Declining cognitive development from 8 to 18 months in preterm children predicts persisting higher parenting stress

Abstract

BackgroundHigher parenting stress in mothers of children born very preterm may be in part a response to poorer neurobehavioral development, reflecting realistic concerns in addition to adaptation to the trauma of preterm delivery. To our knowledge, there are few longitudinal studies of parenting stress that have addressed child cognitive competence. AimsTo examine parenting stress in preterm and full-term children at 8 and 18months corrected chronological age (CCA), in relation to child cognitive development and behavior. SubjectsParticipants were N=152 children (98 preterm born ≤32weeks gestation, and 54 full-term) seen at 8 and 18months CCA, and the primary caregiver parent. Study design/Outcome measuresThe Parenting Stress Index questionnaire was completed by a parent, child interactive behavior was videotaped, and the Bayley Scales of Infant Development (BSID II, Mental Development Index; MDI) were administered at both ages. ResultsTotal Parenting Stress was higher in preterm than full-term children at 8 and 18months CCA (p<.02), accounted for primarily by the Child domain. Hierarchical regression showed (after controlling for neonatal risk, number of children in the home, child interactive behavior and maternal education) that decreasing Bayley MDI scores from 8 to 18months CCA predicted higher parenting stress for preterm children. For full-term children, number of children in the home and child interactive behavior predicted parental stress at 18months. ConclusionHigher parenting stress persisting to 18months CCA in preterm children may partly reflect realistic parental concerns with their child's development.