Maternal psychological impact of medical information in the neonatal period after premature birth Denizot Sophie a, ⁎, Valérie Le Quen a , Valérie Bureau a , Pierre-Yves Ancel b , Gérard Bréart b , Jean-Christophe Rozé a a INSERM CIC 004; Nantes University Hospital, Department of Neonatalogy, Nantes,France b INSERM U953 Research Unit on Perinatal Health and Women's Health, Villejuif,France a b s t r a c t a r t i c l e i n f o Article history: Received 31 August 2009 Received in revised form 26 October 2009 Accepted 27 October 2009 Keywords: Maternal emotional feeling Medical information Prematurity Ultrasound scanning Neonatal intensive care unit The mothers of premature infant born 7 years ago were interviewed regarding memory of neonatal hospi- talization during a 40-minute phone interview using a questionnaire exploring emotional feeling and satisfaction.The memory of a high emotional feeling was significantly associated with cranial ultrasound abnormalities in neonatalperiod, but not outcome.Dissatisfaction was reduced by antenatal maternal hospitalization.We speculate that medical information gathered during perinatal hospitalization explains these relationships. © 2009 Elsevier Ireland Ltd. All rights reserved. 1. Introduction Premature birth remains a traumatic and stressful event for mothers [1] and produces a significant and long-lasting impact [2]. Understand- ing the nature and determinants of maternal emotional reactions and dissatisfaction could lead to the development of interventions to reduce stress.In order to better understand variables predicting maternal distress after premature childbirth, we enrolled mothers of children born prematurely for an interview regarding memory of their emotional feeling and satisfaction in relation to hospitalization of their infant 7 years ago. 2. Methods Mothers of premature infants who were enrolled 7 years before in the EPIPAGE cohort of Pays de la Loire, one of the nine French regions of the EPIPAGE study [3], and who agreed to participate in a study on schoolintegration,were contacted for this study. The characteristics of mothers taken into account included age, maternal education level, hospitalization during pregnancy, and caesarean section.Neonatal characteristicsincluded gestational age, birthweight, CRIB score, duration of hospitalization,and cranialultrasound abnormalities. In France, cranial ultrasonography is performed routinely for very preterm children admitted to NICUs. Each infant usually undergoes 1 to 3 cranial ultrasound examinations in the first 2 weeks of life. Thereafter, a weekly examination is advised for infants with cerebral abnormalities, and less- frequent examinations (every 2 weeks) are recommended for infants without such abnormalities. Qualified neonatologists or radiologists performed the cranial ultrasonography.Cranial ultrasoundswere considered abnormal if white matter damage (cystic periventricular leucomalacia, echodensities persisting for more than 14 days, or isolate ventricular dilatation) or severe intraventricular haemorrhage (grades III and IV) was observed.At 5 years ofage,children had a medical examination and a cognitive assessment with the Kaufman Assessment Battery for Children, and Mental Processing Composite (MPC) scores were recorded (standardized to a mean (SD) of 100). A child with either an MPC score less than 85, hearing loss of less than 70 dB, unilateral/ bilateral impaired vision, or ambulant/non-ambulant cerebral palsy was considered as having a disability. Moreover,teachers in Pays de Loire were questioned [4] on the development of the child at the end of nursery school,and the child was classed as having exhibited bad, normal or good school integration. Mothers who returned this school questionnaire were included in our study. Memory of neonatalhospitalization after 7 years was evaluated by a 40-minute phone interview using a questionnaire containing 11 items that were scored on a 5-point Likert scale, with either a temporal nuance such that the highest score indicated ‘always’ or ‘very often’,or an intensity nuance in which the highest score indicated ‘extremely’or ‘enormously’.Four items constituted the memory of emotionalfeeling score and explored emotion, anxiety,difficulties linked to the infant,and despondency. Seven items constituted the maternal satisfaction score and explored 2 dimensions: a relational Early Human Development 85 (2009) 791–793 ⁎ Corresponding author. E-mail address: sophie.denizot@chu-nantes.fr (D. Sophie). 0378-3782/$ – see front matter © 2009 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.earlhumdev.2009.10.009 Contents lists available at ScienceDirect Early Human Development j o u r n a l h o m e p a g e : w w w. e l s ev i e r. c o m / l o c a t e / e a r l h u m d ev