This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (148)  • Contact me when this article is cited  Related Content  • Related articles  • Similar articles in JAMA  Topic Collections  • Psychiatry  • Alert me on articles by topic  Social Bookmarking   What's this?

Lynn T. Singer, PhD; Ann Salvator, MS; Shenyang Guo, PhD; Marc Collin, MD; Lawrence Lilien, MD; Jill Baley, MD

JAMA. 1999;281:799-805.

Context  Few studies document how parents adapt to the experience of a very low-birth-weight (VLBW; <1500 g) birth despite societal concerns about the ethics and justification of intensive care for these infants.

Objective  To determine the degree and type of stress experienced over time by mothers whose infants vary in degree of prematurity and medical and developmental risk.

Design  Longitudinal prospective follow-up study of a cohort of mothers of high- and low-risk VLBW and term infants from birth to 3 years.

Setting  All level III neonatal intensive care units from a large midwestern metropolitan region.

Participants  Mothers and infants prospectively and consecutively enrolled in a longitudinal study between 1989 and 1991. High-risk VLBW infants were diagnosed as having bronchopulmonary dysplasia, and comparison groups were low-risk VLBW infants without bronchopulmonary dysplasia and term infants (>36 weeks, >2500 g).

Main Outcome Measures  Standardized, normative self-report measures of maternal psychological distress, parenting stress, family impact, and life stressors.

Results  Mothers of VLBW infants (high risk, n=122; low risk, n=84) had more psychological distress than mothers of term infants (n=123) at 1 month (13% vs 1%; P=.003). At 2 years, mothers of low-risk VLBW infants did not differ from term mothers, while mothers of high-risk infants continued to report psychological distress. By 3 years, mothers of high-risk VLBW children did not differ from mothers of term children in distress symptoms, while parenting stress remained greater. Severity of maternal depression was related to lower child developmental outcomes in both VLBW groups.

Conclusions  The impact of VLBW birth varies with child medical risk status, age, and developmental outcome. Follow-up programs should incorporate psychological screening and support services for mothers of VLBW infants in the immediate postnatal period, with monitoring of mothers of high-risk VLBW infants.

Author Affiliations: Department of Pediatrics, School of Medicine (Drs Singer, Collin, and Baley and Ms Salvator), and the Mandel School of Applied Social Sciences (Dr Guo), Case Western Reserve University, MetroHealth Medical Center (Drs Singer and Collin), University Hospitals (Drs Singer and Baley), and Fairview Hospital (Dr Lilien), Cleveland, Ohio.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLES

March 3, 1999
JAMA. 1999;281(9):863-864.
EXTRACT | FULL TEXT  

Stresses of Parenting
JAMA. 1999;281(9):866.
PDF  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

how do mothers and fathers who have a child with a disability describe their adaptation/ transformation process?
Pelchat et al.
J Child Health Care 2009;13:239-259.
ABSTRACT  

Behavioral Problems and Cognitive Performance at 5 Years of Age After Very Preterm Birth: The EPIPAGE Study
Delobel-Ayoub et al.
Pediatrics 2009;123:1485-1492.
ABSTRACT | FULL TEXT  

Psychological stress of parents of preterm infants enrolled in an early discharge programme from the neonatal intensive care unit: a prospective randomised trial
Saenz et al.
Arch. Dis. Child. Fetal Neonatal Ed. 2009;94:F98-F104.
ABSTRACT | FULL TEXT  

Mental health of mothers and fathers of twins conceived via assisted reproduction treatment: a 1-year prospective study
Vilska et al.
Hum Reprod 2009;24:367-377.
ABSTRACT | FULL TEXT  

Respite Care for Children With Special Health Care Needs
Nageswaran
Arch Pediatr Adolesc Med 2009;163:49-54.
ABSTRACT | FULL TEXT  

Very Low Birth Weight and Behavioral Symptoms of Attention Deficit Hyperactivity Disorder in Young Adulthood: The Helsinki Study of Very-Low-Birth-Weight Adults
Strang-Karlsson et al.
Am. J. Psychiatry 2008;165:1345-1353.
ABSTRACT | FULL TEXT  

Psychosocial Distress Associated With Treatment of Hypertensive Diseases in Pregnancy
Leeners et al.
Psychosomatics 2008;49:413-419.
ABSTRACT | FULL TEXT  

Permissive Hypercapnia and Risk for Brain Injury and Developmental Impairment
Hagen et al.
Pediatrics 2008;122:e583-e589.
ABSTRACT | FULL TEXT  

Parental Stress and Child Behavior and Temperament in the First Year After the Newborn Individualized Developmental Care and Assessment Program
van der Pal et al.
Journal of Early Intervention 2008;30:102-115.
ABSTRACT  

Randomised trial of a parenting intervention during neonatal intensive care
Glazebrook et al.
Arch. Dis. Child. Fetal Neonatal Ed. 2007;92:F438-F443.
ABSTRACT | FULL TEXT  

Mental Health and Social Competencies of 10- to 12-Year-Old Children Born at 23 to 25 Weeks of Gestation in the 1990s: A Swedish National Prospective Follow-up Study
Farooqi et al.
Pediatrics 2007;120:118-133.
ABSTRACT | FULL TEXT  

Longitudinal Changes in Family Outcomes of Very Low Birth Weight
Moore et al.
J Pediatr Psychol 2006;31:1024-1035.
ABSTRACT | FULL TEXT  

Reducing Premature Infants' Length of Stay and Improving Parents' Mental Health Outcomes With the Creating Opportunities for Parent Empowerment (COPE) Neonatal Intensive Care Unit Program: A Randomized, Controlled Trial
Melnyk et al.
Pediatrics 2006;118:e1414-e1427.
ABSTRACT | FULL TEXT  

