Work

Crying behavior and emotional-behavioral outcomes in high-risk very preterm infants: A prospective cohort study

Year: 2025

Type: article

Abstract: PURPOSE: Regulatory problems (RPs), including excessive crying (EC), sleeping, and feeding difficulties, affect 5-20 % of infants. Their association with later behavioral and emotional problems remains unclear, particularly in preterm populations at elevated neurodevelopmental risk. METHODS: This prospective observational study included 329 high-risk very preterm infants (gestational age <30 weeks and/or birthweight <1000 g). Parental reports of crying behavior (hours/day) were collected at three and six months corrected age. Emotional and behavioral outcomes were assessed using the Brief Infant-Toddler Social and Emotional Assessment (BITSEA) at 12 months and the Child Behavior Checklist (CBCL) at 24 months. Univariable and multivariable linear regressions were conducted, correcting for perinatal risk factors and maternal trait anxiety. RESULTS: Among 329 infants (56 % male; mean gestational age 28 weeks), 42 (13 %) exhibited EC (≥3 h/day) at three months of age. Crying behavior was associated with higher BITSEA problem scores in univariable analysis (β = 0.187, p = 0.009), but not in multivariable analysis (β = 0.157, p = 0.215). No significant associations were observed between crying behavior and CBCL internalizing or externalizing scores in univariable (β = 0.066, p = 0.459; β = 0.038, p = 0.672) or multivariable analysis (β = 0.301, p = 0.052; β = 0.202, p = 0.222). Maternal trait anxiety was significantly associated with higher BITSEA problem scores (β = 0.353, p = 0.006). CONCLUSION: In very preterm infants, crying behavior was not associated with emotional or behavioral problems, offering reassurance to families. Further studies should explore its influence on other developmental domains.

Source: Early Human Development

DOI: 10.1016/j.earlhumdev.2025.106326

Authors: Babette Steigelmann, Nienke H. Van Dokkum, Arend F. Bos, Elisabeth M.W. Kooi, Kirsten R. Heineman

Institutions: University Medical Center Groningen, University of Groningen, Beatrix Kinderziekenhuis

Language: English

Topic: Infant Development and Preterm Care

Subfield: Pediatrics, Perinatology and Child Health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,840