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A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting
Published on: January 12, 2018
A randomized, controlled trial of the effectiveness of an early-intervention program in reducing parenting stress
Per Ivar Kaaresen1, John A Rønning, Stein Erik Ulvund
1Pediatric Department, University Hospital of North Norway Trust, N-9038 Tromsø, Norway. per.ivar.kaaresen@unn.no
Insights
An early intervention program significantly reduced parenting stress for mothers and fathers of preterm infants. This intervention brought stress levels down to those of parents with full-term infants.
Area of Science:
- Neonatal care
- Parenting studies
- Psychological interventions
Background:
- Preterm birth is linked to increased parenting stress, potentially impacting infant behavior.
- Existing research on this topic is limited, with conflicting findings.
- Data regarding paternal stress after preterm birth is particularly scarce.
Purpose of the Study:
- To assess the impact of an early intervention program on parenting stress in parents of preterm infants.
- To track parenting stress from birth up to one year corrected age.
Main Methods:
- A randomized controlled trial involving preterm infants (birth weight <2000g) and a term control group.
- Intervention included pre-discharge sessions and post-discharge home visits by trained nurses.
- Parenting Stress Index administered to mothers at 6 and 12 months corrected age, and to fathers at 12 months corrected age.
Main Results:
- The intervention group showed significantly lower child, parent, and total stress scores compared to preterm controls.
- Parenting stress in the intervention group was comparable to that of parents with term infants.
- Both mothers and fathers in the intervention group reported lower scores in specific subscales like distractibility/hyperactivity, parental reinforcement, competence, and attachment.
Conclusions:
- The early intervention program effectively reduces parenting stress in both mothers and fathers of preterm infants.
- The program normalizes parenting stress levels to those observed in parents of term infants.
- Further research is ongoing to determine the long-term benefits of this intervention.
Background:
Preterm birth has been associated with increased parenting stress in early infancy, and some reports have found this to be a risk factor for later behavioral problems. There are, however, few studies and conflicting results. Information about the fathers is scarce.
Objectives:
Our goal was to study the effects of an early-intervention program on parenting stress after a preterm birth until 1 year corrected age.
Methods:
A randomized, controlled trial was conducted including infants with a birth weight <2000 g treated at the University Hospital of North Norway Trust, which serves the 2 northern-most counties in Norway, to examine the effects of a modified version of the Mother-Infant Transaction Program on parenting stress measured by the Parenting Stress Index. A term control group was also recruited. The Parenting Stress Index was administered to the mothers at 6 and 12 months' corrected age and to the fathers at 12 months' corrected age. The intervention consisted of 8 sessions shortly before discharge and 4 home visits by specially trained nurses focusing on the infant's unique characteristics, temperament, and developmental potential and the interaction between the infant and the parents.
Results:
Seventy-one infants were included in the preterm intervention group, and 69 were included in the preterm control group. The preterm groups were well balanced. Seventy-four infants were included in the term control group. Compared with the preterm controls, both the mothers and fathers in the preterm intervention group reported significant lower scores in child domain, parent domain, and total stress on all occasions except the mother-reported child domain at 12 months. These differences were not related to birth weight or gestational age. The level of stress among the preterm intervention group was comparable to their term peers. Both parents in the intervention group reported consistently lower scores within the distractibility/hyperactivity, reinforces parents, competence, and attachment subscales compared with the preterm control group. There were no differences in mean summary stress scores between the mothers and fathers in the 2 preterm groups at 12 months, but the intraclass correlation coefficient was higher in the intervention group.
Conclusions:
This early-intervention program reduces parenting stress among both mothers and fathers of preterm infants to a level comparable to their term peers. We are now studying whether this will result in long-term beneficial effects.