する4つの遺伝子に遺伝子型を決定された。母子相互作用における分かち合う喜び （SP-MD） の発生と持続時間はビデオテープから分析された。より高い母親の感受性と抑うつ症状、より良い乳幼児の反応性、遺伝子 TPH2-307 の GG 変異体を持つ幼児は分かち合う喜び (SP) の発生と関連していた。低レベルの抑うつ症状、よりよい母親の行動様式と、より多くの乳児からの関与と、分かち合う喜び （SP） のより長い持続時間は関連していた。分かち合う喜び （SP） において見られるように、母親と乳幼児がお互いの肯定的な合図を読むことができ、それらに反応することが最もうまくできた母子は、相互に肯定的な感情を経験する可能性がより高かった。.母嬰特徵與二元互動中的共享愉悅有關 本研究的目的是分析那些母體因素 （抑鬱症狀丶生活事件的影響丶母親的敏感性和結構） 和嬰兒特徵 （氣質丶社會退縮症狀丶互動行為丶基因型丶性別） 有助於親子互動的共享愉悅感 （SP） 。參與者是 113 名母嬰二人組合。母親們填寫 “愛丁堡產後抑鬱量表” 丶 “嬰兒行為問卷” 和 “生活事件調查問卷” 。作者以自由遊戲， 對二人組合進行錄像， 並使用警報遇險嬰兒量表和情緒可用性量表， 對視頻進行分析。作者以嬰兒的四種基因， 對情緒調節的基因分型。從錄像帶分析母嬰相互作用中 SP （SP-MD） 的發生和持續時間。較高的母體敏感性和抑鬱症狀丶較好的嬰兒反應性及具有基因 TPH2-307 的 GG 變體的嬰兒與 SP 相關。較低的抑鬱症狀丶較好的母體結構和較大的嬰兒參與， 和較長的 SP 持續時間有關。如 SP 中所見， 那些母嬰能夠了解彼此的積極提示， 並對其作出反應， 更有可能經歷相互正面的影響。.سمات الأم والرضيع المرتبطة بالمتعة المشتركة في التفاعل الثنائي كان الهدف من الدراسة تحليل العوامل الاموميه (الاعراض الاكتئابية ، وتاثير احداث الحياة ، وحساسية الأمهات وهيكلتها) وخصائص الرضع (المزاج ، واعراض الانسحاب الاجتماعي ، والسلوك التفاعلي ، والنمط الجيني ، ونوع الجنس) لمعرفة العوامل التي تساهم في المتعة المشتركة (SP) أثناء التفاعل بين الوالدين والرضيع. اشترك في الدراسة 113 ثنائي من 113 الأمهات-الرضع. وقام الأمهات باستكمال مقياس أدنبرة لاكتئاب ما بعد الولادة ، واستبيان سلوك الرضع ، واستبيان أحداث الحياة. وتم تصوير الثنائيات بالفيديو في وضع اللعب الحر ، وتم تحليل تسجيلات الفيديو باستخدام مقياس إنذار الكآبة للأطفال ومقياس التوافر العاطفي. وتم تحليل أربعة جينات مسئولة عن تنظيم العاطفة. وتم تحليل حدوث ومده المتعة المشتركة في تفاعلات الام والرضيع من خلال التسجيلات . وارتبط ارتفاع حساسية الام واعراض الاكتئاب ، والاستجابة الأفضل للرضيع ، ووجود نمط GG من الجينات TPH2-307 بحدوث المتعة المشتركة SP. أما أعراض الاكتئاب من المستوي الأدنى ، وتحسين الهيكلة الأمومية ، والمشاركة الاكبر للرضع ارتبطت بمدة أطول من المتعة المشتركة SP. وفي الثنائيات التي كان فيها الام والرضيع أفضل قدرة علي قراءه الإشارات الايجابية من بعضهم البعض والاستجابة لها كانت أكثر عرضه للتاثير الإيجابي المتبادل ، كما اتضح ذلك في نتائج المتعة المشتركة SP.

