Stressed Parents May Affect Preemie Behavior Later

THURSDAY, March 15 (HealthDay News) — When parents of very
small premature infants are stressed or depressed, their children are more
likely to develop behavioral problems by age 3, according to new
research.

What’s more, the worse the parents scored on psychological well-being
indicators, the more likely their youngsters were to develop the problems.

“The psychological well-being of both parents is a significant
contributor on the behavioral and emotional development of preterm
children,” said study lead author Dr. Mira Huhtala, a researcher at Turku
University Hospital in Finland.

Results of the study, scheduled to be published in the April print
issue of Pediatrics, were released online March 12.

Babies born prematurely have a greater risk of behavioral, emotional
and neurological problems, probably for multiple reasons, according to
this study.

Preemies endure a great deal of stress in the neonatal intensive care
unit, noted Dr. Deborah Campbell, director of neonatology at Montefiore
Medical Center in New York City. While it’s not clear exactly how that
stress might affect a baby, Campbell said it may cause changes in the
developing brain. She said that preemies also have smaller brain volumes
on average, and overall they’re just not as developed as they should be.

At the same time, their parents are incredibly stressed and less
resilient. The premature birth of their child may lead to lowered
expectations, and they may be overly fearful, which may limit the child’s
opportunities for normal development, she noted. If parents are depressed
or feeling a sense of loss, they may not engage or connect with the child
as well, said Campbell.

“It’s difficult to know how much of behavior is from underlying biology
and how much is the influence of the family,” she said.

In an attempt to tease out which factors might matter more, Huhtala and
her colleagues evaluated 140 parents of very low birth-weight children
born before 37 weeks of gestation (40 weeks is considered full-term). Very
low birth weight means a baby weighs less than 1,500 grams (about 3.3
pounds) at birth.

Background data was collected on the parents at the time of birth. When
the babies turned 2 years old, their parents were asked to complete
psychological well-being questionnaires, and researchers assessed the
children’s behavior. Just before the children’s third birthday, parents
completed a questionnaire about the child’s behavior.

Parents were assessed for depression, stress and “sense of coherence.”
Sense of coherence is “readiness to successfully coordinate and take
advantage of personal resources,” according to the study.

“The more symptoms of poor psychological well-being (depressive
symptoms, parenting stress, or weak sense of coherence) the mothers or
fathers experienced, the more behavioral problems their children developed
as reported by the parents,” Huhtala said. “The study showed that not
only the psychological well-being of the mothers but also that of the
fathers contributes to the behavioral problems of preterm children.”

Still, aggressive behaviors and attention problems tended to be more
related to the mother’s psychological well-being, Huhtala added. This may
be because fathers find it easier to tolerate these kinds of behaviors,
she suggested.

Stress is normal after a premature birth, and the study doesn’t show a
cause and effect relationship between stress and behavioral issues, merely
an association.

Huhtala recommended that parents seek out psychosocial support if they
have trouble coping after having a preterm baby.

Campbell agreed that it’s important to seek support. If you don’t have
a family member or friend that you feel you can talk to, she recommended
talking to your doctor or your child’s doctor. She said it may be harder
for men, but it’s important to seek help. Many parents who’ve had a very
premature infant “basically have post-traumatic stress disorder,” she
said, and they have to deal with feelings of guilt, and they need to
grieve the loss of the life they had imagined for their child.

The issue of prematurity is often a lifelong process, Campbell said.
Parents may think they’ve gotten over the worst of it when they get their
baby home, but then the child may have problems when school starts. “For
each issue that comes up, parents have to grieve again,” she said.

More information

Learn more about coping with a premature birth from the March of Dimes.

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