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Parenting Stress and Development of Late Preterm Infants at 4 Months

Corrected Age

Article  in  Research in Nursing & Health · July 2017

DOI: 10.1002/nur.21809

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DOI: 10.1002/nur.21809

RESEARCH ARTICLE

Parenting stress and development of late preterm infants at

4 months corrected age

Muhammad K. Mughal1 | Carla S. Ginn1 | Joyce Magill-Evans2 |

Karen M. Benzies RN, PhD3

1 University of Calgary, Calgary, AB, Canada

2 Department of Occupational Therapy,
University of Alberta, Edmonton, Alberta,
Canada
3 Faculty of Nursing, Department of
Paediatrics, University of Calgary, Calgary,
Alberta, Canada,
Correspondence
Prof. Karen M. Benzies, RN, PhD, Faculty of
Nursing, Department of Paediatrics,
University of Calgary, 2500 University
Dr. N.W., Calgary, Alberta T2N 1N4, Canada
Email: benzies@ucalgary.ca
Funding information
Alberta Innovates (formerly Alberta Heritage
Foundation for Medical Research)
ABSTRACT
Parenting stress has been linked to child development issues in early preterm infants, but
less is known about its effects on development in infants born late preterm. We
examined relationships between parenting stress of 108 mothers and 108 fathers and
development of late preterm infants born at 34 0/7 to 36 6/7 weeks gestation. At
4 months corrected age, mothers and fathers completed the Parenting Stress Index (PSI-
3); mothers were primary caregivers in almost all families and completed the Ages and
Stages Questionnaire (ASQ-2) on child development. Mothers reported significantly
more stress than fathers on the PSI-3 Parent Domain. PSI-3 subscale scores from the
Child Domain were significant predictors of mother-reported infant development as
measured by the ASQ-2 in regression models: Reinforces Parent predicted Gross Motor,
Mood predicted Communication, and Acceptability predicted Communication, Fine
Motor, Problem Solving, and Personal-Social development scale scores. Experiences of
parenting stress differed for mothers and fathers. Further research is required on
specific dimensions of parenting stress related to development of late preterm infants.

KEYWORDS
birth, developmental stages/events, emotional states/feelings, health promotion/weIlness
behaviors, stress and coping, stress management

1 | INTRODUCTION
In Canada, 7.7% of children are born preterm (Public Health Agency of
Canada, 2013); of these, 75% are born late preterm, between 34 weeks
and 0 days and 36 weeks and 6 days gestation (Ananth, Friedman, &
Gyamfi-Bannerman, 2013; Engle, 2006; Engle, Tomashek, Wallman, &
Committee on Fetus and Newborn, 2007). Systematic reviews suggest
that compared to their fullterm counterparts, late preterm infants have
a greater risk of short-term morbidity (McGowan, Alderdice, Holmes, &
Johnston, 2011; Samra, McGrath, & Wehbe, 2011; Teune et al., 2011).
During the birth hospitalization, late preterm infants have greater risk
of respiratory distress syndrome, apnea, feeding difficulties, hypoglyce-
mia, hyperbilirubinemia, sepsis, and intraventricular hemorrhage (Teune
et al., 2011), which may be attributed to physiological immaturity of the
major organ systems (Sahni & Polin, 2013). Neurological immaturity is
associated with the lack of opportunity for the exponential intra-uterine
brain growth and development that occurs in the last 6 to 8 weeks of
gestation (Baron, Litman, Ahronovich, & Baker, 2012). Compared to their
fullterm counterparts, late preterm infants have lower volumes of gray
matter (Munakata et al., 2013) and demonstrate less synchrony and
responsiveness in parent-child interactions (Ludwig, 2007). Similarly, late
preterm infants have less sustained periods of alertness, less vocalizing
and eye contact, more disorganized sleep-awake cycles, lower levels of
arousal while awake, and fatigue more quickly than term infants (Barratt,
Roach, & Leavitt, 1992). Males born late preterm have increased risk for
neurodevelopmental delay, later school achievement, and other long-
term outcomes than females born late preterm (Boyle et al., 2011; Rose &
Engle, 2017). Infants of lower gestational age at birth have greater risk of

Res Nurs Health. 2017;1–10. wileyonlinelibrary.com/journal/nur © 2017 Wiley Periodicals, Inc. | 1

