Introduction: There is evidence that adult patients who have been preterm at birth have a lower
quality of attachment toward their mother, lower self-esteem, and less control of
emotions.
Materials and Methods: This study is part of a clinical trial started 20 years ago with 746 preterm or low-birth-weight
newborns comparing kangaroo mother care (KMC) method and conventional care (control).
We followed up a cohort of young adults with a history of prematurity and being born
with birth weight < 1,800 g. The objective of this study was to evaluate the relationship
between the quality of attachment, the self-esteem score, the HOME environment scale
score, number of days of neonatal separation with the mother and antecedent of suicidal
behavior in these young adults with a history of prematurity, and who had been exposed
either to KMC method or not, and to compare these items between this group of individuals
and a control group composed by young adults born at term.
Results: The study cohort was composed of 246 young adults with a history of prematurity with
birth weight < 1,800 g, and the control group was composed of 37 young adults born
at term. When comparing patients with or without antecedent of suicidal behavior,
the former ones had a lower score of attachment and self-esteem (analysis of variance
[ANOVA] 47.2 vs. 63.0, p < 0.001 and 29.4 vs. 32.2, p = 0.001). The same occurred when comparing formerly preterm born adults exposed to
KMC method or not, and young adults born at term. Patients with suicidal behavior
also had a lower score of acceptance in the family (ANOVA HOME acceptance subscale
score 6.7 vs. 7.7, p = 0.02). This result was similar analyzing formerly preterm born adults with antecedent
of being or not exposed to KMC method in the most fragile group, that is, those admitted
in the neonatal intensive care unit (NICU) (ANOVA HOME acceptance subscale score 8.2
vs. 7.1, p = 0.02).
Conclusion: A good attachment with the mother from the neonatal stage is fundamental in the generation
of a stimulating family environment (HOME) and for the development of an adequate
self-esteem, which decreases the risk of suicidal behavior in young adults. KMC increases
the acceptance in the family of the most fragile group (NICU) and thus indirectly
decreases the risk of suicidal behavior.
Keywords: suicidal behavior, premature kangaroo, mother care
