Stress in parents of children born very preterm is predicted by child externalising behaviour and parent coping at age 7 years
Open accessAbstract
OBJECTIVE: To examine factors which predict parenting stress in a longitudinal cohort of children born very preterm, and seen at age 7 years. METHODS: We recruited 100 very preterm (≤32 weeks gestational age) child-parent dyads and a control group of 50 term-born dyads born between 2001 and 2004 with follow-up at 7 years. Parents completed the Parenting Stress Index, Ways of Coping Questionnaire, Child Behavior Check List, Beck Depression Inventory and the State Trait Anxiety Inventory questionnaires. Child IQ was assessed using the Wechsler Intelligence Scale-IV. RESULTS: After controlling for maternal education, parents of preterm children (95% CI 111.1 to 121.4) scored higher (p=0.027) on the Parenting Stress Index than term-born controls (95% CI 97.8 to 113.2). Regression analyses showed that child externalising behaviour, sex and parent escape/avoidance coping style, predicted higher parenting stress in the preterm group. Parents of preterm girls expressed higher levels of stress than those of boys. CONCLUSIONS: Maladaptive coping strategies contribute to greater stress in parents of very preterm children. Our findings suggest that these parents need support for many years after birth of a very preterm infant.
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Beyond two years, anxiety in mothers of preterm children seems to stabilize at a normal level.
“Beyond two years, anxiety seems therefore to stabilize at a normal level, although one study showed higher symptoms 13 years after birth (Akkus et al., 2021; Linden et al., 2015; Treyvaud et al., 2014)”
From Parental stress and mental health outcomes following very preterm birth: A systematic review of recent findings (2024) · cites this paper as Linden et al., 2015
The Introduction (page unavailable) says very preterm birth has been associated with increased parental anxiety at age seven, contrary to anxiety stabilizing at a normal level beyond two years. It reports no difference in state anxiety only when the children were aged 22–25; this does not establish stabilization shortly after age two. (LLM, conf=0.86)
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Experimental — accuracy not yet measuredTwo studies found higher stress in mothers of VPT and EPT infants compared with mothers of FT infants seven years after birth.
“Similarly, two studies found higher stress in mothers of VPT and EPT vs. mothers of FT seven years after birth (Linden et al., 2015; Treyvaud et al., 2014).”
From Parental stress and mental health outcomes following very preterm birth: A systematic review of recent findings (2024) · cites this paper as Linden et al., 2015
The Group differences section reports significantly higher stress among parents of very preterm children than among parents of full-term children at age seven. However, the study measured primary caregivers rather than mothers specifically, and it does not report a separate stress comparison for parents of extremely preterm children. This verdict concerns Linden et al. only, not the other study cited in the sentence. (LLM, conf=0.87)
Experimental — accuracy not yet measuredParents of VPT children have higher depression and anxiety than parents of FT children.
“Group comparisons found higher depression and anxiety in parents of preterm compared to full-term.”
From Parental stress and mental health outcomes following very preterm birth: A systematic review of recent findings (2024) · cites this paper as Linden et al., 2015
The Results section reports higher depressive-symptom scores among parents of preterm children than among parents of full-term children (p = .012). The paper measures parental anxiety, but the passages found do not report a corresponding group difference in anxiety; the reported anxiety finding is a correlation with parenting stress, not a preterm–full-term comparison. No page number is available in our copy. (LLM, conf=0.85)
Experimental — accuracy not yet measuredHaving a girl contributes to parenting stress.
“having a girl (Linden et al., 2015) also contribute to parenting stress.”
From Parental stress and mental health outcomes following very preterm birth: A systematic review of recent findings (2024) · cites this paper as Linden et al., 2015
In “Predictors of parenting stress in the preterm group,” child sex was a significant predictor, and the Conclusions report higher stress among parents of very preterm girls than boys. The claim omits that population restriction and, if “contributes” implies causation, goes beyond this observational finding. (LLM, conf=0.84)
Experimental — accuracy not yet measuredOne study showed higher anxiety symptoms 13 years after birth.
“although one study showed higher symptoms 13 years after birth (Akkus et al., 2021; Linden et al., 2015; Treyvaud et al., 2014)”
From Parental stress and mental health outcomes following very preterm birth: A systematic review of recent findings (2024) · cites this paper as Linden et al., 2015
The Introduction reports increased parental anxiety at age seven after very preterm birth, citing earlier work. This paper's own follow-up was also at age seven and found higher parenting stress; it does not report higher anxiety symptoms 13 years after birth. (LLM, conf=0.85)
Experimental — accuracy not yet measured
Akkus et al. (2021) at two years and Linden et al. (2015) at seven years observed no difference in anxiety for mothers of VPT vs FT.
“Conversely, Akkus et al. (2021) at two years ( n = 18) and Linden et al. (2015, n = 100) at seven years after birth observed no difference in anxiety for mothers of VPT vs FT.”
From Parental stress and mental health outcomes following very preterm birth: A systematic review of recent findings (2024) · cites this paper as Linden et al., 2015
The Participants section describes 100 very-preterm children and full-term controls assessed at age seven, and the Measures passage says the study assessed parents’ trait anxiety. But the Results passages provided do not report whether anxiety differed between the groups; they report group differences in depressive symptoms and parenting stress instead. The claimed absence of an anxiety difference for mothers is therefore not established by our copy. (LLM, conf=0.72)
Experimental — accuracy not yet measured
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- Authors
- Linden, M. A., Cepeda, I. L., Synnes, A., & Grunau, R. E.
- Affiliations
- Queen's University Belfast (GB)
- Child and Family Research Institute (CA)
- University of British Columbia (CA)
- Corresponding author
- Linden, Mark A
- Venue
- Archives of Disease in Childhood
- Publisher
- BMJ
- Published
- 2015-03-11
- Volume
- 100
- Issue
- 6
- Pages
- 554-558
- ISSN
- 0003-9888 (ISSN-L)
- 1468-2044
- OpenAlex
- W2008998466
- Cited by
- 21
- References
- 40
- Citations by year
- 2024: 2 · 2023: 5 · 2022: 2 · 2021: 1 · 2020: 1 · 2019: 2 · 2018: 2 · 2017: 1 · 2016: 3 · 2015: 2
- FWCI
- 2.66
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Archives of Disease in Childhood (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (Queen's University Belfast) (acceptedVersion, other-oa)
- Funders
- Child and Family Research Institute
- Michael Smith Health Research BC
- University of British Columbia
- Canadian Institutes of Health Research (MOP42469)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD039783, HD39783)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Development and Preterm Care
- Social Sciences › Psychology › Clinical Psychology › Family and Disability Support Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Keywords
- parental stress, very preterm infants, parental coping, escape-avoidance coping, sex differences, parental depression, parental anxiety, child IQ, long-term follow-up
- MeSH terms
- Adaptation, Psychological, Child, Child Behavior Disorders, Female, Gestational Age, Humans, Longitudinal Studies, Male, Parent-Child Relations, Parents, Psychiatric Status Rating Scales, Surveys and Questionnaires, Regression Analysis, Stress, Psychological, Infant, Extremely Premature
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