title: Severe congenital malformations, family functioning and parents' separation/divorce: a longitudinal study.
abstract: BACKGROUND
  We aim to explore the association of a severe congenital malformation (SCM) with postnatal family functioning and parents' separation/divorce and to examine if this association might be moderated by birth order of the child and parental level of education. SCM refers to malformations that, without medical intervention, cause handicap or death.
  
  
  METHODS
  Using the Quebec Longitudinal Study of Child Development, an ongoing population-based birth cohort study initiated in 1998, we compared 1675 families of children with and without a SCM to identify if having a child with a SCM was associated with maternal perception of family functioning. We examined if an SCM was associated with parents' separation and examined parents' education level and birth order of the children to evaluate whether these factors had any moderating effect on the results.
  
  
  RESULTS
  There were no significant differences in family functioning between families with and without a SCM child at 5 and 17 months. At 5 months, family functioning was significantly better (P = 0.03) for families with a SCM firstborn child than for families with a SCM child that is not firstborn. For parental separation, no significant differences were observed at 5 and 29 months and 4 years. No significant moderating effects were observed for birth order and parental education on parental separation.
  
  
  CONCLUSIONS
  Families of children with a SCM do not appear to be at higher risk of family dysfunction within the first 17 months after birth nor of parental separation within the first 4 years after birth. Family functioning tends to be worst in families where the child with SCM is the second or subsequent child born.
authors.affiliation: School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin, Ireland.
authors.forename: M
authors.initials: M
authors.lastname: Brenner
authors.affiliation: School of Public Health, University of Montreal, Montreal, Canada.|Institute of Genetic, Neurobiological and Social Foundations of Child Development, Tomsk State University, Tomsk, Russian Federation.
authors.forename: S M
authors.initials: SM
authors.lastname: Côté
authors.affiliation: School of Psychology, Laval University, Québec, Canada.|Institute of Genetic, Neurobiological and Social Foundations of Child Development, Tomsk State University, Tomsk, Russian Federation.
authors.forename: M
authors.initials: M
authors.lastname: Boivin
authors.affiliation: Institute of Genetic, Neurobiological and Social Foundations of Child Development, Tomsk State University, Tomsk, Russian Federation.|School of Public Health, Physiotherapy and Population Science, University College Dublin, Dublin, Ireland.|Departments of Pediatrics and Psychology, University of Montreal, Montreal, Canada.
authors.forename: R E
authors.initials: RE
authors.lastname: Tremblay
mesh_terms: D000293:Adolescent; D000328:Adult; D001722:Birth Order; D002648:Child; D002657:Child Development; D002675:Child, Preschool; D000013:Congenital Abnormalities / Q000453:epidemiology / Q000523:psychology*; D004243:Divorce / Q000523:psychology / Q000706:statistics & numerical data; D004522:Educational Status; D005195:Family Relations / Q000523:psychology; D005260:Female; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D008393:Marriage / Q000523:psychology / Q000706:statistics & numerical data; D011792:Quebec / Q000453:epidemiology; D012944:Social Support; D013315:Stress, Psychological / Q000453:epidemiology / Q000523:psychology*
keywords: congenital malformation; family relationship; longitudinal study