2 |
complications than those of higher gestational age at birth (Potijk, de
Winter, Bos, Kerstjens, & Reijneveld, 2015).
In addition, parental age (Sutcliffe, Barnes, Belsky, Gardiner, &
Melhuish, 2012), and education (Bornstein, Putnick, Suwalsky, & Gini,
2006) can affect late preterm infant development. Mothers of late
preterm infants can experience breastfeeding difficulties (Nagulesapillai,
McDonald, Fenton, Mercader, & Tough, 2013), which can subsequently
affect infant health and development and increase maternal distress
(Brandon et al., 2011). Parenting stress is one aspect of the family
environment associated with suboptimal outcomes for children (Coletti
et al., 2015) and may be particularly important for late preterm infants who
have greater risk of developmental delays. The aim of this study was to
examine specific dimensions of parenting stress associated with
development in late preterm infant at 4 months corrected age.
2 | P A R E N T I N G ST R E S S I N TE R M I N F A N T S
Parenting stress is multi-dimensional, can diminish parent-child
interactions, and negatively affect children’s social development
(Ashiabi & O’Neal, 2015), with mutually increasing effects (Neece,
Green, & Baker, 2012). Higher stress in the parent domain has been
linked to: (a) decreased sense of competence as a parent (Slagt, Deković,
de Haan, van den Akker, & Prinzie, 2012); (b) lack of social support from
family and friends (Hostinar & Gunnar, 2015); (c) lack of emotional
closeness to the child (Tharner et al., 2012); (d) inability to recognize
infant’s social cues (Landsem, Handegard, Tunby, Ulvund, & Ronning,
2014); (e) deteriorating parental health (Treyvaud et al., 2011); (f)
experiencing the parental role as restricting freedom and identity
(Hildingsson & Thomas, 2014); (g) depressive symptoms (Dunkel
Schetter & Tanner, 2012); and (h) lack of emotional and tangible
support for parenting from the other parent (Raby et al., 2015).
Higher parenting stress related to the child includes parental
perceptions of their child as: (a) distractible (Benzies, Harrison, & Magill-
Evans, 2004); (b) unable to adjust to changes in the environment (Dix & Yan,
2014); (c) displaying behaviors not positively reinforcing parenting (Slagt
et al., 2012); (d) placing many demands on the parent (Kim, Mayes, Feldman,
Leckman, & Swain, 2013); (e) unhappy or distressed (Rutherford, Goldberg,
Luyten, Bridgett, & Mayes, 2013); and (f) not meeting expectations the
parents had for their infant (Spinelli, Poehlmann, & Bolt, 2013).
3 | P A R E N T I N G ST R E S S AN D P R E T E R M
INFANTS
There is much literature regarding early preterm birth (less than 32 weeks
gestation) and parenting stress (Brett, Staniszewska, Newburn, Jones, &
Taylor, 2011; Muller-Nix et al., 2004; Singer, Salvator, Guo, Collin, Lilien, &
Baley, 1999; Treyvaud, 2014). However, late preterm infants are a
recently identified population (Engle, 2006), and it is unclear whether the
stress experienced by parents of early preterm infants can be extended to
parents of late preterm infants. Additionally, there is limited research
about the specific dimensions of parenting stress that affect development
in late preterm infants under 12 months of age (Coletti et al., 2015).
MUGHAL ET AL.
3.1 | Parenting stress in mothers and fathers of
preterm infants
Parenting stress may be manifested differently for mothers and fathers of
children born term and preterm, with different effects on child
development. In one study of parents of 37 children born at full term
and 25 children born at 30 to 36 weeks gestation (Benzies et al., 2004),
there was a positive relationship between maternal-reported parenting
stress related to children’s distractibility during infancy and conduct
disorder. That is, mothers who reported higher parenting stress related to
their infants’ distractibility reported more conduct disorder in their children
at age 7 years. In contrast, there was a negative relationship between
paternal-reported parenting stress related to children’s distractibility
during infancy and conduct disorder at age 7 years. The authors speculated
that fathers who were more involved with their infants experienced
greater parenting stress, and that this involvement diminished later
conduct disorder in their children. Other studies of fathers are limited by
low response rates and limited detail about the dimensions of parenting
stress that contributed to infant development (Wigfall, Brannen, Mooney,
& Parutis, 2013; Wong, Roubinov, Gonzales, Dumka, & Millsap, 2013).
The purpose of this study was to examine the relationships
between parenting stress in mothers and fathers who were
co-parenting their late preterm infants and child development at
4 months corrected age. Our research questions were:
1. Does parenting stress differ for mothers and fathers of late preterm
infants as measured by the Parenting Stress Index—Third Edition
(PSI-3) Parent and Child Domain scores?
2. What is the relationship between parenting stress as measured by
the PSI-3 Parent and Child Domain scores and subscale scores, and
infant development as measured by the Ages and Stages
Questionnaires—Second Edition (ASQ-2) Domain scores?
3. Which PSI-3 subscale scores predict child development on ASQ-2
Domains?
Bronfenbrenner’s (2005) bioecological model provided the
theoretical foundation for this study. Bronfenbrenner (1977) empha-
sized the need to study children and their families in their natural
settings, considering how they are affected by, and affect, their
environment through interconnected systems during transitions
across the lifespan. As such, child development is considered a
dynamic process of reciprocal interactions between the child and
parents at the microsystem level (Bronfenbrenner, 2005). Parenting
stress can influence these interactions and ultimately influence child
development.
4 | METHO D
4.1 | Participants
This cross-sectional study was a secondary analysis of baseline data
from a randomized controlled trial (RCT) testing an intervention to
improve the quality of fathers’ interactions with their late preterm
MUGHAL ET AL.
infants (Benzies et al., 2013). The study was approved by two Health
Research Ethics Boards (ID E-21846 and Pro00016692).
The RCT had three groups: (a) a two-home-visit intervention
group; (b) a four-home-visit intervention group; and (c) a comparison
group receiving one home visit with information only. The intervention
consisted of video self-modelling of father-child interactions, with
immediate feedback from trained research assistants regarding
behaviors that fostered child development. For fathers in the two-
home-visit group, interventions occurred when the infant was 4 and 6
months old; for the four-home-visit group, interventions occurred at 4,
5, 6, and 7 months. Fathers in the comparison group were video-
recorded interacting with their infant at age 4 months, with no viewing
of the recording or feedback. In overall intervention results, compared
with those in the comparison group, fathers who received either
intervention (two or four visits) had improved interactions with their
infants.
Inclusion criteria were: (a) first-time, biological parent of a healthy,
singleton, late preterm infant; (b) age 18 years or older; (c) English-speaking
in at least 50% of interactions with infant; (d) cohabiting with infant’s other
biological parent; and (e) living within 100 km of the university. A total of
222 participants (111 mothers and 111 fathers) were enrolled from two
Canadian cities between December 2008 and June 2011.
At 4 months corrected age, there were 108 mothers and 108
fathers with complete data. Most parents (76%) were European
Canadian, with the next highest ethnicity South Asian (6%). Parents
were either married (82%) or in a common law relationship (18%). The
mean gestational age of the late preterm infants was 354/7 weeks and
ranged from 340/7-366/7 weeks; 57% were boys.
On average, mothers were 32 years old (SD = 5.03 years; range 19–46
years). More than half (58%) had university education, and the majority were
on parental leave, with less than 5% working outside the home. Canada has a
government policy supporting paid maternity and parental leave for the first
year of a child’s life (https://www.canada.ca/en/services/benefits/ei/ei-
maternity-parental.html). The majority of mothers (94%) were the primary
caregivers for their infants, with remaining infants cared for by relatives and/
or friends. On average, fathers were 34 years old (SD = 5.90 years; range
19–50 years). About half of the fathers (55%) had university education, and
the majority (94%) were employed.
4.2 | Measurement
4.2.1 | Ages and Stages Questionnaires—second
edition (ASQ-2)
The ASQ-2 is a parent-reported developmental screener to capture
risk of delay in children ages 4 to 60 months. The ASQ-2 addresses five
domains: (a) Communication; (b) Gross Motor; (c) Fine Motor; (d)
Problem Solving; and (e) Personal-Social (Squires, Potter, & Bricker,
1999). The ASQ-2 consists of 37 age-appropriate items, each
describing a skill, ability, or behavior to which a parent responds
with three response categories: 10 (yes) to 5 (sometimes) to 0 (not yet).
Item scores are summed to create a raw score; a higher raw score
indicates more optimal child development. Using the raw scores from a
| 3
normative sample, clinical cut-offs are categorized as: (a) above cut-off
(typical development); or (b) below cut-off (a score of 2.0 standard
deviations or more below the mean). Examples of items from the ASQ-2
Communication and Personal-Social Domains include: (a) Does your
baby laugh; and (b) Does your baby watch his hands? Cronbach’s α was
.84, and test-retest reliability was .89 (Squires et al., 1999). The ASQ-2
was written at a 5th grade reading level and takes 10 to 15 min to
complete. As recommended by the ASQ-2 developer and others
(Kerstjens, de Winter, Bocca-Tjeertes, Bos, & Reijneveld, 2012), we
used corrected age to administer the ASQ-2. For this study, we
predicted child development using ASQ-2 domain raw scores, and
described the proportions of children in the clinical range using ASQ-2
categories.
4.2.2 | Parenting Stress Index—third edition (PSI-3)
The PSI-3 is a 120-item, self-reported measure of stress associated
with parenting children from 1 month to 12 years (Abidin, 1995). The
Parent Domain has seven subscales (Competence, Isolation,
Attachment, Health, Role Restriction, Depression, and Spouse).
The Child Domain has six subscales (Distractibility/Hyperactivity,
Adaptability, Reinforces Parent, Demandingness, Mood, and Ac-
ceptability). Examples of items from the Child Domain Mood
subscale include: (a) My child seems to cry or fuss more often
than most children; and (b) I feel that my child is very moody and
easily upset. Examples of items from the Child Domain Acceptability
subscale include: (a) My child looks a little different than I expected
and it bothers me at times; and (b) My child does not seem to learn as
quickly as most children.
Parents responded on a 5-point scale from 1 (strongly agree) to 5
(strongly disagree); items were summed to create total scores for the
Parent and Child Domains, and each subscale within the domains.
Higher scores indicate greater parenting stress. PSI-3 Parent and Child
Domain, and subscale scores ≥ 85th percentile are considered in the
clinical range. Cronbach’s α for the Parent Domain subscales range from
.92 to .93, and .90 to .91 for the Child Domain subscales (Abidin, 1995).
In our study, Cronbach’s α were .92 (Parent Domain) and .91 (Child
Domain) for mothers, and .89 and .88, respectively for fathers. Test-
retest reliability ranges from .69 to .91 for the Parent Domain, and .55 to
.82 for the Child Domain (Abidin, 1995). The PSI-3 was written at a 5th
grade reading level and takes about 20 min to complete.
4.3 | Procedures
Mothers and fathers of late preterm infants were recruited in hospital
at birth. Prior to any intervention, and when their infant was
approaching 4 months corrected age, a questionnaire package was
mailed to the family. Mothers and fathers completed the PSI-3
separately; mothers completed the ASQ-2 for their infants because in
the majority of cases, mothers were the primary caregivers. During a
home visit by a research assistant, questionnaires were scanned for
completeness and returned to the university research office for data
entry and cleaning.
4 | MUGHAL ET AL.

