Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Parental perception of child vulnerability among mothers of very low birth weight infants: psychological predictors and neurodevelopmental sequelae at 2 years

Journal of Perinatology volume 37, pages 454–460 (2017)Cite this article

Subjects

Abstract

Objective:

The objective of this study was to examine the impact of maternal psychological distress on the development of parental perception of child vulnerability (PPCV) in mothers of very low birth weight (VLBW) infants; and to examine the impact of PPCV on neurodevelopmental outcome in VLBW infants in the second year of life.

Study Design:

This is a prospective study of 69 mothers and their VLBW infants recruited from 2011 to 2012 for whom maternal psychological data were collected during the neonatal intensive care unit (NICU) hospitalization. Maternal PPCV was assessed at 4 months corrected age (CA). Neurodevelopmental outcome was assessed at 20 months CA. Regression analyses modeled the development of PPCV and the impact of PPCV on neurodevelopmental outcome.

Results:

PPCV at 4 months CA was predicted by maternal anxiety and history of previous fetal loss reported during the NICU stay. Higher PPCV at 4 months CA was associated with lower language scores at 20 months CA.

Conclusion:

Targeted interventions aimed at reducing PPCV in the NICU are supported.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. Forsyth BWC, Horwitz SM, Leventhal JM, Burger J . The Child Vulnerability Scale: an instrument to measure parental perceptions of child vulnerability. J Pediatr Psychol 1996; 21 (1): 89–101.

    Article  CAS  PubMed  Google Scholar 

  2. Chambers PL, Mahabee-Gittens EM, Leonard AC . Vulnerable child syndrome, parental perception of child vulnerability, and emergency department usage. Pediatr Emerg Care 2011; 11: 10009–10013.

    Google Scholar 

  3. Tallandini MA, Morsan V, Gronchi G, Macagno F . Systematic and meta-analytic review: triggering agents of parental perception of child’s vulnerability in instances of preterm birth. J Pediatr Psychol 2015; 40 (6): 545–553.

    Article  PubMed  Google Scholar 

  4. Horwitz SM, Storger-Issner A, Kerker BD, Lilo E, Leibovitz A St, John N et al. A model for the development of mothers’ perceived vulnerability of preterm infants. J Dev Behav Pediatr 2015; 36: 371–380.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Estroff D, Yando R, Burke K, Snyder D . Perceptions of vulnerability by mothers who had delivered preterm. J Pediatr Psychol 1994; 19 (6): 709–721.

    Article  CAS  PubMed  Google Scholar 

  6. De Ocampo AC, Macias MM, Saylor CF, Katikaneni LD . Caretaker perception of child vulnerability predicts behavior problems in NICU graduates. Child Psychiatry Hum Dev 2003; 34 (2): 83–96.

    Article  PubMed  Google Scholar 

  7. Greene MM, Rossman B, Patra K, Kratovil A, Janes J, Meier PP . Depressive, anxious and perinatal post-traumatic distress in mothers of very low birth weight infants. J Dev Behav Pediatr 2015; 36 (5): 362–370.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Centers for Disease Control and Prevention. CDC Health Disparities and Inequalities Report-United States-2013. CDC Morbidity and Mortality Weekly Report. 2013; Supplement Volume 62:3.

  9. Bonanno GA, Westphal M, Anthony D, Mancini AD . Resilience to loss and potential trauma. Ann Rev Clin Psych 2011; 7: 511–535.

    Article  Google Scholar 

  10. Holditch-Davis D, Santos H, Levy J et al. Patterns of psychological distress in mothers of preterm infants. Inf Behav Dev 2015; 41: 154–163.

    Article  Google Scholar 

  11. Kim WJ, Lee E, Namkoong K, Park ES, Rha D-w . Progress of PTSD symptoms following birth: a prospective study in mothers of high-risk infants. J Perinatol 2015; 35 (8): 575–579.

    Article  CAS  PubMed  Google Scholar 

  12. Allen EC, Manuel JC, Legault C, Naughton MJ, Pivor C, O’Shea TM . Perception of child vulnerability among mothers of former premature infants. Pediatrics 2004; 113 (2): 267–273.

    Article  PubMed  Google Scholar 

  13. Stephens BE, Vohr BR . Neurodevelopmental outcome of the premature infant. Pediatr Clin North Am 2009; 56 (3): 631–646.