Mood States and Milk Output in Lactating Mothers of Preterm and Term Infants
Hill et al.
J Hum Lact 2006;22:305-314.
ABSTRACT  

Individual and Combined Effects of Postpartum Depression in Mothers and Fathers on Parenting Behavior
Paulson et al.
Pediatrics 2006;118:659-668.
ABSTRACT | FULL TEXT  

A Randomized, Controlled Trial of the Effectiveness of an Early-Intervention Program in Reducing Parenting Stress After Preterm Birth
Kaaresen et al.
Pediatrics 2006;118:e9-e19.
ABSTRACT | FULL TEXT  

The impact of extremely low birth weight on the families of school-aged children.
Drotar et al.
Pediatrics 2006;117:2006-2013.
ABSTRACT | FULL TEXT  

Family-Based Intervention to Enhance Infant-Parent Relationships in the Neonatal Intensive Care Unit
Browne and Talmi
J Pediatr Psychol 2005;30:667-677.
ABSTRACT | FULL TEXT  

International Comparison of Care for Very Low Birth Weight Infants: Parents' Perceptions of Counseling and Decision-Making
Partridge et al.
Pediatrics 2005;116:e263-e271.
ABSTRACT | FULL TEXT  

Emotional reactions of parents after the birth of an infant with extremely low birth weight
Eriksson and Pehrsson
J Child Health Care 2005;9:122-136.
ABSTRACT  

Helping Parents Cope With the Trauma of Premature Birth: An Evaluation of a Trauma-Preventive Psychological Intervention
Jotzo and Poets
Pediatrics 2005;115:915-919.
ABSTRACT | FULL TEXT  

Infants in a neonatal intensive care unit: parental response
Redshaw
Arch. Dis. Child. Fetal Neonatal Ed. 2005;90:F96-F96.
FULL TEXT  

Infants in a neonatal intensive care unit: parental response
Carter et al.
Arch. Dis. Child. Fetal Neonatal Ed. 2005;90:F109-F113.
ABSTRACT | FULL TEXT  

Supporting parents in the neonatal unit
Fowlie and McHaffie
BMJ 2004;329:1336-1338.
FULL TEXT  

Health Status and Health-Related Quality of Life in a Population-Based Sample of Neonatal Intensive Care Unit Graduates
Klassen et al.
Pediatrics 2004;113:594-600.
ABSTRACT | FULL TEXT  

Perception of Child Vulnerability Among Mothers of Former Premature Infants
Allen et al.
Pediatrics 2004;113:267-273.
ABSTRACT | FULL TEXT  

Neurobehavioral Outcomes of School-age Children Born Extremely Low Birth Weight or Very Preterm in the 1990s
Anderson and Doyle
JAMA 2003;289:3264-3272.
ABSTRACT | FULL TEXT  

Relationships between the Family's Way of Functioning and Children's Temperament as Rated by Parents of Pre-Term Children
Eriksson and Pehrsson
J Child Health Care 2003;7:89-100.
ABSTRACT  

Initiation of Breastfeeding Among Mothers of Very Low Birth Weight Infants
Smith et al.
Pediatrics 2003;111:1337-1342.
ABSTRACT | FULL TEXT  

Effect of Newborn Hospitalization on Family and Child Behavior: A 12-Year Follow-up Study
Rautava et al.
Pediatrics 2003;111:277-283.
ABSTRACT | FULL TEXT  

Bronchopulmonary Dysplasia: An Enduring Challenge
Vaucher
Pediatr. Rev. 2002;23:349-358.
FULL TEXT  

Cognitive and Behavioral Outcomes of School-Aged Children Who Were Born Preterm: A Meta-analysis
Bhutta et al.
JAMA 2002;288:728-737.
ABSTRACT | FULL TEXT  

Parental stress in families of 2 year old extremely low birthweight infants
Tommiska et al.
Arch. Dis. Child. Fetal Neonatal Ed. 2002;86:F161-F164.
ABSTRACT | FULL TEXT  

Evaluation of Psycho-Social Support to Parents with an Infant Born Preterm
Eriksson and Pehrsson
J Child Health Care 2002;6:19-33.
ABSTRACT  

Attitudes of Parents and Health Care Professionals Toward Active Treatment of Extremely Premature Infants
Streiner et al.
Pediatrics 2001;108:152-157.
ABSTRACT | FULL TEXT  

Long-term Family Outcomes for Children With Very Low Birth Weights
Taylor et al.
Arch Pediatr Adolesc Med 2001;155:155-161.
ABSTRACT | FULL TEXT  

Relation of Plasma Oxytocin and Prolactin Concentrations to Milk Production in Mothers of Preterm Infants: Influence of Stress
Chatterton et al.
J. Clin. Endocrinol. Metab. 2000;85:3661-3668.
ABSTRACT | FULL TEXT  

Kangaroo Care Compared to Incubators in Maintaining Body Warmth in Preterm Infants
Ludington-Hoe et al.
Biol Res Nurs 2000;2:60-73.
ABSTRACT  

Other Articles Noted
Evid. Based Nurs. 1999;2:105-112.
FULL TEXT  

Stresses of Parenting in Mothers of Very-Low-Birth-Weight Infants
JWatch Psychiatry 1999;1999:18-18.
FULL TEXT  

Stresses of Parenting in Mothers of Very-Low-Birth-Weight Infants
JWatch Women's Health 1999;1999:17-17.
FULL TEXT  

Stresses of Parenting in Mothers of Very-Low-Birth-Weight Infants
JWatch General 1999;1999:5-5.
FULL TEXT