Effect of maternal psychopathology on neurodevelopmental outcome and quality of the dyadic relationship in preterm infants: an explorative study

Abstract

Background: The literature shows that parents of preterm infants are at risk of psychological distress and that this may impact on the quality of the parent–child relationship and on the child’s development.

Aim: This longitudinal study was conducted to examine in preterm infants relationships between maternal psychological variables, parental protective factors, perinatal infant variables, and neurodevelopmental outcome. Furthermore, we explored the impact of these variables on the quality of the mother–infant relationship (dyadic synchrony).

Subjects and methods: A total of 29 preterm infants (GA < 34 weeks) and their mothers were evaluated twice: at t₀, during the infant’s hospitalization in the neonatal intensive care unit (NICU), and at 12 months of infant corrected age (t2).

Results: With the exception of decreases in anxiety and perceived social support and an increase in the rate of severe depression at follow-up, there were no significant changes between t₀ and t₁ assessments. The infant’s perinatal risk status was the variable that impacted most on maternal psychopathology. Furthermore, our data revealed that baseline maternal stress related to the appearance of the child and to the mother’s perception of her parenting role represent a risk factor in relation to developmental outcome at 12 months of corrected age. Finally, no correlations emerged between dyadic synchrony and infant perinatal data, maternal psychological variables (at t₀ and at t₁), or child developmental outcome at t₁.

Conclusions: Our results underline the need to identify negative maternal affective states early in the mother–child relationship and to provide mothers with adequate support in the NICU, to enhance their parental role.

Keywords:

• Motherhood
• neurodevelopmental outcome
• preterm birth
• stress

Acknowledgments

The authors thank Andrea Landini and Francesca Nuccini for their supervision and help in coding the CARE-Index for the quality of parent–child interaction.

The authors particularly thank Catherine Wrenn for her help in translating and revising this manuscript.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

All phases of this study were supported by grants of the Italian Ministry of Health RC 2010–2017 to Fondazione IRCCS Policlinico San Matteo, Pavia, Italy and by grants of the Italian Ministry of Health RC 2013–2016 to C. Mondino National Neurological Institute, Pavia, Italy. No external funding was secured for this study.