Infant social behavior develops in the context of early parent–infant interaction. Persisting withdrawal from social interaction is a sign of infant distress and is linked with the existence of risk factors. Impaired social behavior of the infant not only may be an indicator of pathology in the infant but the first sign of an effect of a psychosocial risk. In this study, we assessed 39 seven-month-old infants in videotaped interaction with their mothers and then compared the total score of the infant social behavior rated with the Alarm Distress Baby Scale (ADBB; A. Guedeney & A. Fermanian, 2001) with variables of mother–infant interaction rated with the Emotional Availability Scales, second edition (EAS 2; Z. Biringen, J. Robinson, & R.N. Emde, 2000). The ADBB total score had a strong negative correlation with maternal sensitivity in the EAS 2 (r = −0.75) and with the EAS 2 child variables of child involvement (r = 0.82) and child responsiveness (r = 0.85), indicating that the infants with more signs of social withdrawal had less sensitive mothers and were less involving and responsive in the interaction. Against our expectations, the ADBB total score had no correlation with maternal structuring. Our results give further support of the ability of the ADBB to screen for early signs of pathology in infant social behavior and problems in parent–infant interaction. La conducta social del infante se desarrolla dentro del contexto de la temprana interaccion entre progenitor e infante. Una persistente retractacion de la interaccion social es un signo de la angustia del infante y esta enlazada con la existencia de factores de riesgo. La conducta social incapacitada del infante pudiera ser no solamente un indicador de patologia del infante, sino tambien la primera senal del efecto de un riesgo sicosocial. En este estudio evaluamos treinta y nueve infantes de 7 meses de edad en una interaccion grabada en video con sus madres y luego comparamos el puntaje total de la observada conducta social del infante calificada con ADBB, con las variables de la interaccion madre-infante calificadas con las Escalas de Disponibilidad Emocional (EAS). El puntaje total de ADBB mostro una fuerte correlacion negativa con la sensibilidad maternal en EAS (r = -0.75) y con las variables del nino de EAS en cuanto a la participacion del nino (r = -0.82) y el interes sensible del nino (r = -0.85), lo cual indica que los infantes con mas senales de retractacion social tenian madres menos sensibles y se mostraron menos involucrados y menos sensiblemente interesados en la interaccion. Contra nuestras expectativas, el puntaje total de ADBB no tuvo correlacion con la estructuracion maternal. Nuestros resultados dan aun mas apoyo a la capacidad de ADBB de detectar senales tempranas de patologia en la conducta social del infante y problemas en la interaccion progenitor-infante. Le comportement relationnel du bebe se developpe dans le contexte de l’interaction precoce parent-bebe. Le retrait persistant de l’interaction relationnelle est un signe de detresse du bebe et lie a l’existence de facteurs de risque. Un comportement relationnel deteriore du bebe peut non seulement