Studying psychosocial and physiological factors related to prematurity invites the Psychology - Medicine interdisciplinary collaboration because: a) premature infants possess behavioral characteristics and have neurological immaturity that may contribute in making them difficult interactive partners (Singer, 2003) and increase their health risks (Javorka, 2017); and b) a steady increase in the neonatal survival rates since the advent of modern intensive care for the preterm infant has been related to a growing concern for preterm infants‟ developmental outcome and quality of life (Forcada-Guex, 2006). Women from low SES and in low-income countries are disproportionally affected by preterm delivery, perinatal depression / anxiety, and lack access to mental health care. This results in economic and social hardships that affect individuals, families and society as a whole, furthering the cycle of poverty and health inequities (Prom, 2022). The implications of this study may highlight the need to advance the debate about the responsibility of society to counteract health inequalities (M‟hamdi, 2017) and to interrupt the pattern of intergenerational mental illness and suffering (Prom, 2022). This is important because the perinatal mental health literature has focused on individual women as the main agent for change while social determinants of mental health, such as poverty, are of critical importance for women in the perinatal period (Howard & Khalifeh, 2020). At the economic level, identification of early risk factors for the development of preterm infants may has implications for policymakers since preterm infants incur higher early intervention costs (Clements, 2007).
The main aim of this study is to investigate the association of certain psychosocial and biological factors across the first year of life of preterm infants’ development, with focus on low socio-economic status families. Thus, we plan to accomplish the following two objectives: Objective 1: To explore the way psychosocial factors, such as maternal mental health, maternal perception of infant‟s intersubjectivity and attachment, across the first year of preterm birth are related with infants‟ emotional and cognitive development at 9 months (corrected age). Further, we will explore whether this association varies between infants from low and high SES. In addition, we will investigate whether other characteristics (family functioning, perceived social support and dyadic coping) may be related to these associations and if these characteristics can moderate for the risks posed by low socio-economic status, Objective 2: To assess the way physiological factors, such as autonomic nervous system maturation, measured according to heart rate variability, is associated with premature infants‟ emotional and cognitive development at 9 months (corrected age) and whether this association varies between low and high SES. Further, we will explore whether maternal derived-melatonin through breastfeeding intervenes this association.
