Rethinking Stress in Parents of Preterm Infants: A Meta-Analysis

Abstract

BackgroundWith improved medical outcome in preterm infants, the psychosocial situation of their families is receiving increasing attention. For parents, the birth of a preterm infant is generally regarded as a stressful experience, and therefore many interventions are based on reducing parental stress. Nevertheless, it remains unclear whether parents of children born preterm experience more stress than parents of term-born children, which would justify these interventions. This meta-analysis provides a comprehensive account of parental stress in parents of preterm infants, from birth of the infant through to their adolescence. Mean levels of stress in specific domains of family functioning were investigated, and stress levels in parents of preterm and term infants, and fathers and mothers of preterm infants, were compared. Furthermore, we investigated moderators of parental stress.Methods and FindingsA random-effects meta-analysis was conducted including 38 studies describing 3025 parents of preterm (<37 wk) and low birth weight (<2500 g) infants. Parental stress was measured with two parent-reported questionnaires, the Parenting Stress Index and the Parental Stressor Scale: Neonatal Intensive Care Unit. The results indicate that parents of preterm-born children experience only slightly more stress than parents of term-born children, with small effect sizes. Furthermore, mothers have slightly more stress than fathers, but these effect sizes are also small. Parents report more stress for infants with lower gestational ages and lower birth weights. There is a strong effect for infant birth year, with decreasing parental stress from the 1980s onward, probably due to increased quality of care for preterm infants.ConclusionsBased on our findings we argue that prematurity can best be regarded as one of the possible complications of birth, and not as a source of stress in itself.

Antenatal Counseling Regarding Resuscitation and Intensive Care Before 25 Weeks of Gestation

“…51,52 Although survivors of extreme prematurity can have significant longterm health and developmental problems, former extremely preterm infants generally report better health outcomes than expected, 53,54 except perhaps during adolescence. 55 Even though parents report more health care-related concerns, they generally rate the health quality of life of their children fairly high.…”

Validación y clasificación de la escala de creencias de los padres de niños prematuros

“…Em relação ao item 14 ("Eu sei como a aparência e o comportamento do meu bebê são diferentes da aparência e do comportamento de um bebê a termo [nascido no tempo esperado])", visto que grande parte dos pais de ambos os grupos concordou com a afirmação, acredita-se que possa estar relacionado ao fato de os pais do grupo de "Insuficiência moderada da capacidade de cuidado" deterem esse conhecimento em decorrência da influência da percepção de fragilidade do seu bebê, visto que sentimentos como ansiedade dos pais podem aumentar a percepção de vulnerabilidade do bebê (Boykova & Kenner, 2012;Schappin, Wijnroks, Venema, & Jongmans, 2013). Para o item 16 ("Eu me sinto confiante em perguntar aos médicos e às enfermeiras sobre a condição clínica de meu bebê"), a ausência de diferenças estatísticas entre os dois grupos de pais pode estar associada ao desconhecimento dos pais que se enquadravam no grupo de "Insuficiência moderada da capacidade de cuidado" diante do real estado de saúde dos seus bebês.…”

Metaanálisis: efecto de las intervenciones para disminuir el nivel de estrés en padres de prematuros

“…Las intervenciones que incluyen apoyo psicosocial resultaron en mejores resultados para los padres. El estrés fue el constructo principal en esta medición, ya que la literatura lo reporta con frecuencia en las familias que tienen la experiencia de un nacimiento prematuro (54).…”