Impact of preterm birth on maternal well-being and women's perceptions of their baby: a population-based survey

Jane Henderson, Claire Carson, Maggie Redshaw, Jane Henderson, Claire Carson, Maggie Redshaw

Abstract

Background: Approximately 15 million babies were born preterm worldwide in 2010 and in England in 2014 there were 52 249 preterm births. Preterm babies are at increased risk of poor outcomes and this can put enormous strain on the family.

Objective: This study aimed to test the hypothesis that giving birth preterm affects maternal health, mood and well-being, and alters women's feelings and perceptions about their baby.

Methods: Data collected in a population-based survey of maternity care in England in 2014 were used. Women were randomly selected and asked about their pregnancy, birth and postnatal experience when their babies were about 3 months of age. Descriptive statistics were produced, and logistic regression used to estimate ORs, adjusted for key confounders.Main outcome measures-Women's self-reported postnatal health, Edinburgh Postnatal Depression Scale, women's perceptions of their baby.

Results: 4578 women returned completed questionnaires. Of these, 42 (0.9%) had babies born before 32 weeks' gestation and 243 (5.5%) at 32-36 weeks. Comparing the three gestational age groups, no statistically significant differences in rates of depressive symptoms measured on the Edinburgh Postnatal Depression Scale were found. However, using a health problems checklist, anxiety, fatigue and flash-backs were more common in mothers of preterm babies. Overall, mothers of preterm babies had less early contact with their baby, more postnatal health problems, substantially less positive feelings towards their baby and made less use of the support options available.

Conclusions: Women with preterm births are at increased risk of ill-health and negative feelings about their baby in the early months after birth. They make less use of postnatal services and support than other women and this may be an area where the use of specialist services would be appropriate.

Keywords: anxiety; maternal health; perceptions; postnatal health; preterm birth.

Conflict of interest statement

Conflicts of Interest: None declared.

