Grant: Doctoral Award - Frederick Banting and Charles Best Canada Graduate Scholarships

Every year, approximately 8% of infants in Canada are born very preterm (<32 weeks gestation). Advances in medical technologies have allowed the majority of these infants to survive, however their long-term developmental outcomes, including problems with behavior, have not improved. As part of their life-saving care preterm infants undergo repeated painful procedures that that induce stress during a period of rapid brain and stress system development. Brain injuries and abnormal stress levels are common in these vulnerable infants. Subsequently, as early as 18 months of age, children born very preterm have been described as having more stress behaviors (anxiety) compared to their term-born peers, which can lead to a substantial burden of suffering for the individual, family, and social systems. However, very little is known about the relationships between neonatal pain-related stress, brain development, stress hormone levels and behavioral outcomes in these children. Therefore, using state-of-the-art interdisciplinary methods we aim to determine how neonatal pain, stress and abnormal brain development affect the development of anxiety behaviors in young children born very preterm. The results of this research will provide a foundation for understanding mechanisms of altered behavior in children born preterm. Relationships among stress, outcomes and coping are complex in preterm infants, who appear to be more sensitive to their environment than term-born peers. A positive social environment is viewed as a key factor for optimizing long-term outcomes in children born very preterm, who are known to have more difficulty appropriately responding to stress. Therefore, we will also assess mother-infant interactive behaviors and examine the extent that they are protective against adverse effects on later behavior at 18 months. Characterization of optimal caregiver behaviors can be used to lead evidence-based interventions to improve the lives of children born preterm.