title: Influence of older primiparity on childbirth, parenting stress, and mother-child interaction.
abstract: OBJECTIVE
  Delivery at 35 years and above has increased in Japan. While there is much research concerning obstetrical risk and delivery at advanced age, little research addresses child-rearing after birth. This study seeks to identify how older primiparas' characteristics of child-rearing, parenting stress, and mother-child interaction differ from those of younger mothers.
  
  
  METHODS
  Participants were primipara women aged 35 years and above and primiparas aged 20-29 years; all delivered in the hospital. Questionnaires were distributed during hospitalization after birth and during home visits at 3 months, 1 year, and 2 years post-partum. Mother-child interactions during home visits were assessed using the Nursing Child Assessment Teaching Scale (NCATS).
  
  
  RESULTS
  The older group included 13 primiparas, and the control group included seven primiparas at the study's end. Some older primiparas used fertility treatment and cesarean section, but primiparas in their 20s used neither. There were no significant differences in terms of depression, psychological health, size of networks, and number of daytime or night-time feedings. Statistically significant differences were as follows. Older primiparas experienced more social isolation and overall stress, and their children exhibited greater hypersensitivity/lack of adaptability at 3 months. Older mothers were more likely to report little effort by their children to please them at 1 and 2 years after birth. Under observation, older primiparas received higher NCATS caregiver scores, but children of primiparas in their 20s received higher child scores.
  
  
  CONCLUSIONS
  Mothers and child-care specialists should recognize that older primiparas interact more favorably with their children, but have more parenting stress.
authors.affiliation: Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan.
authors.forename: Mami
authors.initials: M
authors.lastname: Sonobe
authors.affiliation: Teikyo Heisei University, Tokyo, Japan.
authors.forename: Masami
authors.initials: M
authors.lastname: Usui
authors.affiliation: Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Kayoko
authors.initials: K
authors.lastname: Hiroi
authors.affiliation: Department of Nursing, School of Health and Social Service, Saitama Prefectural University, Koshigaya, Japan.
authors.forename: Hiromi
authors.initials: H
authors.lastname: Asai
authors.affiliation: Sophia School of Social Welfare, Koshigaya, Japan.
authors.forename: Mayumi
authors.initials: M
authors.lastname: Hiramatsu
authors.affiliation: Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan.
authors.forename: Yasutoshi
authors.initials: Y
authors.lastname: Nekoda
authors.affiliation: Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Taiko
authors.initials: T
authors.lastname: Hirose
mesh_terms: D002648:Child; D005260:Female; D006801:Humans; D009034:Mother-Child Relations; D010290:Parents / Q000523:psychology*; D010298:Parity; D011446:Prospective Studies; D013315:Stress, Psychological
keywords: childbirth; mental health; mother-child interaction; older primipara; parenting stress