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

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.

Abbreviations: ANOVA, Analysis of variance, ANCOVA, Analysis of covariance, BPD, Bronchopulmonary dysplasia, BSI, Brief Symptom Inventory, CHQ, Child Health Questionnaire, DAS, Dyadic Adjustment Scale, ELBW, Extremely low birth weight, FILE, Family Inventory of Life Events and Changes, GEE, Generalized estimating equation, GSI, General Severity Index, MANCOVA, Multivariate analysis of covariance, MSPSS, Multidimensional Scale of Perceived Social Support, PF50, Parent Form 50, PSI, Parenting Stress Index, SES, Socioeconomic Status, VLBW, Very low birth weight, WISC-III, Wechsler Intelligence Scale for Children III