4.4 | Data analyses negatively correlated with ASQ-2 domain scores: (a) Reinforces
Parent with ASQ-2 Gross Motor and Personal-Social; (b) Demand-
Data were analyzed separately for mothers and fathers using SPSS
ingness with ASQ-2 Communication; (c) Mood with ASQ-2
version 22.0. The significance level was fixed at p < .05, except for
Communication and Personal-Social; and (d) Acceptability with all
correlation analyses, where the significance was set at p ≤ .01 to
ASQ-2 Domains, except Gross Motor (Table 3).
decrease chances of obtaining spurious results. We calculated
means and standard deviations for the PSI-3 and ASQ-2 scores,
along with frequencies and percentages of scores in the clinical 5.2 | Maternal PSI-3 subscale scores predicting infant
range. development
To compare PSI-3 Parent and Child Domain scores for mothers
We tested five 3-step hierarchical linear regression models to
and fathers, we used independent sample t-tests. To examine
determine predictors of the five ASQ-2 domain scores from among
relationships between ASQ-2 Domain scores and PSI-3 Parent and
the dimensions of parenting stress. In Step 1, we entered infant sex
Child Domain and subscale scores, we used Pearson product-moment
and gestational age as control variables. In Step 2, we added
correlations. To predict child development using PSI-3 scores, we
maternal education and age. In Step 3, we entered the PSI-3 Parent
conducted hierarchical regression models. The variables of infant sex,
Domain subscale scores and the PSI-3 Child Domain subscale
gestational age, mother’s age, and education were controlled for in our
scores that were significantly correlated (p ≤ .01) with ASQ-2
regression models, as they were associated with child development in
scores. All of the models were statistically significant: Communi-
the literature. Household income was not included as a control variable
cation, F (7, 107) = 7.77, p < .001; Gross Motor, F (6, 107) = 3.40,
due to our homogenous sample; 80.2% of participants had income
p = .004; Fine Motor, F (5, 107) = 4.18, p = .002; Problem Solving, F
levels of $80,000 or more.
(5, 107) = 3.29, p = .008; and Personal-Social, F (8, 107) = 5.19,
p < .001 (see Table 5).
5 | RE SULTS

