title: Health-related quality of life of mothers of very low birth weight children at the age of five: results from the Newborn Lung Project Statewide Cohort Study.
abstract: OBJECTIVE
  This study aimed to determine the health-related quality of life (HRQoL) in mothers of 5-year-old very low birth weight (VLBW) and normal birth weight (NBW) children, with a focus on the role of stress.
  
  
  METHODS
  This cohort study is ancillary to the Newborn Lung Project. A telephone interview collected information on symptoms of stress and HRQoL from 297 mothers of VLBW children and 290 mothers of NBW children who were enrolled in the Newborn Lung Project Statewide Cohort Study. Staged multiple regression analyses were used to evaluate the relationship between caregiver status and maternal HRQoL and the role stress played in this relationship. Additional multiple regression analyses were also used to evaluate the correlates of poor maternal HRQoL among VLBW mothers.
  
  
  RESULTS
  Mothers of VLBW children experienced worse physical and mental HRQoL than mothers of NBW children. Adjusted analyses showed that physical HRQoL was significantly different between these mothers (β: -1.87, P = 0.001); this relationship was attenuated by maternal stress. Among the mothers of VLBW children, stress significantly contributed to adverse HRQoL outcomes when children were aged five. Child behavior problems at the age of two were also associated with worse subsequent maternal mental HRQoL (β: -0.18, P = 0.004), while each week of neonatal intensive care unit stay was associated with worse physical HRQoL (β: -0.26, P = 0.02).
  
  
  CONCLUSIONS
  Caring for a VLBW child is negatively associated with the HRQoL of mothers; this relationship might be, in part, explained by maternal stress. Addressing maternal stress may be an important way to improve long-term HRQoL.
authors.affiliation: Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, 610 North Walnut Street, Office 503, Madison, WI 53726, USA. wwitt@wisc.edu
authors.forename: Whitney P
authors.initials: WP
authors.lastname: Witt
authors.forename: Kristin
authors.initials: K
authors.lastname: Litzelman
authors.forename: Hilary A
authors.initials: HA
authors.lastname: Spear
authors.forename: Lauren E
authors.initials: LE
authors.lastname: Wisk
authors.forename: Nataliya
authors.initials: N
authors.lastname: Levin
authors.forename: Beth M
authors.initials: BM
authors.lastname: McManus
authors.forename: Mari
authors.initials: M
authors.lastname: Palta
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000367:Age Factors; D001034:Apgar Score; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight / Q000523:psychology*; D008297:Male; D008429:Maternal Welfare / Q000523:psychology*; D009035:Mothers / Q000523:psychology*; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology*; D012044:Regression Analysis; D013223:Statistics as Topic; D013315:Stress, Psychological; D013997:Time Factors; D014922:Wisconsin