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Maternal behavior toward premature twins: implications for development

Published online by Cambridge University Press:  21 February 2012

Barbara M Ostfeld*
Affiliation:
Division of Neonatology, UMDNJ-Robert Wood Johnson Medical School, St Peter's University Hospital, New Brunswick, NJ. [email protected]
Richard H Smith
Affiliation:
(Retired) Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, MA.
Mark Hiatt
Affiliation:
Division of Neonatology, UMDNJ-Robert Wood Johnson Medical School, St Peter's University Hospital, New Brunswick, NJ.
Thomas Hegyi
Affiliation:
Division of Neonatology, UMDNJ-Robert Wood Johnson Medical School, St Peter's University Hospital, New Brunswick, NJ.
*
*Correspondence: Dr BM Ostfeld, St Peter's University Hospital, 254 Easton Avenue, New Brunswick, NJ08903, USA. Tel: (732) 745 8523; Fax: (732) 249 6306

Abstract

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Assisted reproductive techniques and fertility enhancing therapies have increased multiple births and, therefore, the risk of prematurity and its developmental consequences. Parent intervention is an effective source of compensation for the cognitive effects of prematurity. We hypothesized that relative to parents of preterm singletons, parents of preterm twins are less able to provide such enhancing care, resulting in a developmental disadvantage for preterm twins. Maternal–infant interactions of premature singletons (n =22; birth weight =1668 ± 350 g, gestational age =32.3 ± 2.1 weeks) and premature twins (n = 8; birth weight = 1618 ± 249 g; gestational age = 32.0 ± 2.6 weeks) with comparable demographic and medical status were observed at home at 1 and 8 months corrected age using a 30 min checklist of developmentally facilitative behavior. Mental (MDI) and psychomotor (PDI) indices of the Bayley Scales of Infant Development and Caldwell Home Observations for Measurement of the Environment (HOME) inventories were administered (18 months corrected age). Compared with mothers of premature singletons, mothers of premature twins exhibited fewer initiatives (P < 0.001) and responses (P < 0.01) and were less responsive to positive signals (P < 0.01) and crying (P < 0.01). Unprompted by the infant, twin mothers lifted or held (P < 0.05), touched (P < 0.01), patted (P < 0.05) or talked (P < 0.01) less. Singleton MDIs surpassed twins (119.4 ± 7.7 vs 103.6 ± 7.7; P < 0.01). Maternal verbal behavior and the acceptance of child factor (HOME), both favoring singletons, correlated with MDI (R-square = 0.46, P < 0.0002). Mothers of premature twins exhibited fewer initiatives and responses toward offspring than did mothers of premature singletons. Maternal behavior was predictive of cognitive development. Twin Research (2000) 3, 234–241.

Type
Articles
Copyright
Copyright © Cambridge University Press 2000