Compared to fathers, mothers reported significantly greater stress on 5.2.1 | ASQ-2 Communication scores
the PSI-3 Parent Domain score, t(216) = 2.66, p = .008. There were no
In combination, infant sex, gestational age, and PSI-3 Child Mood
significant differences between mothers and fathers on any Child
and Acceptability subscale scores explained 31% of the variance in
Domain scores, t(216) = .82, p = .41. Descriptive statistics for the PSI-3
ASQ-2 Communication scores. In the final model, male sex and
Domain and subscale scores for mothers and fathers are presented in
increased gestational age were positively correlated and PSI-3 Mood
Table 1. For mothers, 6–24% of PSI-3 Parent Domain subscale scores
and ASQ-2 Acceptability subscale scores were negatively correlated
and 10–24% of PSI-3 Child Domain subscale scores fell in the clinical
with Communication scores. Mothers of male late preterm infants
range. For fathers, 1–14% of PSI-3 Parent Domain subscale scores and
with older gestational age and mothers who reported greater stress
9–23% of PSI-3 Child Domain subscale scores fell in the clinical range.
related to the infant’s mood (i.e., frequently crying or not content)
Means and standard deviations for the ASQ-2 domain raw scores,
and acceptability (i.e., not possessing physical, intellectual, or
and frequency and percentages of scores below the clinical cut-off are
emotional characteristics matching mothers’ expectations) also
presented in Table 2. Between 4.6% and 13.0% of infants scored below
reported indicators of greater risk of delay in communication
the clinical cut-off.
development.

