Environmental Risks to NICU Outcomes

Abstract

Environmental exposures have a significant impact on high-risk infant (HRI) outcomes. While prematurity and medical severity are well understood in terms of infant survival, it is critical that clinicians understand and appreciate the impact that biological, psychological, and social risk factors have on an infant’s future functioning. Taking these risk factors into a biopsychosocial framework, the chapter proposes a life course theory perspective of timeline, timing, environment, and equity to explain HRI outcomes. Specifically this chapter explores how exposures such as in utero drug exposure, parental distress and posttraumatic stress, and low socioeconomic status and low caregiver education level negatively impact infant neurodevelopment. An emphasis is placed on the strain that each of these exposures places on the caregiver-infant relationship, which is the foundation for supporting an infant’s development and regulation. In discussing ways to address these environmental risk factors, methods such as breastfeeding, mental health support for NICU parents, and interdisciplinary HRI follow-up clinics are discussed and how each intervention is positioned to uniquely support this caregiver-infant dyad.