Boissel Laure, Pinchaux Emeric, Guilé Marine, Corde Pascal, Crovetto Cécile, Diouf Momar, Mariana Charlotte, Meynier Jonathan, Picard Carl, Scoury Daphné, Cohen David, Benarous Xavier, Viaux-Savelon Sylvie, Guilé Jean-Marc
Department of Psychiatry, Université Picardie Jules Verne, Amiens, France.
Department of Medicine, Université Libre de Bruxelles, Brussels, Belgium.
Front Psychiatry. 2022 Oct 5;13:938482. doi: 10.3389/fpsyt.2022.938482. eCollection 2022.
Maternal sensitivity (MS), the ability to perceive and synchronously respond to the social signals (SSs), is affected by prematurity. The development of early supportive psychotherapy to foster MS, before discharge of the infant from the neonatal intensive care unit (NICU) is a major challenge in the prevention of subsequent developmental and mental disorders in the child. There are currently no reliable methods for evaluating MS to social interactions with very to moderate preterm infants. We investigated the reliability of a newly developed procedure for assessing MS in interactions between the mother and her 34- to 36-week postmenstrual age (PMA) preterm infant: the Preterm Infant Coding System for Maternal Sensitivity (PRICOSMAS).
This study encompassed three steps: testing of the capacity to videorecord SSs in very to moderate preterm infants, selection, by an expert committee, of the recordable and relevant SSs, and investigation of the internal consistency and interrater reliability. The synchronicity between infant and mother's SSs was determined on a 1 s period basis, using ELAN software. Preterm infants born after 25-weeks gestational age (GA) were included while being between 34- and 36-weeks PMA. A perinatal risk inventory score > 10 for the infant precluded from inclusion. Interrater reliabilities were assessed independently by two raters blind to the clinical situation of the mother and infant.
The resulting PRICOSMAS encompassed two four-item SS sections, one covering the preterm infant's SSs and the other, the mother's SSs. Reliability was assessed on a sample of 26 videorecorded observations for 13 mother-preterm infant dyads. Infants' mean age at birth was 30.4 ± 3.1-weeks GA (range: 26.4-35) and PMA at the time of the test was 34.7-weeks (±0.8). Internal consistency ranged from 0.81 to 0.89. Interrater reliability ranged from substantial to almost perfect (0.73-0.88).
This study shows that the infants' SSs and MS can be reliably scored in preterm infants as young as 34- to 36-weeks PMA. Our findings suggest that the PRICOSMAS is sufficiently reliable for use, including in NICU, by healthcare professionals or researchers for coding early parent-infant interactions with 34- to 36-week PMA preterm infants.
母亲敏感性（MS），即感知并同步回应社会信号（SSs）的能力，会受到早产的影响。在婴儿从新生儿重症监护病房（NICU）出院前，开发早期支持性心理治疗以促进母亲敏感性是预防儿童后续发育和精神障碍的一项重大挑战。目前尚无可靠方法来评估母亲对极早产儿至中度早产儿社会互动的敏感性。我们研究了一种新开发的程序在评估母亲与月经龄（PMA）为34至36周的早产儿互动中母亲敏感性的可靠性：早产儿母亲敏感性编码系统（PRICOSMAS）。
本研究包括三个步骤：测试极早产儿至中度早产儿社会信号的录像能力，由专家委员会选择可记录且相关的社会信号，以及调查内部一致性和评分者间信度。使用ELAN软件，以1秒为周期确定婴儿与母亲社会信号之间的同步性。纳入孕龄（GA）25周后出生、PMA在34至36周之间的早产儿。婴儿围产期风险评估量表得分>10则排除在外。由两名对母婴临床情况不知情的评分者独立评估评分者间信度。
最终的PRICOSMAS包括两个各有四项的社会信号部分，一个涵盖早产儿的社会信号，另一个涵盖母亲的社会信号。对13对母婴二元组的26次录像观察样本进行了信度评估。婴儿出生时的平均孕龄为30.4±3.1周（范围：26.4 - 35周），测试时的PMA为34.7周（±0.8）。内部一致性范围为0.81至0.89。评分者间信度范围从高到几乎完美（0.73 - 0.88）。
本研究表明，在PMA为34至36周的早产儿中，可以可靠地对婴儿的社会信号和母亲敏感性进行评分。我们的研究结果表明，PRICOSMAS可靠性足够高，可供医疗保健专业人员或研究人员在NICU等环境中用于对与PMA为34至36周的早产儿的早期亲子互动进行编码。