5.1 | Correlations between parent and child domain

stress scores and infant development
For mothers, there was a significant negative correlation between the
PSI-3 Parent Domain scores and infants’ ASQ-2 Personal-Social
Domain scores. There were significant negative correlations between
the PSI-3 Child Domain scores and infants’ ASQ-2 Communication and
Personal-Social Domain scores (Table 3). For fathers, there were no
significant correlations between the PSI-3 Parent or Child Domain
scores and any ASQ-2 Domain scores (Table 4). Therefore, no further
analyses of fathers’ PSI-3 subscale scores predicting infant develop-
ment were conducted.
For mothers, two PSI-3 Parent Domain subscales were
significantly negatively correlated with ASQ-2 domain scores: (a)
Competence with ASQ-2 Personal-Social; and (b) Health with ASQ-2
Gross Motor. Four PSI-3 Child subscale scores were significantly
5.2.2 | ASQ-2 Gross Motor
The PSI-3 Child Domain Reinforces Parent subscale score alone
explained 12% of the variance in the ASQ-2 Gross Motor scores and
was negatively correlated with it. Mothers who reported greater stress
related to the infant’s reinforcement of her parenting (i.e., not
experiencing positive interactions) reported indicators of greater risk
of delay in gross motor development.
5.2.3 | ASQ-2 Fine Motor and Problem Solving
The PSI-3 Acceptability subscale score alone explained 13% and 10%
of the variance in the ASQ-2 Fine Motor and Problem Solving scores,
respectively, and both were negatively correlated with stress of
acceptability. Mothers who reported greater stress related to her
MUGHAL ET AL.
| 5

TABLE 1 Parenting stress scores for mothers and fathers: Means, standard deviations, and frequency of scores in the clinical range in domains
and subscales
Mothers (n = 108) Fathers (n = 108)

Frequency (%) Frequency (%)