etre un indicateur de pathologie chez le bebe mais aussi le premier signe de l’effet d’un risque psychosocial. Dans cette etude nous avons evalue trente neuf bebes de 7 mois dans une interactions filmee a la video avec leurs meres et ensuite avons compare le score total du comportement relationnel observe du bebe avec l’ADBB avec des variables d’interaction mere-bebe evaluees avec les Echelles de Disponibilite Emotionnelle (Emotional Availability Scales, abrege EAS). Le score total ADBB avait une forte correlation negative avec la sensibilite maternelle dans l’EAS (r = -0,75) et avec les variables d’implication de l’enfant pour l’EAS (r = -0,82) et la reaction de l’enfant (r = -0,85), indiquant que les bebes avec plus de signes de retrait relationnel avaient des meres moins sensibles et etaient moins accueillantes et reactives dans l’interaction. Contrairement a ce a quoi on s’attendait, le score total ADBB n’avait aucune correlation avec la structuration maternelle. Nos resultats confirme la capacite qu’a l’ADBB a depister les premiers signes de pathologie dans le comportement relationnel du bebe et les problemes de l’interaction parent-bebe. Das Sozialverhalten von Sauglingen entwickelt sich im Kontext von fruher Eltern-Kind-Interaktion. Anhaltender Ruckzug aus sozialen Interaktionen ist ein Zeichen fur ein Leiden des Sauglings und ist mit dem Bestehen von Risikofaktoren verknupft. Das beeintrachtigte Sozialverhalten des Sauglings muss kein Indikator fur eine Pathologie des Sauglings sein, aber ist das erste Anzeichen eines psychosozialen Risikos. In dieser Studie haben wir neununddreisig 7-Monate alte Sauglinge bei der Interaktion mit ihren Muttern, welche auf Video aufgezeichnet wurde, untersucht. Der Gesamtwert des mit der ADBB beobachteten Sozialverhaltens des Sauglings wurde mit Variablen der Mutter-Kind-Interaktion, die mithilfe der Emotional Availability Scales (EAS) erfasst wurden, verglichen. Der ADBB Gesamtwert hatte eine starke negative Korrelation mit der mutterlichen Sensitivitat in den EAS (r = -0,75) und mit den EAS-Skalen Kindliche Involvierung (r = -0.82) und Kindliche Responsivitat (r = -0.85), was darauf hinweist, dass Sauglinge mit mehr Anzeichen von sozialem Ruckzug weniger sensitive Mutter hatten und weniger involvierend und responsiv in der Interaktion waren. Entgegen unserer Erwartungen zeigte der ADBB Gesamtwert keine Korrelation mit mutterlicher Strukturierung. Unsere Ergebnisse unterstutzen den Einsatz des ADBB zum Screening fur fruhe pathologische Anzeichen im Sozialverhalten von Sauglingen und Probleme in der Eltern-Kind-Interaktion. 抄録：乳児の社会的行動は、早期の親－乳児相互交流のコンテクストの中で発達する。社会的相互交流からの持続的な引きこもりは、乳児の苦痛の兆候であり、リスク因子の存在と関連する。乳児の社会的行動の障害は、乳児の病理の指標であるだけでなく、心理社会的リスクの影響の最初の兆候かもしれない。この研究では、私たちは39人の7か月児を、ビデオ録画された母親との相互交流のなかで評価し、その後ADBBで評価された観察された乳児の社会的行動の全スコアと、情緒応答性尺度Emotional Availability Scales (EAS)で評価された母－乳児相互交流の変数を、比較した。ADBB全スコアは、EASの母親の感受性 (r = -0.75)、EASの子どもの変数である子どもの巻き込まれ(r = -0.82)および応答性(r = -0.85) と強い逆相関があった。これは、社会的引きこもりの兆候が多い乳児の方が母親の感受性がより低く、相互交流の中で巻き込まれたり応答的であることも少ないことを示していた。私たちの予期に反して、ADBBの全スコアは、母親の構造化structuringとは関連がなかった。私たちの結果は、ADBBが、乳児の社会的行動における病理の早期の兆候と親－乳児相互交流における問題のスクリーニングに可能性があることを、更に支持する。

