To characterize state regulation and behavior of preterm infants after discharge from the neonatal intensive care unit (NICU).
We recruited singleton infants born at ≤35 weeks of gestational age (GA) before NICU discharge. Parents completed surveys at discharge and 1, 3, and 6 months after discharge. Infant medical history was gleaned from the medical record. Surveys captured sociodemographic information and measures of infant state regulation (Baby Pediatric Symptom Checklist [BPSC]) and feeding behaviors. We calculated the median BPSC subscale scores at each time point and the proportion of infants with scores in the problem range (≥3/5). We explored longitudinal and cross-sectional correlates of BPSC scores.
Fifty families completed the discharge questionnaire, and 42 (84%) completed the 6-month questionnaire. The median GA at birth was 34 weeks (IQR 30.1, 34.4 weeks); the median birth weight was 1930 g (IQR 1460, 2255 g). The median scores were above population norms for irritability and difficulty with routines. Twenty-one infants (40%) had irritability subscale scores in the problem range at 1 month, and 20 (38%) had problem scores on difficulties with routines. Only 9 infants (17%) had problem scores on the inflexibility subscale. Scores in all 3 domains showed different patterns from population norms from 1 to 6 months. BPSC scores were correlated with infant feeding behaviors at 1, 3, and 6 months.
Scores for irritability and difficulty with routines among preterm infants were high compared with population norms and differed from normative values through 6 months after discharge. Preterm infants demonstrate problems with state regulation after NICU discharge that may require directed intervention.
*Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, MA;
†Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, MA.
Address for reprints: Jonathan S. Litt, MD, MPH, ScD, Department of Neonatology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Rose 3, Boston, MA 02215; e-mail: email@example.com.
Disclosure: The authors declare no conflict of interest.
Received May 01, 2018
Accepted December 26, 2018