PSI-3 scores M (SD) in clinical range M (SD) in clinical range
Parent domain 114.84 (21.61) 8 (7.4) 107.64 (18.07) 2 (1.9)
Competence 25.11 (5.72) 6 (5.6) 25.23 (5.20) 3 (2.8)
Isolation 12.81 (3.89) 16 (14.8) 12.13 (3.57) 11 (10.2)
Attachment 11.56 (2.72) 9 (8.3) 12.50 (2.97) 15 (13.9)
Health 12.91 (3.19) 26 (24.1) 11.69 (2.70) 10 (9.3)
Role restriction 17.37 (4.13) 10 (9.3) 15.80 (4.07) 5 (4.6)
Depression 18.28 (5.61) 12 (11.1) 15.69 (4.05) 1 (0.9)
Spouse 16.81 (4.36) 18 (16.7) 14.61 (4.03) 6 (5.6)
Child domain 94.44 (17.55) 13 (12.0) 96.34 (16.41) 12 (11.1)
Distractibility 24.25 (4.01) 16 (14.8) 24.70 (3.40) 14 (13.0)
Adaptability 24.31 (5.44) 15 (13.9) 25.53 (5.42) 25 (23.1)
Reinforces parent parent 8.48 (2.41) 11 (10.2) 8.82 (2.67) 15 (13.9)
Demandingness 16.09 (4.74) 12 (11.1) 16.04 (4.28) 10 (9.3)
Mood 9.60 (3.16) 26 (24.1) 9.69 (2.92) 20 (18.5)
Acceptability 11.71 (3.19) 16 (14.8) 11.56 (3.06) 11 (10.2)

PSI-3, Parenting Stress Index-third edition.

infant’s acceptability reported greater risk of delay in fine motor and In summary, maternal PSI-3 subscale scores that were significant
problem solving development. predictors of infant development in the final models were from the
Child Domain of parenting stress. They were Reinforces Parent
(predicted Gross Motor development), Mood (predicted Communica-
5.2.4 | ASQ-2 personal-social tion development), and Acceptability (predicted Communication, Fine
Motor, Problem Solving, and Personal-Social development).
In combination, maternal age, education, and PSI-3 Acceptability
subscale scores explained 24% of the variance in the ASQ-2 Personal-
Social scores. In the final model, maternal age, and Acceptability scores
6 | DISCUSSION
were negatively correlated with ASQ-2 Personal-Social development
scores, and education was positively correlated. Older and less
In this study, mothers experienced greater parenting stress than
educated mothers who reported higher stress related to acceptability
fathers of late preterm infants at 4 months corrected age. Maternal
of their infant also reported indicators of greater risk of delay in
stress related to being a parent (Parent Domain) was significantly
personal-social development.
related to reports of children’s personal-social development. Similarly,
stress related to characteristics of the child (Child Domain) was
significantly related to reports of children’s communication and
TABLE 2 Child development of late preterm infants (N = 108) at
personal-social development. This result is in keeping with Bronfen-
4 months corrected age: means and standard deviations of ASQ-2
domain raw scores and frequency (%) of scores below the clinical brenner’s (1986) identification of stress within the family system as
cutoff contributing to poorer child outcomes. However, fathers’ stress was
Frequency (%) below not significantly related to children’s development in any domain.
ASQ-2 domain M (SD) clinical cutoff
Communication 46.71 (9.96) 10 (9.3)
Gross Motor 52.52 (9.16) 14 (13.0) 6.1 | Parenting stress of mothers and fathers
Fine Motor 47.81 (10.36) 5 (4.6)
Stress levels related to qualities of their child were similar for
Problem Solving 53.56 (7.97) 5 (4.6)
mothers and fathers of late preterm infants, which is not surprising
Personal-Social 50.01 (8.97) 5 (4.6)
given they were considering the same child. However, mothers
ASQ-2,Ages and Stages Questionnaires-second edition. reported significantly more stress than fathers in relationship to their
6 | MUGHAL ET AL.

