Preterm Infant ’ s Early Crying Associated With Child’ s Behavioral Problems and Parents’ Stress WHAT’S KNOWN ON THIS SUBJECT: Preterm infants are at an increased risk of regulatory difficulties during infancy and of behavioral problems in childhood. In the full-term population, persistent crying problems that last beyond 3 months of age have been related to later behavioral problems. WHAT THIS STUDY ADDS: Excessive crying by a preterm infant may reflect an increased risk for later behavioral problems and higher parenting stress even years later. Therefore, it is clinically relevant to assess systematically the crying behavior of preterm infants. abstract OBJECTIVE: To study how the early crying behavior of preterm infants at term, 6 weeks, and 5 months of corrected age is related to later behavioral problems at age 3 and 4 years and parenting stress at 2 and 4 years. METHODS: The study group included 202 live-born, low birth weight infants (birth weight #1500 g) born from January 2001 through December 2006 at the Turku University Hospital, Finland. A Baby Day Diary was used to assess the preterm infants’ crying behavior at term, 6 weeks, and 5 months of corrected age. The children’ s behavior was assessed using the Child Behavior Check List at 3 and 4 years old, and parenting stress was assessed by using the Parenting Stress Index when the child was 2 and 4 years old. RESULTS: The duration and frequency of crying bouts in infancy was associated with Child Behavior Check List scores at 4 years old and to both mothers’ and fathers’ stress when the child was 2 and 4 years old. CONCLUSIONS: Early excessive crying, especially if lasting up to 5 months of corrected age, is a clinically relevant signal in preterm infants because it may reflect infants’ regulatory problems and/or parenting stress. The crying behavior of preterm infants should be systematically inquired about at well-baby clinics. Pediatrics 2014;133: e339–e345 AUTHORS: Riikka Korja, PhD, a Mira Huhtala, MD, b Jonna Maunu, MD, PhD, a Päivi Rautava, MD, PhD, c Leena Haataja, MD, PhD, b,d Helena Lapinleimu, MD, PhD, b and Liisa Lehtonen, MD, PhD, b on behalf of the PIPARI Study Group Departments of a Child Psychiatry, b Pediatrics, and d Child Neurology, Turku University and Turku University Hospital, Turku, Finland; and c Clinical Research Centre in Turku University Hospital and Department of Public Health, University of Turku, Finland KEY WORDS preterm infant, crying, behavior, parenting stress ABBREVIATIONS CBCL—Child Behavior Check List PSI—Parenting Stress Index All authors are responsible for the reported research. All of the authors have participated in the concept; the design, analysis and interpretation of data; and the drafting or revising of the manuscript. In addition, all authors have approved the manuscript as submitted. www.pediatrics.org/cgi/doi/10.1542/peds.2013-1204 doi:10.1542/peds.2013-1204 Accepted for publication Oct 28, 2013 Address correspondence to Riikka Korja, PhD, Department of Child Psychiatry, Turku University Hospital, Kiinanmyllynkatu 4-8, 20520 Turku, Finland. E-mail: riikka.korja@utu.fi PEDIATRICS (ISSN Numbers: Print, 0031-4005; Online, 1098-4275). Copyright © 2014 by the American Academy of Pediatrics FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose. FUNDING: Funding for the full-time research work was received from the Emil Aaltonen Foundation and by the Hospital District of South-West Finland. The funding sources had no role in the study design; in the collection, analysis, or interpretation of data; in the writing of the article; or in the decision to submit it for publication. POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose. PEDIATRICS Volume 133, Number 2, February 2014 e339 ARTICLE by guest on December 4, 2016 Downloaded from