Objective. Early mother–infant relationships in preterm populations were evaluated in the context of a systematic review of the literature. Design and setting. A systematic search of three electronic databases (PsychINFO, PubMed and Cochrane Library) was undertaken. Three studies of maternal attachment, 18 studies of mother–preterm infant interaction and eight studies of infant attachment were included. Studies of preterm infant attachment were also evaluated using a meta-analysis. Results. Studies of mother–preterm infant interactions showed that the differences in maternal interaction behavior between mothers of preterm infants and mothers of full-term infants seem to be most evident during the first six months of life. Differences in the preterm infant's interaction behavior seem also to continue for six months after birth. However, five of 18 studies showed an equal or even higher quality of mother–infant interaction in groups of preterm compared to groups of full-term infants. Studies of maternal and infant attachment indicated that preterm infants and their mothers are not at higher risk of insecure attachment than full-term infants and their mothers. Conclusions. The mother–preterm infant relationship is complex, and some relational patterns forecast greater psychological risk than others. It is important to decrease maternal stress and early separation in every possible way during hospitalization as well as after discharge.

To investigate how mother's recollections of birth experiences and first contact with the newborn relate to the child's behavioral and emotional problems at five to six years of age.The study included 28 mothers of preterm (birth weightor =2500 g) and 39 mothers of full-term children, born in Tampere University Hospital in 1998. When the children were five to six years old, maternal recollections of the birth experiences were assessed using the Clinical Interview for Parents of High-Risk Infants (CLIP) and children's behavioral and emotional problems were assessed using the Child Behavior Checklist (CBCL).Mothers of the preterm children still had more negative recollections of the labor (p0.001) and first contact with the newborn (p0.001) than mothers of the full-term children. These recollections related to the child's behavioral and emotional symptoms when the child was five to six years old in the preterm group but not in the full-term group.The impact of mother's birth experience seems to have long-lasting effects on the preterm child. This finding emphasizes the importance of early physical mother-infant contact and supporting the mothers of preterm infants, especially if they articulate negative or traumatic experiences related to the birth of their child.

Aim: To investigate visiting frequency of family members, including mother, father, siblings and grandparents and associated factors during hospitalisation of preterm infants. Methods: The study included all premature (< 37 weeks) infants born in Tampere University Hospital in 1997–1998 admitted to the neonatal intensive care unit (NICU) with a birth weight less than 2500 g (n = 210). Maternal and infant data and visits made by family members were compiled from the infants' hospital records. Results: The length of the infants' hospitalisation varied from 2 to 133 days (median 26, quartiles 19, 45). Mothers visited the NICU on average 6.7 days/week; fathers 4.8 days/week. Mothers visited less frequently the lower the gestational age and the longer the distance between home and hospital. Fathers visited less frequently if distance from home to hospital was longer and if the infant had siblings. A total of 92% of siblings and 80% of grandparents visited the hospital. Conclusions: The results showed active visiting by the parents in the NICU. A lower gestational age was associated with lower visiting frequency for mothers. In contrast, more practical limitations such as geographical distance and other children to be taken care of had greater effect on the visiting frequency for fathers.

Shared pleasure (SP) was analyzed in fifty-eight 2-month-old infants and their mothers in face-to-face interaction (T1, at 2 months). The association of SP with child's emotional and behavioral outcome at 2 years (T2) was examined. SP as a possible protecting factor in the presence of parental psychopathology also was studied. Mean duration of SP moments (SP-MD) was related to subsequent socioemotional outcome of the child: Infants of dyads with longer SP-MD showed fewer internalizing and externalizing problems 2 years later. In hierarchical linear regressions, SP-MD uniquely and significantly contributed to internalizing problems after adjusting for infant and maternal factors and mother's interactive behavior. SP protected the child against the influence of parental psychopathology. Father's mental health problems during the follow-up increased the child's risk for higher externalizing and internalizing problems, but only among children with short SP-MD at T1. Internalizing symptoms at T2 increased when moving from the category "no mental health problems" to "mental health problems in one parent" and further to "mental health problems in both parents," but this increase was found only among those with short SP-MD at T1. SP in parent-child interaction is an important feature that fosters positive psychological development and moderates the health effects of other risks such as parental psychopathology.

Postnatal psychological symptoms have been studied less often in fathers than in mothers. However, recent research shows that fathers' psychopathology may have long-term effects on their children's emotional and behavioural development independently of maternal psychopathology. More research is needed on factors associated with paternal symptoms at the early stage of child development.The aim of the study was to examine the paternal, maternal, infant and family factors associated with the occurrence of depressive and anxiety symptoms in fathers of infants.As part of a study conducted in Tampere, Finland, on infants' social withdrawal symptoms, both parents of 4-, 8- and 18-month-old infants (n = 194) completed the Edinburgh Postnatal Depression Scale (EPDS) and general information questionnaires during routine check-ups of the infants in well-baby clinics. Parental depressive and anxiety symptoms were screened using the recommended cut-off points for this purpose (5/6 for fathers and 7/8 for mothers on the EPDS). The associations between the fathers' symptoms and paternal, maternal, infant and family factors were explored.Twenty-one per cent of the fathers and 24% of the mothers scored above the cut-off points for depressive and anxiety symptoms on the EPDS. Both paternal and maternal factors predicted high paternal symptom level in regression models. Infant factors were not statistically significantly associated with paternal symptoms.Father's psychological symptoms were associated with many facets of both parents' impaired well-being. The whole family system should be considered whenever there are concerns about either parent's psychological well-being.

