Bollen Bieke, Van den Brande Astrid, Bernagie Chiara, Seghers Alexandra, Amelynck Steffie, Vanhole Christine, Boets Bart, Naulaers Gunnar, Bosmans Guy, Ortibus Els
Department of Development and Regeneration, Faculty of Medicine, KU Leuven, Leuven, Belgium.
Neonatology Department, University Hospitals Leuven, Leuven, Belgium.
Sci Rep. 2025 Jan 13;15(1):1872. doi: 10.1038/s41598-024-84089-6.
Self-regulation and executive functioning are known key predictors of future cognitive development and mental health. We examined the effect of early life neonatal stress, maternal perinatal stress, kangaroo care, maternal parenting behavior and secure child attachment on executive function at 2 years corrected age (CA) in children born preterm (i.e. < 34 weeks of gestation and/or < 1500 g birth weight). Neonatal child characteristics were recorded at the Neonatal Intensive Care Unit (NICU). We examined self-reported perinatal maternal stress during NICU stay, maternal emotional availability at 4 months CA, and child attachment security at 14 months CA. The executive function battery at 2 years CA was completed by 97 children. Low birth weight, a high number of skin breaking procedures and high level of maternal stress predicted lower executive function scores. Kangaroo care, non-intrusive maternal parenting behavior and secure attachment were associated with higher executive function scores. Even after controlling for background factors, modifiable factors such as neonatal child and mother stress, kangaroo care, parenting style, and child attachment style uniquely predict later executive functioning development, indicating that preventive interventions need to integrate multiple aspects of neuroprotective care, including supporting the child-parent bond, both at the NICU and beyond.
自我调节和执行功能是未来认知发展和心理健康的已知关键预测因素。我们研究了早产（即妊娠<34周和/或出生体重<1500克）儿童在2岁矫正年龄（CA）时，早期新生儿应激、母亲围产期应激、袋鼠式护理、母亲养育行为和安全的儿童依恋对执行功能的影响。在新生儿重症监护病房（NICU）记录新生儿特征。我们调查了在NICU住院期间自我报告的母亲围产期应激、矫正年龄4个月时母亲的情感可及性以及矫正年龄14个月时儿童依恋安全性。97名儿童完成了矫正年龄2岁时的执行功能测试。低出生体重、大量的皮肤破损操作和高水平的母亲应激预测较低的执行功能得分。袋鼠式护理、非侵入性母亲养育行为和安全依恋与较高的执行功能得分相关。即使在控制了背景因素之后，新生儿和母亲应激、袋鼠式护理、养育方式和儿童依恋方式等可改变因素也能独特地预测后期执行功能发展，这表明预防性干预需要整合神经保护护理的多个方面，包括在NICU内外支持儿童与父母的关系。
