INS NYC 2024 Program

Poster	Poster Session 10 Program Schedule 02/17/2024 09:00 am - 10:15 am Room: Majestic Complex (Posters 61-120) Poster Session 10: Neurodevelopmental \| Congenital Conditions Final Abstract #64 Maternal Health is Baby Health: Understanding Maternal Factors and Preterm Infant Neurodevelopment Kelsea Marschall, Dartmouth-Hitchcock Medical Center; Antioch University New England, Lebanon, United States Molly O'Reilly, Antioch University New England, Keene, United States Tyler Hartman, Dartmouth-Hitchcock Medical Center, Lebanon, United States Nina Sand-Loud, Dartmouth-Hitchcock Medical Center, Lebanon, United States Kathryn Richards, Dartmouth-Hitchcock Medical Center, Lebanon, United States Jonathan Lichtenstein, Dartmouth-Hitchcock Medical Center, Lebanon, United States Jennifer Amato, Dartmouth-Hitchcock Medical Center, Lebanon, United States Category: Prenatal/Perinatal Factors/Prematurity Keyword 1: child development (normal) Keyword 2: prenatal factors Keyword 3: prematurity Objective: Babies cared for in the neonatal intensive care unit (NICU) are especially vulnerable to poor neurodevelopmental outcomes due to medical and psychosocial factors. Although emerging literature recognizes an association between maternal characteristics (e.g., age, race, ethnicity, socioeconomic position, access to care) and infant development, the impact of these effects is not well understood. Additionally, identification of prenatal maternal risk factors for infant developmental delays are continuing to emerge. The current study aims to explore: 1) the relationship between maternal characteristics and known neonatal risk factors for neurodevelopmental delays; and 2) if maternal characteristics predict perinatal complications including degree of prematurity, medical issues, and neurodevelopmental outcomes at 12 months. Participants and Methods: This sample includes a total of 75 infants previously admitted to the NICU at a rural academic medical center and seen in the NICU follow-up clinic. Infants were 50.7% female and born to majority white (69.3%) mothers. Average maternal age was 29.19 (SD=5.51), and education varied: high school education/equivalent (26.7%), some college credit (20%), and bachelor’s degree (14.7%). The average number of prenatal care visits was 9.16 (SD=4.03). The average gestational age was 29.5 weeks (SD=3.77), and average birth weight was 1395.71 grams (SD=734.11). All infants were assessed using the Bayley Scales of Infant and Toddler Development-Third Edition (Bayley-III) at 12 months. The average cognitive standard score was 89.39 (SD=13.31); language standard score was 89.69 (SD=12.05); and motor standard score was 85.75 (SD=16.40). Relationships between factors were analyzed using Pearson correlations. Hierarchical linear regressions were used to determine whether maternal characteristics predict neurodevelopment at 12 months. Results: Analyses revealed significant correlations between maternal characteristics and well-established prenatal risk factors for poor neurodevelopment. Payment source and access to care were significantly correlated with maternal weight gain and number of neonatal medical complications. Additionally, payment source was correlated with education, while access to care was correlated with gestational age and degree of prematurity. Linear regressions established that maternal factors (i.e., maternal weight gain, maternal age, total number of prenatal visits) significantly predicted degree of prematurity, F(3, 50)=10.13, p<.001 and number of neonatal complications, F(3, 50)=4.81, p<.005. When controlling for gestational age and amount of neonatal complications, maternal characteristics significantly predicted cognitive R²= .222, F(5, 49)=2.80, p<.05, adjusted R²= .143, language R²= .215, F(5, 49)=2.68, p<.05, adjusted R²= .135, and motor scores R²= .278, F(5, 49)=3.77, p<.01, adjusted R²= .204 on the Bayley-III. Conclusions: Although earlier gestational age and low birth weight are known risk factors for neurodevelopmental delay, these factors alone do not explain neurodevelopmental outcomes. Our analyses show that cognitive, language, and motor development at 12 months are significantly impacted by younger maternal age, more weight gain, and total prenatal visits. Importantly, these results suggest the need to recognize maternal factors related to social determinants of health when considering developmental outcomes. The identification of modifiable maternal characteristics allows for perinatal intervention to improve long-term outcomes for high-risk mother-infant dyads.

