Parental mental health experiences during the first few weeks after a very preterm (VP) birth may have long-lasting effects on parenting behaviors and cognitive outcomes of the child, according to results of a study published in the Journal of Pediatric Psychology.
Families of surviving infants (N=143) born at less than 30 weeks’ gestation between 2011 and 2013 at the Royal Women’s Hospital in Melbourne, Australia were recruited for this study. In the first weeks after birth, the primary caregiver completed family social risk, Center for Epidemiologic Studies Depression Scale (CES-D), and Hospital Anxiety Depression Scale (HADS-A) questionnaires. Parenting behaviors at 1 year were evaluated using the Emotional Availability Scales (EAS) assessment during a 15-minute semi-structured play interaction and children were evaluated for general cognitive ability at 4.5 to 5 years of age using the Wechsler Preschool and Primary Scale of Intelligence (WPPSI) instrument.
The surviving infants were born at an average 27.8 (SD, 1.5) weeks’ gestation, with a birth weight of 1031 (SD, 260) g, 56% were singleton pregnancies, 43% were first births, and 50% were boys. The mothers had a mean age of 32.8 (SD, 5.4) years and fathers 35.0 (SD, 6.6) years at birth.
During the first weeks after birth, the mothers had a CES-D score of 15.34 (SD, 9.98) and HADS-A score of 7.69 (SD, 3.96) and the (SD, 8.77) and 7.14 (SD, 4.21), respectively. At 1 year the mothers had an EAS sensitivity score of 5.00 (SD, 0.96) and structuring score of 4.97 (SD, 0.97). The fathers had scores of 4.35 (SD, 1.08) and 4.24 (SD, 1.21), respectively.
At 4.5 to 5 years of age, the children had a WPPSI score of 100.79 (SD, 14.59).
Among mothers, 4 significant correlations were observed, including CES-D and HADS-A scores (r, 0.74; P <.001), EAS sensitivity and structuring scores (r, 0.69; P <.001), and gestational age and cognitive outcomes (r, 0.22; P <.05). Among fathers, 8 significant correlations were observed, including EAS sensitivity scores and child cognitive outcomes (r, 0.33; P <.001) and child gender (r, 0.22; P <.05) as well as structuring EAS scores and child cognitive outcomes (r, 0.41; P <.01).
The hypothesis that increased depressive and/or anxiety symptoms soon after birth would negatively impact parenting behaviors at 1 year which in turn would associate with lower general cognitive abilities at 4.5 to 5 years of age, had a good fit for mother’s (X2, 0.07) and father’s (X2, 3.68) data, accounting for 8% and 23% of the variance in childhood cognitive ability, respectively.
In the network analysis, the mother’s symptoms of depression in the weeks after birth negatively affected structuring (P <.001) and sensitive (P =.034) parenting behaviors at 1 year whereas symptoms of anxiety positively affected structuring behaviors (P =.009).
The findings of this study may not be generalizable for children born at term.
Study authors concluded, “The findings of this study indicate that mothers’ depressive and anxiety symptoms measured shortly after VP birth can influence mothers’ future sensitive and structuring parenting behaviors.”
McMahon GE, Treyvaud K, Spittle AJ, et al. Parental mental health and parenting behaviors following very preterm birth: associations in mothers and fathers and implications for child cognitive outcome. J Pediatr Psychol. 2023;jsac094. doi:10.1093/jpepsy/jsac094