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Stress in parents of children born very preterm is predicted by child externalising behaviour and parent coping at age 7 years
  1. Mark A Linden1,
  2. Ivan L Cepeda2,
  3. Anne Synnes2,3,
  4. Ruth E Grunau1,2,3
  1. 1School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
  2. 2Department of Developmental Neurosciences & Child Health, Child & Family Research Institute, Vancouver, British Columbia, Canada
  3. 3Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
  1. Correspondence to Dr Mark A Linden, School of Nursing and Midwifery, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK; M.Linden{at}


Objective To examine factors which predict parenting stress in a longitudinal cohort of children born very preterm, and seen at age 7 years.

Methods We recruited 100 very preterm (≤32 weeks gestational age) child-parent dyads and a control group of 50 term-born dyads born between 2001 and 2004 with follow-up at 7 years. Parents completed the Parenting Stress Index, Ways of Coping Questionnaire, Child Behavior Check List, Beck Depression Inventory and the State Trait Anxiety Inventory questionnaires. Child IQ was assessed using the Wechsler Intelligence Scale-IV.

Results After controlling for maternal education, parents of preterm children (95% CI 111.1 to 121.4) scored higher (p=0.027) on the Parenting Stress Index than term-born controls (95% CI 97.8 to 113.2). Regression analyses showed that child externalising behaviour, sex and parent escape/avoidance coping style, predicted higher parenting stress in the preterm group. Parents of preterm girls expressed higher levels of stress than those of boys.

Conclusions Maladaptive coping strategies contribute to greater stress in parents of very preterm children. Our findings suggest that these parents need support for many years after birth of a very preterm infant.

  • Child Psychology
  • Outcomes research
  • Psychology

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