Poster

02/17/2024
09:00 am - 10:15 am
Room: Majestic Complex (Posters 61-120)

Poster Session 10: Neurodevelopmental | Congenital Conditions

Final Abstract #64

Maternal Health is Baby Health: Understanding Maternal Factors and Preterm Infant Neurodevelopment

Kelsea Marschall, Dartmouth-Hitchcock Medical Center; Antioch University New England, Lebanon, United States
Molly O'Reilly, Antioch University New England, Keene, United States
Tyler Hartman, Dartmouth-Hitchcock Medical Center, Lebanon, United States
Nina Sand-Loud, Dartmouth-Hitchcock Medical Center, Lebanon, United States
Kathryn Richards, Dartmouth-Hitchcock Medical Center, Lebanon, United States
Jonathan Lichtenstein, Dartmouth-Hitchcock Medical Center, Lebanon, United States
Jennifer Amato, Dartmouth-Hitchcock Medical Center, Lebanon, United States

Category: Prenatal/Perinatal Factors/Prematurity

Keyword 1: child development (normal)
Keyword 2: prenatal factors
Keyword 3: prematurity

Objective:

Babies cared for in the neonatal intensive care unit (NICU) are especially vulnerable to poor neurodevelopmental outcomes due to medical and psychosocial factors. Although emerging literature recognizes an association between maternal characteristics (e.g., age, race, ethnicity, socioeconomic position, access to care) and infant development, the impact of these effects is not well understood. Additionally, identification of prenatal maternal risk factors for infant developmental delays are continuing to emerge. The current study aims to explore: 1) the relationship between maternal characteristics and known neonatal risk factors for neurodevelopmental delays; and 2) if maternal characteristics predict perinatal complications including degree of prematurity, medical issues, and neurodevelopmental outcomes at 12 months.

Participants and Methods:

This sample includes a total of 75 infants previously admitted to the NICU at a rural academic medical center and seen in the NICU follow-up clinic. Infants were 50.7% female and born to majority white (69.3%) mothers. Average maternal age was 29.19 (SD=5.51), and education varied: high school education/equivalent (26.7%), some college credit (20%), and bachelor’s degree (14.7%). The average number of prenatal care visits was 9.16 (SD=4.03). The average gestational age was 29.5 weeks (SD=3.77), and average birth weight was 1395.71 grams (SD=734.11). All infants were assessed using the Bayley Scales of Infant and Toddler Development-Third Edition (Bayley-III) at 12 months. The average cognitive standard score was 89.39 (SD=13.31); language standard score was 89.69 (SD=12.05); and motor standard score was 85.75 (SD=16.40). Relationships between factors were analyzed using Pearson correlations. Hierarchical linear regressions were used to determine whether maternal characteristics predict neurodevelopment at 12 months.

Results:

Analyses revealed significant correlations between maternal characteristics and well-established prenatal risk factors for poor neurodevelopment. Payment source and access to care were significantly correlated with maternal weight gain and number of neonatal medical complications. Additionally, payment source was correlated with education, while access to care was correlated with gestational age and degree of prematurity. Linear regressions established that maternal factors (i.e., maternal weight gain, maternal age, total number of prenatal visits) significantly predicted degree of prematurity, F(3, 50)=10.13, p<.001 and number of neonatal complications, F(3, 50)=4.81, p<.005. When controlling for gestational age and amount of neonatal complications, maternal characteristics significantly predicted cognitive R²= .222, F(5, 49)=2.80, p<.05, adjusted R²= .143, language R²= .215, F(5, 49)=2.68, p<.05, adjusted R²= .135, and motor scores R²= .278, F(5, 49)=3.77, p<.01, adjusted R²= .204 on the Bayley-III.

Conclusions:

Although earlier gestational age and low birth weight are known risk factors for neurodevelopmental delay, these factors alone do not explain neurodevelopmental outcomes. Our analyses show that cognitive, language, and motor development at 12 months are significantly impacted by younger maternal age, more weight gain, and total prenatal visits. Importantly, these results suggest the need to recognize maternal factors related to social determinants of health when considering developmental outcomes. The identification of modifiable maternal characteristics allows for perinatal intervention to improve long-term outcomes for high-risk mother-infant dyads.