Parental protection of extremely low birth weight children at age 8 years.
OBJECTIVE
To examine parent protection and its correlates among 8-year-old ELBW children compared with normal birth weight (NBW) controls.


METHODS
The population included 217 eight-year-old ELBW children born 1992-1995 (92% of the surviving birth cohort; mean birth weight, 811 g; mean gestational age, 26.4 weeks) and 176 NBW controls. The primary outcome measure, the Parent Protection Scale (PPS), included a total score and four domains including Supervision, Separation, Dependence, and Control. Multivariate analyses were performed to examine the predictors of parental protection and overprotection.


RESULTS
After adjusting for socioeconomic status (SES), race, sex, and age of the child, parents of ELBW children reported significantly higher mean total Parent Protection Scale scores (31.1 vs 29.7, p = .03) than parents of NBW children and higher scores on the subscale of Parent Control (8.0 vs 7.5, p = .04). These differences were not significant when the 36 children with neurosensory impairments were excluded. Parents of ELBW children also reported higher rates of overprotection than controls (10% vs 2%, p = .001), findings that remained significant even after excluding children with neurosensory impairments (8% vs 2%, p = .011). Multivariate analyses revealed lower SES to be associated with higher total Parent Protection Scale scores in both the ELBW (p < .001) and NBW (p < .05) groups. Additional correlates included neurosensory impairment (p < .05) and functional limitations (p < .001) in the ELBW group and black race (p < .05) and maternal depression (p < .01) in the NBW group. Lower child IQ was significantly associated with higher PPS scores only in the neurosensory impaired subgroup of ELBW children.


CONCLUSIONS
Longer term follow-up will be necessary to examine the effects of the increased parent protection on the development of autonomy and interpersonal relationships as the children enter adolescence.
Wightman
Aaron
A
Department of Pediatrics, Case Western Reserve University, Cleveland, OH, USA.
Schluchter
Mark
M
Drotar
Dennis
D
Andreias
Laura
L
Taylor
H Gerry
HG
Klein
Nancy
N
Wilson-Costello
Deanne
D
Hack
Maureen
M
D002648:Child; D015331:Cohort Studies; D003710:Demography; D005260:Female; D006801:Humans; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D010287:Parent-Child Relations; D016487:Parenting; D010290:Parents; D011795:Surveys and Questionnaires