Effect of home environment on neuropsychiatric development in preterm infants discharged from NICU at 18 months corrected age
Background There have been numerous intervention studies focusing on the development of preterm infants, but there has been limited investigation into the home environment as a determinant of developmental outcomes in preterm infants. The aspects and extent to which the home environment affects the...
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BMJ Publishing Group
2025-01-01
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| Series: | General Psychiatry |
| Online Access: | https://gpsych.bmj.com/content/38/1/e101634.full |
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| author | Yuan Tian Chuncao Zhang Li Shen Haifeng Jiang Feng Liu Jinjin Chen Xia Hong |
| author_facet | Yuan Tian Chuncao Zhang Li Shen Haifeng Jiang Feng Liu Jinjin Chen Xia Hong |
| author_sort | Yuan Tian |
| collection | DOAJ |
| description | Background There have been numerous intervention studies focusing on the development of preterm infants, but there has been limited investigation into the home environment as a determinant of developmental outcomes in preterm infants. The aspects and extent to which the home environment affects the early (18 months corrected age) neuropsychological development of preterm infants are still unclear.Aims This study aimed to analyse the effect of the home environment on the neuropsychiatric development of preterm infants at 18 months corrected age after discharge from the neonatal intensive care unit (NICU). It also sought to provide a basis for promoting neuropsychiatric development among preterm infants by improving the home environment.Methods In this retrospective cross-sectional study, 275 preterm infants born between January 2019 and January 2022 were followed up for systematic management after discharge from the NICU at Shanghai Children’s Hospital. The Home Nurture Environment Questionnaire was used to assess the home environment of the infants and analyse its impact on the developmental quotient (evaluated by the Gesell Developmental Scale) and the rate of developmental delays at 18 months corrected age.Results A total of 41.454% of the infants were extremely preterm. The developmental quotient scores at 18 months corrected age were in the middle of the scale. The language domain had the highest rate of developmental delay (46.182%), followed by the adaptive domain (37.091%). Multiple logistic regression analyses showed that compared with infants in supportive home environments, infants with moderate/unsupportive home environments had significantly elevated risks of development delay: 2.162-fold for global (odds ratio (OR) 2.162, 95% confidence interval (CI) 1.274 to 3.665, p=0.004), 2.193-fold for fine motor (OR 2.193, 95% CI 1.161 to 4.140, p=0.016), 2.249-fold for language (OR 2.249, 95% CI 1.336 to 3.786, p=0.002) and 2.042-fold for personal-social (OR 2.042, 95% CI 1.149 to 3.628, p=0.015).Conclusions A supportive home environment is a crucial protective factor for the neuropsychological development of preterm infants. It is associated with higher developmental quotient scores and protects against neuropsychiatric delays. Incorporating evaluation and continuous improvement of the home environment into the management framework for preterm infants to promote optimal neurodevelopment is essential. |
| format | Article |
| id | doaj-art-7cc18e415a954385ac7782b32b85d105 |
| institution | Kabale University |
| issn | 2517-729X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMJ Publishing Group |
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| series | General Psychiatry |
| spelling | doaj-art-7cc18e415a954385ac7782b32b85d1052025-01-22T03:55:09ZengBMJ Publishing GroupGeneral Psychiatry2517-729X2025-01-0138110.1136/gpsych-2024-101634Effect of home environment on neuropsychiatric development in preterm infants discharged from NICU at 18 months corrected ageYuan Tian0Chuncao Zhang1Li Shen2Haifeng Jiang3Feng Liu4Jinjin Chen5Xia Hong6School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China1 Department of Child Health Management, Children`s Hospital of Shanghai, Shanghai, China1 Key Laboratory of Zoonosis Research & Department of Epidemiology and Biostatistics, Jilin University School of Public Health, Changchun, ChinaShanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaNational Clinical Research Center for Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China1 Department of Child Health Care, Shanghai Children’s Hospital, Shanghai, China1 Department of Child Health Care, Shanghai Children’s Hospital, Shanghai, ChinaBackground There have been numerous intervention studies focusing on the development of preterm infants, but there has been limited investigation into the home environment as a determinant of developmental outcomes in preterm infants. The aspects and extent to which the home environment affects the early (18 months corrected age) neuropsychological development of preterm infants are still unclear.Aims This study aimed to analyse the effect of the home environment on the neuropsychiatric development of preterm infants at 18 months corrected age after discharge from the neonatal intensive care unit (NICU). It also sought to provide a basis for promoting neuropsychiatric development among preterm infants by improving the home environment.Methods In this retrospective cross-sectional study, 275 preterm infants born between January 2019 and January 2022 were followed up for systematic management after discharge from the NICU at Shanghai Children’s Hospital. The Home Nurture Environment Questionnaire was used to assess the home environment of the infants and analyse its impact on the developmental quotient (evaluated by the Gesell Developmental Scale) and the rate of developmental delays at 18 months corrected age.Results A total of 41.454% of the infants were extremely preterm. The developmental quotient scores at 18 months corrected age were in the middle of the scale. The language domain had the highest rate of developmental delay (46.182%), followed by the adaptive domain (37.091%). Multiple logistic regression analyses showed that compared with infants in supportive home environments, infants with moderate/unsupportive home environments had significantly elevated risks of development delay: 2.162-fold for global (odds ratio (OR) 2.162, 95% confidence interval (CI) 1.274 to 3.665, p=0.004), 2.193-fold for fine motor (OR 2.193, 95% CI 1.161 to 4.140, p=0.016), 2.249-fold for language (OR 2.249, 95% CI 1.336 to 3.786, p=0.002) and 2.042-fold for personal-social (OR 2.042, 95% CI 1.149 to 3.628, p=0.015).Conclusions A supportive home environment is a crucial protective factor for the neuropsychological development of preterm infants. It is associated with higher developmental quotient scores and protects against neuropsychiatric delays. Incorporating evaluation and continuous improvement of the home environment into the management framework for preterm infants to promote optimal neurodevelopment is essential.https://gpsych.bmj.com/content/38/1/e101634.full |
| spellingShingle | Yuan Tian Chuncao Zhang Li Shen Haifeng Jiang Feng Liu Jinjin Chen Xia Hong Effect of home environment on neuropsychiatric development in preterm infants discharged from NICU at 18 months corrected age General Psychiatry |
| title | Effect of home environment on neuropsychiatric development in preterm infants discharged from NICU at 18 months corrected age |
| title_full | Effect of home environment on neuropsychiatric development in preterm infants discharged from NICU at 18 months corrected age |
| title_fullStr | Effect of home environment on neuropsychiatric development in preterm infants discharged from NICU at 18 months corrected age |
| title_full_unstemmed | Effect of home environment on neuropsychiatric development in preterm infants discharged from NICU at 18 months corrected age |
| title_short | Effect of home environment on neuropsychiatric development in preterm infants discharged from NICU at 18 months corrected age |
| title_sort | effect of home environment on neuropsychiatric development in preterm infants discharged from nicu at 18 months corrected age |
| url | https://gpsych.bmj.com/content/38/1/e101634.full |
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