BY JANICE NEUMANN
Fri Mar 20, 2015 3:54pm EDT
(Reuters Health) - - Preemies often have lasting health issues and their parents often feel stressed, but a new study suggests parents might stay calmer if they had support in figuring out ways to deal with the behavioral challenges of these youngsters.
Parents of seven-year-olds who were born very preterm – seven or more weeks early - felt much more stressed than those with full-term children when the kids were acting out. But parents who used more constructive problem-solving for outbursts stayed calmer than their counterparts who used avoidance to cope.
“The full-term parents were better at using this form of coping than preterm parents,” said Mark Linden, the study’s first author and a lecturer in Health Sciences at the School of Nursing and Midwifery, Queen’s University, Belfast, UK. “This may have been one of the things which lead to parents of full-term children experiencing less stress.”
Mothers of children who act out already have higher stress levels and may play and interact with their children less than mothers whose kids behave, the researchers write in Archives of Disease in Childhood. Having a preemie with medical complications may just make those interactions worse.
Linden noted that while survival rates for preemies have increased in recent years, preterm youngsters can have more disabilities.
“For parents of children who are born premature or with other medical complications, the joy of a new baby is tempered with worry,” Linden told Reuters Health in an email. “The medicalized environment in which the baby is placed in the days and weeks following delivery is unfamiliar and at times frightening for parents.”
To see what factors might predict whether parents of preterm babies would feel overly stressed even years later, the researchers looked at data from a larger long-term study of children in Vancouver, Canada.
They studied two groups, one with 50 boys and 50 girls born very preterm between 2001 and 2004, and the other with 20 boys and 30 girls born full-term during the same period.
Researchers used various questionnaires to gauge parental stress and coping levels, as well as tools to measure children’s behavior and IQ, when the children were seven years old.
The full-term children had higher IQs at age seven than the preterm children, but patterns of misbehavior in both groups were similar.
After accounting for child behavioral problems, IQ, gender and the parents’ coping styles, the study found that parents were more likely to be stressed if their child acted out, if they avoided dealing with their child’s behavioral problems and if the youngster was a girl.
Though parents reported more acting out by boys, mothers tended to avoid behavioral problems in their daughters more than in their sons.
The authors say they can’t know whether the parents’ stress is a result of the children’s behavior problems, or a cause.
“Their finding that there is a little bit more stress in the group of parents who had preterm infants was not such a surprise,” said Marsha Gerdes, a psychologist at The Children’s Hospital of Philadelphia, “but I thought their addition of looking at coping strategies was a helpful thing.”
“The findings of this article really did ring true with me,” said Gerdes, who also co-directs her hospital’s Neonatal Follow-up Program and was not involved in the study.
Dr. Martha G. Welch, a psychiatrist at Columbia University Medical Center in New York, said her own research had also shown that preemies’ problems can “weigh heavily on families.”
"This is an important observational study by an excellent research group demonstrating for the first time the long-term risks for parents of preterm infants,” Welch told Reuters Health by email. “These children are themselves at great risk for problems in emotion regulation, attention, impulse control, school performance, as well as (autism spectrum disorder)."
Gerdes said parenting classes through pediatrians' offices could help. “Oftentimes (parents are) more likely to participate in a parenting group if you say, ‘Right here in this location, Thursday night, we are have a parenting group,’ than if you gave them an agency miles away that does the same thing,” she said. “Because people tend to trust their pediatricians.”
Linden said support groups, telephone help lines or regular visits to the family general practitioner could also help parents reduce their stress and find better ways of coping.
SOURCE: bmj.co/18L4x1I Archives of Disease in Childhood, online March 11, 2015.