Date of Award

2010-04-01

Degree Name

PhD Nursing

Dissertation Committee

Cynthia D. Connelly, PhD, RN, FAAN, Chair; Jane M. Georges PhD, RN; Andrea L. Hazen, PhD

Keywords

Apgar score, birth weight, gender, Gestational age, high risk infants, home environment, Maternal Depression, Neonatal Intensive Care Unit, Neurodevelopment, nursing, parent-child interaction

Abstract

Background: Infant developmental research has revealed amazing physical, cognitive, and social capacities of the human infant. Along with this knowledge is a growing appreciation of numerous factors that have the potential to impact the individual infant's developmental trajectory, either enhancing or compromising the eventual outcome. Enhanced understanding of those factors that shape infant developmental trajectories will provide an evidence base for the establishment of a supportive environment for the youngest members of society. Purpose: To determine the relationship between neurodevelopmental outcome and gestational age, birth weight, Apgar scores, NICU admission, infant gender, maternal depression, home environment, and parent-child interaction. Methodology: This study utilized a descriptive, correlational design and secondary analysis of data from the Healthy Families San Diego (HFSD) randomized controlled clinical trial conducted by Landsverk and colleagues (2002). Data Analysis: Multiple linear regression was utilized to produce the best combination of predictors of neurodevelopmental outcome, which was measured by the Bayley Scales of Infant Development, 2nd ed. (BSID-II) (Bayley, 1993). Results: The model of predictor variables significantly predicted all three BSID-II developmental outcomes (MDI, PDI, and BRS) measured at year 2. Mental Development: The model explained 34% of variance in the BSID-II MDI. MDI scores at year 1, parent-child interaction (NCAST) scores at year 2, and infant gender significantly contributed to the model. Motor Development: The model explained 16% of variance in the Y2 BSID-II PDI. PDI scores at year one, BRS scores at year 1, birth weight, and infant gender significantly contributed to the model. Behavioral Development: The model explained 20% of variance in the Y2 BSID-II BRS. Y2 NCAST scores, Y2 home inventory (HOME) scores, birth weight, gestational age, and infant gender significantly contributed to the model. Conclusions: Optimal development of a community's children is a vital component of a healthy and sustainable society. Based on the results of this study, future research may focus on the unique contribution of gender to developmental dynamics. Also of interest is the significance of early parent-child interaction, the home environment, birth weight, and gestational age in shaping infant developmental trajectories. Research efforts may focus on determining which of these risk factors are most amenable to preventative and interventional strategies, and identifying the stage of development where these strategies would be most effective.

Document Type

Dissertation: Open Access

Department

Nursing

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Nursing Commons

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