the first aim of this two-phase study was to describe and compare, between two university hospitals, the early physical contact of mothers and their preterm or sick newborn infants in the delivery room. Secondly, the staff's perceptions of factors facilitating and promoting or impeding this contact were evaluated. Thirdly, the association between early physical contact and the initiation of breast feeding was examined.a structured survey was conducted between November 2008 and March 2009 in two university hospitals in Finland.in phase I, the sample consisted of all preterm or sick infants who needed NICU care and whose questionnaires were completed by labour ward staff (hospital A, n=178/185, hospital B, n=203/235). In phase II, a subsample of these infants (A, n=76, B, n=94) and their mothers who completed their questionnaires participated in the study.structured questionnaires developed for this study were used.the implementation of early physical contact differed between the study hospitals. The infants had physical contact with their mothers more often in hospital A than in hospital B whether they were sick full-term (83% versus 58%, p0.001) or late preterm (49% versus 34%, p=0.051). None of the very preterm infants (32 weeks) had early physical contact in the delivery room in either hospital. An infant's unstable condition and delivery by caesarean section were the most common obstacles against early contact. There was a moderate association between early contact and the initiation of breast feeding.caring practices concerning early physical contact seemed to be different in the study hospitals. The obstacles impeding early contact should be re-evaluated. Guidelines might enhance early physical contact between preterm or sick infants and their mothers.

Early mother-infant relationships in preterm populations were evaluated in the context of a systematic review of the literature.A systematic search of three electronic databases (PsychINFO, PubMed and Cochrane Library) was undertaken. Three studies of maternal attachment, 18 studies of mother-preterm infant interaction and eight studies of infant attachment were included. Studies of preterm infant attachment were also evaluated using a meta-analysis.Studies of mother-preterm infant interactions showed that the differences in maternal interaction behavior between mothers of preterm infants and mothers of full-term infants seem to be most evident during the first six months of life. Differences in the preterm infant's interaction behavior seem also to continue for six months after birth. However, five of 18 studies showed an equal or even higher quality of mother-infant interaction in groups of preterm compared to groups of full-term infants. Studies of maternal and infant attachment indicated that preterm infants and their mothers are not at higher risk of insecure attachment than full-term infants and their mothers.The mother-preterm infant relationship is complex, and some relational patterns forecast greater psychological risk than others. It is important to decrease maternal stress and early separation in every possible way during hospitalization as well as after discharge.

Objective To investigate the effect of parental visits during neonatal intensive care on the behavioral and emotional development of the child at school age. Design All premature infants born in Tampere University Hospital in Tampere, Finland, in 1989 who were admitted to the neonatal intensive care unit and who lived in the Tampere region (N = 67; 31 boys and 36 girls) formed the study group. Data on parental visits were collected from the hospital records. Child behavior was evaluated according to the Achenbach Child Behavior Checklist at the age of 7 to 8 years. A total of 48 (72%) of the mothers returned the questionnaires. Results The median number of visiting days per week was 6.2 for the mothers and 4.7 for the fathers. The children whose mothers visited daily had fewer behavioral and emotional problems at school age than those who had had fewer visits from their mothers ( P = .04). The visiting frequency of the fathers was not significantly associated with later behavioral and emotional problems of the child. In this study, infrequent visits by the mother were a stronger risk factor for later psychological development than the medical risks of the preterm infant. Conclusions Infrequent visits by mothers to the neonatal intensive care unit seem to be a marker for their children’s later behavioral and emotional problems. This emphasizes the significance of early parent-infant contact and the vulnerability in early interaction. Less frequent visits may also indicate factors influencing the parent-child relationship in a way that leads to subsequent behavioral problems.