Published online July 3, 2006
PEDIATRICS Vol. 118 No. 1 July 2006, pp. e57-e65 (doi:10.1542/peds.2005-1333)
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Right arrow Premature & Newborn

Relation of Prematurity and Brain Injury to Crying Behavior in Infancy

Jonna Maunu, MDa, Jarkko Kirjavainen, MDb, Riikka Korja, Psych Licc, Riitta Parkkola, MDd, Hellevi Rikalainen, MDd, Helena Lapinleimu, MDe, Leena Haataja, MDa, Liisa Lehtonen, MDe and the PIPARI Study Group

a Department of Pediatric Neurology, Turku University Hospital, Turku, Finland
b Department of Pediatric Neurology, Central Hospital of Central Finland, Jyväskylä, Finland
c Department of Child Psychiatry, Turku University Hospital, Turku, Finland
d Department of Radiology, Turku University Hospital, Turku, Finland
e Department of Pediatrics, Turku University Hospital, Turku, Finland

OBJECTIVES. The objective of this study was to assess crying behavior during infancy in very preterm infants with or without brain injury.

METHODS. A total of 125 very low birth weight infants survived during January 2001 to July 2004 in Turku University Hospital, Finland. They were categorized according to the most pathologic brain finding either in ultrasound or MRI. Baby Day Diary was used to assess crying behavior at term, 6 weeks, and 5 months of corrected age. The behavior of a group of term control infants (n = 49) was assessed at 5 months.

RESULTS. Severe brain injuries in very low birth weight infants did not affect the duration of fussing or crying. In very low birth weight infants, brain injuries did not affect the frequency of fussing or crying bouts or the development of circadian rhythm in crying behavior. At 5 months of corrected age, fussing bouts were more frequent in very low birth weight infants compared with term control infants (6.4 per day vs 4.5 per day), and very low birth weight infants were held more (169 minutes [97] vs 130 minutes [69], respectively).

CONCLUSIONS. This prospective study using a validated cry diary showed that brain injuries that are related to prematurity do not have major effects on crying behavior or development of circadian rhythm. Prematurity does not increase the duration but increases the frequency of fussing and crying at 5 months of corrected age compared with term control infants. It also seems that prematurity and brain pathology may increase caregiving activity in the form of holding.

Key Words: preterm • VLBW • MRI • ultrasound • fussing • crying • behavior • diary • follow-up • brain injury

Abbreviations: IVH—intraventricular hemorrhage • WM—white matter • PVL—periventricular leukomalacia • VLBW—very low birth weight • TR—repetition time • TE—echo time

Accepted Jan 6, 2006.