Brief report: Birth status, medical complications, and social environment:Individual differences in development of preterm, very low birth weight infants

Objective: To assess whether medical complications mediate the relationship between birth status (i.e., birth weight and gestational age) and developm ental outcome of preterm, very low birth weight (VLBW) infants, as well as the role of the early social environment (maternal distress and social supp ort) in infant development. Method: Birth status and medical complication information was collected dur ing the child's NICU stay. Maternal distress was assessed with the Beck Dep ression Inventory and the Parenting Stress Index at 4 months corrected infa nt age. Social support was measured with the Dunst Scales at 4 months corre cted age. Child development measures were collected at 4 and 13 months corr ected age (Bayley MDI and PDI), and at 36 months chronological age (PPVT-R and Achenbach CBCL). Results: Medical complications mediated the birth status-outcome relationsh ip at 4 and 13 months, but not at 36 months. The 36-month outcomes were pre dicted by 4-month maternal distress and social support. Conclusions: Prematurity and VLBW are indirectly related to early developme ntal outcome through their association with medical complications. However, by 36 months, developmental outcomes are more closely related to aspects o f the early social environment than to early physiological factors.