Early interactive behaviors in preterm infants and their mothers: influences of maternal posttraumatic stress and infant development

Introduction Literature reports difficulties in mother-preterm infant interactions, especially in case of maternal post-traumatic stress (PTSD). While previous studies investigated the effects on interactions from the sixth month, there is a lack concerning the first months. The study aimed at evaluating the relationship between maternal PTSD, infant development and dyadic interactions. Method at 3 months of c.a., 60 preterm babies and their mothers were invited to our Laboratory, where 5 minutes of face-to-face mother-infant interaction were video-recorded and later coded according to the Global Ratings Scale (GRS-Murray et al., 1996). GRS assesses 3 interactive dimensions: Mother scales, Infant scales, Interaction. Maternal PTSD and infant’s level of development were assessed through the Perinatal Post-traumatic Stress Disorder Questionnaire (PPQ-Quinnell, Hynan, 1999) and the Griffiths Mental Development Scale (GMDS-Griffith, 1996), respectively. Exclusion criteria were: gestational age >32 weeks, birth weight >1500 grams, presence of congenital malformations, cerebral palsy, evident parental psychiatric illness, foreign nationality. Results Sixteen (26.7%) mothers were experiencing a high level of traumatic stress, as showed by high-score (>19) at PPQ. During the interactions, mothers with PTSD appeared less sensitive (p=0.042), accepting (p=0.01) and relaxed (p=0.05); their infants appeared less engaged with environment (p=0.042), more distressed (p=0.05) and fretful (p=0.039). No significant associations emerged between the quality of interactive patterns and the infant’s level of development (p>0.05). Conclusions Results confirmed the traumatic impact of premature birth and its influence on mother–infant early interactive behavior. Early diagnosis of symptoms can help to plan supportive interventions in the neonatal period, to promote appropriate parent-infant interactions.