    Article  PubMed  Google Scholar 

  14. Lewit EM, Baker LS, Corman H, Shiono PH . The direct cost of low birth weight. Future Child 1995; 5 (1): 35–56.

    Article  CAS  PubMed  Google Scholar 

  15. Rossman B, Greene MM, Meier PP . The role of peer support in the development of maternal identity for ‘NICU Mom.’. J Obstet Gynecol Neonatal Nurs 2015; 44 (1): 3–16.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Rossman B, Kratovil AL, Greene MM, Engstrom JL, Meier PP . ‘I have faith in my milk’: the meaning of milk for mothers of very low birth weight infants hospitalized in the neonatal intensive care unit. J Hum Lact 2013; 29 (3): 359–365.

    Article  PubMed  Google Scholar 

  17. Bell MJ, Ternberg JL, Feigin RD, Keating JP, Marshall R, Barton L et al. Neonatal necrotizing enterocolitis. Therapeutic decisions based upon clinical staging. Ann Surg 1979; 187 (1): 1–7.

    Article  Google Scholar 

  18. Bigger HR, Fogg LJ, Patel A, Johnson T, Engstrom JL, Meier PP . Quality indicators for human milk use in very low-birthweight infants: are we measuring what we should be measuring? J Perinatol 2014; 34 (4): 287–291.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Radloff L . The CES-D scale: a self-report depression scale for research in the general population. Appl Psych Meas 1977; 1: 385–401.

    Article  Google Scholar 

  20. Spielberger CD, Gorsuch R, Lushene R, Vagg R, Jacobs GA . State-Trait Anxiety Inventory for Adults: Manual. Consulting Psychologists Press: Palo Alto, CA, USA, 1983.

    Google Scholar 

  21. Rogers CE, Kidokoro H, Wallendorf W et al. Identifying mothers of very preterm infants at-risk for postpartum depression and anxiety prior to discharge. J Perinatol 2013; 33: 171–176.

    Article  CAS  PubMed  Google Scholar 

  22. DeMier RI, Hynan MT, Harris HB et al. Perinatal stressors as predictors of symptoms of posttraumatic stress in mothers of infants at high risk. J Perinatol 1996; 16: 276–280.

    CAS  PubMed  Google Scholar 

  23. Callahan JL, Borja SE, Hynan MT . Modification of the Perinatal PTSD Questionnaire to enhance clinical utility. J Perinatol 2006; 26: 533–539.

    Article  CAS  PubMed  Google Scholar 

  24. Gray MJ, Litz BT, Hsu JL, Lombardo TW . Psychometric properties of the life events checklist. Assessment 2004; 11: 330–341.

    Article  PubMed  Google Scholar 

  25. Perrin EC, West PD, Culley B . Is my child normal yet? Correlates of vulnerability. Pediatrics 1989; 83 (3): 355–363.

    CAS  PubMed  Google Scholar 

  26. Bayley N . Bayley Scales of Infant Development. Third edition. The Psychological Corporation: San Antonio, TX, USA, 2006.

    Google Scholar 

  27. Green M, Solnit AJ . Reactions to the threatened loss of a child: a vulnerable child syndrome. Pediatrics 1964; 34: 58–66.

    CAS  PubMed  Google Scholar 

  28. Patra K, Greene MM, Patel AL, Meier P . Maternal education level predicts cognitive, language and motor outcome in preterm infants in the second year of life. Am J Perinatol 2016; 33 (8): 738–744.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Van IJzendoorn MH, Dijkstra J, Bus AG . Attachment, intelligence and language: a meta-analysis. Soc Dev 1995; 4: 115–128.

    Article  Google Scholar 

Download references

Acknowledgements

This project was partially funded by NR010009 awarded to PM, principal investigator and from an internal grant from Rush University Medical Center’s Departments of Adult Health and Gerontologic Nursing and Women, Children, and Family Nursing awarded to MG and BR.

Author information

Authors and Affiliations

  1. Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA

    M M Greene

  2. College of Nursing, Rush University Medical Center, Chicago, IL, USA

    B Rossman & P Meier

  3. Department of Pediatrics, Rush University Medical Center, Chicago, IL, USA

    K Patra

Authors
  1. M M Greene
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. B Rossman
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. P Meier
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. K Patra
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M M Greene.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Greene, M., Rossman, B., Meier, P. et al. Parental perception of child vulnerability among mothers of very low birth weight infants: psychological predictors and neurodevelopmental sequelae at 2 years. J Perinatol 37, 454–460 (2017). https://doi.org/10.1038/jp.2016.197

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/jp.2016.197

This article is cited by

Search

Advanced search

Quick links