title: Stress in parents of children born very preterm is predicted by child externalising behaviour and parent coping at age 7 years.
abstract: OBJECTIVE
  To examine factors which predict parenting stress in a longitudinal cohort of children born very preterm, and seen at age 7 years.
  
  
  METHODS
  We recruited 100 very preterm (≤32 weeks gestational age) child-parent dyads and a control group of 50 term-born dyads born between 2001 and 2004 with follow-up at 7 years. Parents completed the Parenting Stress Index, Ways of Coping Questionnaire, Child Behavior Check List, Beck Depression Inventory and the State Trait Anxiety Inventory questionnaires. Child IQ was assessed using the Wechsler Intelligence Scale-IV.
  
  
  RESULTS
  After controlling for maternal education, parents of preterm children (95% CI 111.1 to 121.4) scored higher (p=0.027) on the Parenting Stress Index than term-born controls (95% CI 97.8 to 113.2). Regression analyses showed that child externalising behaviour, sex and parent escape/avoidance coping style, predicted higher parenting stress in the preterm group. Parents of preterm girls expressed higher levels of stress than those of boys.
  
  
  CONCLUSIONS
  Maladaptive coping strategies contribute to greater stress in parents of very preterm children. Our findings suggest that these parents need support for many years after birth of a very preterm infant.
authors.affiliation: School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Linden
authors.affiliation: Department of Developmental Neurosciences & Child Health, Child & Family Research Institute, Vancouver, British Columbia, Canada.
authors.forename: Ivan L
authors.initials: IL
authors.lastname: Cepeda
authors.affiliation: Department of Developmental Neurosciences & Child Health, Child & Family Research Institute, Vancouver, British Columbia, Canada Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Anne
authors.initials: A
authors.lastname: Synnes
authors.affiliation: School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK Department of Developmental Neurosciences & Child Health, Child & Family Research Institute, Vancouver, British Columbia, Canada Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Ruth E
authors.initials: RE
authors.lastname: Grunau
mesh_terms: D000223:Adaptation, Psychological; D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis*; D005260:Female; D005865:Gestational Age; D006801:Humans; D062071:Infant, Extremely Premature; D008137:Longitudinal Studies; D008297:Male; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D013315:Stress, Psychological / Q000175:diagnosis*; D011795:Surveys and Questionnaires
keywords: Child Psychology; Outcomes research; Psychology