Elsevier

The Journal of Pediatrics

Volume 151, Issue 5, November 2007, Pages 463-469
The Journal of Pediatrics

Original article
Parenting Very Low Birth Weight Children at School Age: Maternal Stress and Coping

https://doi.org/10.1016/j.jpeds.2007.04.012Get rights and content

Objective

To compare severity and determinants of stress and coping in mothers of 8-year-old very low birth weight (VLBW) and term children varying in medical and developmental risk.

Study design

Three groups of mothers/infants were prospectively compared in a longitudinal study from birth to 8 years (110 high-risk VLBW, 80 low-risk VLBW, and 112 term). Maternal psychological distress, coping, parenting/marital stress, child health, and family impact were measured in the children at age 8 years.

Results

Mothers of VLBW children differed from term mothers, reporting less consensus with partners, more concern for their children’s health, less parent–child conflict, and fewer years of education attained. Mothers of high-risk VLBW children experienced the greatest family and personal strains and used less denial and disengagement coping. The groups exhibited no differences in the sense of parenting competence, divorce rate, parenting/marital satisfaction, family cohesion, and psychological distress symptoms. Multiple birth, low socioeconomic status, and lower child IQ added to maternal stress.

Conclusions

VLBW birth has long-term negative and positive impacts on maternal/family outcomes related to the infant’s medical risk.

Section snippets

Methods

Mothers were interviewed in a longitudinal study of the outcomes of infants with bronchopulmonary dysplasia (BPD), a chronic lung disease of prematurity,19, 20 and VLBW.4, 9, 12, 21 Children with VLBW admitted to all neonatal intensive care units in a Midwest region were prospectively enrolled between 1989 and 1991 at birth, with current follow-up at 8 years.

High-risk children with VLBW (high-risk VLBW; n = 110) had a diagnosis of BPD, birth weight <1500 g, supplementary oxygen requirement for

Sample Characteristics

Demographic and medical characteristics of the high-risk and low-risk VLBW groups at 8 years reflect the research design (Table). The high-risk VLBW children had lower birth weights, gestational ages, more neurologic and medical risk at birth, and lower IQ at 8 years compared with the low-risk VLBW and term children (Table). IQ scores were in the range of mental retardation (IQ < 70) for 19% of the high-risk VLBW children, 9% of the low-risk VLBW children, and <2% for the term children (χ2 =

Discussion

At child age 8 years, the pattern of maternal adaptation to VLBW birth was similar to that noted at the 3-year follow-up,12 indicating significant stress in mothers of high-risk VLBW children but largely equivalent experiences between the mothers of low-risk VLBW children and those of term children. However, there were several areas in which the mothers of both high-risk and low-risk VLBW children differed from term mothers. The mothers of VLBW children did not advance in educational attainment

References (38)

  • K.A. Dodge

    Developmental psychopathology in children of depressed mothers

    Dev Psychol

    (1990)
  • L.T. Singer et al.

    The relationship of prenatal cocaine exposure and maternal postpartum psychological distress to child developmental outcome

    Dev Psychopathol

    (1997)
  • L.T. Singer et al.

    Social support, psychological distress, and parenting strains in mothers of very low birthweight infants

    Fam Relat

    (1996)
  • M.C. McCormick et al.

    The very low birth weight transport goes home: impact on the family

    J Dev Behav Pediatr

    (1986)
  • D.R. Pederson et al.

    Maternal emotional responses to preterm birth

    Am J Orthopsychiatry

    (1987)
  • L.T. Singer et al.

    Maternal psychological distress and parenting stress after the birth of a very low birthweight infant

    JAMA

    (1999)
  • G.H. Taylor et al.

    Long-term family outcomes for children with very low birth weights

    Arch Pediatr Adolesc Med

    (2001)
  • D. Drotar et al.

    The impact of extremely low birth weight on the families of school-age children

    Pediatrics

    (2006)
  • S.W. Jacobson et al.

    Maternal age, alcohol abuse history, and quality of parenting as moderators of the effects of prenatal alcohol exposure on 7.5-year intellectual function

    Alcohol Clin Exp Res

    (2004)
  • Cited by (64)

    View all citing articles on Scopus

    Supported by grants from the Maternal and Child Health Program, Health Resources and Services Administration, Department of Health and Human Services (MCJ-390592, MC-00127, and MC-00334).

    No reprints are available from the authors.

    View full text