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

References

    1. Office for National Statistics. Birth characteristics in England and Wales, 2014. Table 7 2015.
    1. McCormick MC, Litt JS, Smith VC et al. . Prematurity: an overview and public health implications. Annu Rev Public Health 2011;32:367–79. 10.1146/annurev-publhealth-090810-182459
    1. Lasiuk GC, Comeau T, Newburn-Cook C. Unexpected: an interpretive description of parental traumas’ associated with preterm birth. BMC Pregnancy Childbirth 2013;13(Suppl 1):S13 10.1186/1471-2393-13-S1-S13
    1. Robinson M, Israel C, Parker D et al. . Randomised trial of parental support for families with very preterm children. Arch Dis Child Fetal Neonatal Ed 1998;79:F4–F11. 10.1136/fn.79.1.F4
    1. Johnson S, Ring W, Anderson P et al. . Randomised trial of parental support for families with very preterm children: outcome at 5 years. Arch Dis Child 2005;90:909–15. 10.1136/adc.2004.057620
    1. Franck LS, Cox S, Allen A et al. . Measuring neonatal intensive care unit-related parental stress. J Adv Nurs 2005;49:608–15. 10.1111/j.1365-2648.2004.03336.x
    1. Muller-Nix C, Forcada-Guex M, Pierrehumbert B et al. . Prematurity, maternal stress and mother-child interactions. Early Hum Dev 2004;79:145–58. 10.1016/j.earlhumdev.2004.05.002
    1. Vigod SN, Villegas L, Dennis CL et al. . Prevalence and risk factors for postpartum depression among women with preterm and low-birth-weight infants: a systematic review. BJOG 2010;117:540–50. 10.1111/j.1471-0528.2009.02493.x
    1. Treyvaud K, Lee KJ, Doyle LW et al. . Very preterm birth influences parental mental health and family outcomes seven years after birth. J Pediatr 2014;164:515–21. 10.1016/j.jpeds.2013.11.001
    1. Gray PH, Edwards DM, O'Callaghan MJ et al. . Parenting stress in mothers of very preterm infants—influence of development, temperament and maternal depression. Early Hum Dev 2013;89:625–9. 10.1016/j.earlhumdev.2013.04.005
    1. Eiser C, Eiser JR, Mayhew AG et al. . Parenting the premature infant: balancing vulnerability and quality of life. J Child Psychol Psychiatry 2005;46:1169–77. 10.1111/j.1469-7610.2005.00415.x
    1. Treyvaud K, Ure A, Doyle LW et al. . Psychiatric outcomes at age seven for very preterm children: rates and predictors. J Child Psychol Psychiatry 2013;54:772–9. 10.1111/jcpp.12040
    1. Carson C, Redshaw M, Gray R et al. . Risk of psychological distress in parents of preterm children in the first year: evidence from the UK Millennium Cohort Study. BMJ Open 2015;5:e007942 10.1136/bmjopen-2015-007942
    1. Redshaw M, Henderson J. Safely delivered: a national survey of women's experience of maternity care 2014. Oxford: NPEU, 2014.
    1. Green JM, Coupland VA, Kitzinger JV. Expectations, experiences, and psychological outcomes of childbirth: a prospective study of 825 women. Birth 1990;17:15–24. 10.1111/j.1523-536X.1990.tb00004.x
    1. Padden T, Glenn S. Maternal experiences of preterm birth and neonatal intensive care. J Reprod Infant Psychol 1997;15:121–39. 10.1080/02646839708404539
    1. Nicolaou M, Rosewell R, Marlow N et al. . Mothers’ experiences of interacting with their premature infants. J Reprod Infant Psychol 2009;27:182–94. 10.1080/02646830801922796
    1. Evans J, Heron J, Francomb H et al. . Cohort study of depressed mood during pregnancy and after childbirth. BMJ 2001;323:257–60. 10.1136/bmj.323.7307.257
    1. Evans J, Melotti R, Heron J et al. . The timing of maternal depressive symptoms and child cognitive development: a longitudinal study. J Child Psychol Psychiatry 2012;53:632–40. 10.1111/j.1469-7610.2011.02513.x
    1. Wolf MJ, Koldewijn K, Beelen A et al. . Neurobehavioral and developmental profile of very low birthweight preterm infants in early infancy. Acta Paediatr 2002;91:930–8. 10.1111/j.1651-2227.2002.tb02858.x
    1. Brazelton TB, Nugent JK. The neonatal behavioural assessment scale. 4th edn Cambridge: MacKeith Press, 2011.
    1. Redshaw ME, Harris A. Maternal perceptions of neonatal care. Acta Paediatr 1995;84:593–8. 10.1111/j.1651-2227.1995.tb13705.x
    1. Stern DN. The first relationship: Infant and mother. 2nd edn Cambridge, MA: Harvard University Press, 2004.
    1. Nugent KJ, Keefer CH, Minear S et al. . Understanding Newborn Behavior and early relationships: the newborn behavioral observations (NBO) system handbook. Baltimore: Brookes Publishing Company, 2007.
    1. Redshaw M, Heikkila K. Delivered with care: a national survey of women's experience of maternity care 2010. Oxford: NPEU, 2010.
    1. Care Quality Commission. National findings from the 2013 survey of women's experiences of maternity care. London: CQC, 2013.
    1. Leigh B, Milgrom J. Risk factors for antenatal depression, postnatal depression and parenting stress. BMC Psychiatry 2008;8:24 10.1186/1471-244X-8-24
    1. Bat-Erdene U, Metcalfe A, McDonald SW et al. . Validation of Canadian mothers’ recall of events in labour and delivery with electronic health records. BMC Pregnancy Childbirth 2013;13(Suppl 1):S3 10.1186/1471-2393-13-S1-S3
    1. Quigley MA, Hockley C, Davidson LL. Agreement between hospital records and maternal recall of mode of delivery: evidence from 12 391 deliveries in the UK Millennium Cohort Study. BJOG 2007;114:195–200. 10.1111/j.1471-0528.2006.01203.x
    1. Poulsen G, Kurinczuk JJ, Wolke D et al. . Accurate reporting of expected delivery date by mothers 9 months after birth. J Clin Epidemiol 2011;64:1444–50. 10.1016/j.jclinepi.2011.03.007
    1. Treyvaud K. Parent and family outcomes following very preterm or very low birth weight birth: a review. Semin Fetal Neonatal Med 2014;19:131–5. 10.1016/j.siny.2013.10.008

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