Early detection of parenting stress in mothers of preterm infants during their first-year home

Abstract

Background: Maternal stress following the birth of an infant is well acknowledged. It is particularly so when infants are born prematurely as their mothers cannot fully take on their parenting role until their infant(s) is discharged from neonatal intensive care units (NICUs). In this exploratory study, we examined whether these mothers' parenting stress would lessen during their first-year reunification with their infant(s) as they settle into motherhood at home.

Methods: Two groups of mothers with infants born between 24- and 33-week gestational age were recruited. A group of 25 mothers were monitored at their infants' 1-month corrected age (CA) and a second group of 24 mothers were monitored at their infants' 12-month CA. Subjects completed the long form Parental Stress Index (PSI) ranking how stressful they perceive the individual subscales in the Child and Parent Domains of the self-reported questionnaire (PSI-3; Abidin; PAR Inc). The PSI theorizes that the stress mothers perceive is a resultant of their respective characteristics, interactions with their infant(s), family, and environment. Statistical analyses include descriptive statistics, χ² square analysis, and independent t-test.

Results: There was no significant difference in the levels of perceived stress in the PSI subscales between the two groups of mothers at 1- and 12-month CA. Scores for the majority of respondents fell within the 15th to 80th percentile (% ile) distribution of Abidin's normative population, with some mothers falling below the 15th % ile.

Discussion/conclusion: The data collected suggest that: 1. the perceived stress experienced by mothers during their first-year reunited with their preterm infants is within the normal range observed in Abidin's normative population. 2. As the PSI is a self-reported survey, care providers need to be aware that some mothers may downplay their stress responses. 3. With the ability to monitor individual participants, the PSI can be readily offered to mothers at their infants' first year routine clinical visits to assist in the early identification of parenting issues that may threaten the development of a healthy mother-infant dyad. Early appropriate guidance and social support would help "at-risk" mothers develop more constructive parenting routines.

Keywords: Maternal stress perception; Parenting[al] Stress Index [stress index]; Preterm mother-infant dyad.

Fig. 1

PSI profiles of Non-Defensive (ND; black lines) and Defensive (D; grey lines) mothers at 1-month CA (dashed line), 12-month CA (dotted line) and average of both times (solid line); %ile columns: frequency distribution of Abidin’s normative population; Maternal Raw Scores in Child and Maternal Domains; Y-axis: subscales in Child and Maternal Domains; Child and Parent Domain (CD; PD) Total Stress (TS); Life Stress (LS)

Fig. 2

Profile of a ND mother with high stress scores (> 85%ile) for the majority of subscale levels at 1-month CA visit. Raw scores > 99%ile noted above corresponding subscales