title: Delivering a very low birth weight infant and the subsequent risk of divorce or separation.
abstract: BACKGROUND
  The simultaneous rise over the last two decades in the U.S. in the proportion of VLBW (<1500 grams) deliveries and the improvement in their chance of survival has increased the number of families caring for VLBW infants and children. The families of VLBW infants with adverse outcomes can face psychological and monetary stresses, which in turn may influence marital instability and increase the risk of divorce or separation. The purpose of this paper is to identify the relationship of having a VLBW birth with the probability of divorce or separation in the first two years following delivery.
  
  
  METHODS
  We use data from the 1988 National Maternal and Infant Health Survey (NMIHS). This national stratified, systematic "follow-back" survey augments information from birth records in 1988 by obtaining information on social, demographic, and economic variables from women that delivered a baby in 1988. We estimate a proportional discrete time hazard model of transitions to divorce/separation.
  
  
  RESULTS
  Parents of a VLBW infant have 2-fold higher odds of divorce/separation compared with parents of a child with a birth weight greater than 1500 grams. Two years after delivery of a non-VLBW baby 95 percent of the marriages remain stable, while about 90 percent of the marriages remain stable following the birth of a VLBW baby. If the pregnancy was not desired, then only 85 percent of the marriages remain stable 2 years following the delivery of a VLBW infant.
  
  
  CONCLUSIONS
  There is an evident need to counsel and support families with VLBW infants on mechanisms to cope with the initial stressors that can be anticipated to arise.
authors.affiliation: Department of Maternal and Child Health, School of Public Health, University of Alabama at Birmingham, 320-A Ryals Building, 1665 University Boulevard, Birmingham, Alabama 35294-0022, USA. SSwaminathan@ms.soph.uab.edu
authors.forename: Shailender
authors.initials: S
authors.lastname: Swaminathan
authors.forename: Greg R
authors.initials: GR
authors.lastname: Alexander
authors.forename: Sheree
authors.initials: S
authors.lastname: Boulet
mesh_terms: D000293:Adolescent; D000328:Adult; D002658:Developmental Disabilities; D004243:Divorce / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D006306:Health Surveys; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000191:economics; D011275:Pregnancy, Unwanted / Q000523:psychology; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000191:economics; D014481:United States