Parenting stress in mothers after very preterm birth
and the effect of the Infant Behavioural Assessment
and Intervention Program
D. E. Meijssen,* M. J. Wolf,† K. Koldewijn,† A. G. van Wassenaer,‡ J. H. Kok‡ and A. L. van Baar§
*Developmental Psychology, Tilburg University, Tilburg
†Department of Rehabilitation, Academic Medical Center, University of Amsterdam
‡Department of Neonatology, Academic Medical Center, University of Amsterdam, Amsterdam, and
§Pedagogical and Educational Sciences, Utrecht University, Utrecht, the Netherlands
Accepted for publication 20 April 2010
Keywords
early intervention,
mothers, parenting stress,
prematurity
Correspondence:
Dominique E. Meijssen,
AMC, Department of
Rehabilitation (A01-426),
PO Box 22660, 1100 DD
Amsterdam, the
Netherlands
E-mail:
d.e.meijssen@amc.uva.nl
Abstract
Objective Purpose of this study was to examine maternal parenting stress as a secondary outcome
of the Infant Behavioural Assessment and Intervention Program (IBAIP).
Methods In a randomized controlled trial 86 very preterm infants and their parents were assigned
to the intervention group and 90 to the control group. Maternal parenting stress was assessed with
the Dutch version of the Parenting Stress Index at 12 and 24 months post term.
Results Mothers in the intervention group mothers assessed their infants as happier and less
hyperactive/distractible compared with the control group mothers. However, mothers in the
intervention group reported more feelings of social isolation.
Conclusions The IBAIP appears to have made mothers more satisfied about their infants’ mood
and distractibility, but also may have evoked more feelings of social isolation. Next to long-term
evaluation of the development in very preterm born children, follow-up on functioning of their
parents is important.
Introduction
Parenting stress is caused by a mismatch between the per-
ceived demands of parenting and the resources available to
meet those demands (Abidin 1995). Increased parenting stress
is a risk factor for maladaptive parenting (Kazdin & Whitley
2003), as well as higher levels of child disruptive behaviour
problems (Barry et al. 2005). Parent as well as child character-
istics influence parenting stress in complex ways. Risk factors
are single parenthood (Ricciuti 2004; Williford et al. 2007),
parental psychopathology (Misri et al. 2006; Sheinkopf et al.
2006; Williford et al. 2007), difficult temperament (Ostberg &
Hagekull 2000) and regulation difficulties of the child (Calkins
& House 2004).
The demands of parenting a young child could be especially
stressful for parents if the child is born very preterm, which
results in an increased risk for morbidity and potential devel-
opmental delay (de Kleine et al. 2007). Reports on the impact of
preterm birth on parenting stress are inconsistent. Some studies
report more parenting stress in mothers of high-risk very low
birthweight infants (Singer et al. 1999, 2007; Taylor et al. 2001;
Auslander et al. 2003; Drotar et al. 2006). Other studies find
similar levels of parenting stress in parents of term or preterm
infants (Saigal et al. 2000; Candelaria et al. 2006). Intervention
programmes focused upon improving preterm infants’ devel-
opment, could also affect parenting stress, either as a direct
result from extra attention for the family and child, or through
improvements in development of the children. A review on
Child:
care, health and development
Original Article doi:10.1111/j.1365-2214.2010.01119.x
© 2010 Blackwell Publishing Ltd 1