TABLE 3 Pearson product-moment correlations between mothers’ parenting stress (PSI-3) and Child development (ASQ-2) domain raw scores
ASQ-2 domain scores

PSI-3 scores Communication Gross Motor Fine Motor Problem Solving Personal-Social
Parent domain −.23 −.16 −.09 −.08 −.25*
Competence −.24 −.17 −.03 −.07 −.28*
Isolation −.14 −.07 −.04 −.15 −.13
Attachment −.20 −.07 −.15 −.14 −.20
Health −.17 −.25* −.10 −.11 −.21
Role Restriction −.21 −.19 −.10 −.01 −.17
Depression −.13 −.07 −.06 −.04 −.18
Spouse −.07 .00 −.05 .05 −.11
Child domain −.34** −.13 −.24 −.14 −.28*
Distractibility −.13 .08 −.06 −.06 −.01
Adaptability −.10 −.06 −.18 −.09 −.10
Reinforces Parent −.19 −.30** −.21 −.12 −.35**
Demandingness −.30** −.12 −.14 −.01 −.21
Mood −.48** −.15 −.17 −.12 −.33**
Acceptability −.44** −.14 −.39** −.32** −.45**

PSI-3, Parenting Stress Index-third edition; ASQ-2, Ages and Stages Questionnaires-second edition.
*p ≤ .01
**p ≤ .001

parenting role. Using a short form of the PSI, fathers of late preterm less than mothers’. Tandberg, Sandtrø, Vårdal, & Rønnestad (2013)
infants at 6 months (gestational age 30–36 weeks) experienced reported different sources of stress for mothers and fathers of
significantly more stress than fathers of term infants (Ravn et al., preterm infants at the time of hospital discharge. According to
2012). However, for fathers in our study, Parent Domain stress was Bronfenbrenner (1977), although sources of environmental stress

TABLE 4 Pearson product-moment correlations between fathers’ parenting stress (PSI-3) and mother-reported child development (ASQ-2)
domain raw scores
ASQ-2 domain scores

PSI-3 Scores Communication Gross Motor Fine Motor Problem Solving Personal-Social
Parent domain −.06 −.18 −.11 −.01 −.22
Competence .04 −.01 .12 .15 .04
Isolation −.09 −.14 −.12 −.04 −.18
Attachment −.12 −.12 −.14 −.11 −.23
Health −.07 −.13 −.15 −.11 −.16
Role Restriction −.11 −.16 −.16 .04 −.20
Depression .02 −.12 −.05 .01 −.15
Spouse −.03 −.20 −.12 −.09 −.22
Child domain −.12 −.10 −.11 −.02 −.10
Distractibility .06 −.03 .04 .13 .15
Adaptability −.06 −.15 −.10 −.02 −.08
Reinforces Parent −.14 −.01 −.06 −.03 −.16
Demandingness −.10 −.06 −.10 .03 −.04
Mood −.27* −.10 −.09 −.07 −.19
Acceptability −.12 −.06 −.21 −.14 −.20

PSI-3, Parenting Stress Index-third edition; ASQ-2, Ages and Stages Questionnaires-second edition.
*p ≤ .01
MUGHAL ET AL.
| 7

TABLE 5 Hierarchical multiple regression models predicting infant development from infant and mother characteristics and parenting stress
subscales
Communication Gross Motor Fine Motor Problem-Solving Personal-Social

Predictor variables β Adj. R2

β Adj. R 2
β Adj. R 2
β Adj. R 2
β Adj. R2
Step 1 .08** .00 .00 .02 .00
Infant sex .17 .10 .05 −.11 .01
Gestational age .30** .13 .06 .16 .06
Step 2 .10** .00 .00 .02 .00
Infant sex .18 .09 .06 −.10 .00
Gestational age .31** .12 .05 .16 .04
Age (parent) .18 −.11 .00 .07 −.15
Education −.13 .11 .07 .06 .16
Step 3 .31*** .12** .13** .10** .24***
Infant sex .20* .10 .07 −.09 .04
Gestational age .23** .13 .00 .12 −.01
Age (parent) .08 −.14 −.04 .04 −.21*
Education −.05 .15 .12 .09 .24*
Competence – – – −.05
Health −.15 – – –
Reinforces Parent −.28** – – −.14
Demandingness .09 – – – –
Mood −.35** – – – −.11
Acceptability −.25* – −.41*** −.30** −.32**

Education, 1 = university level or above and 0 = below university level. Infant sex, 1 = male and 0 = female. The symbol (–) denotes the PSI-3 subscale was not
included in the model due to insignificant correlations at the bivariate level.
*p < .05
**p < .01
***p < .001

may differ (such as hospital or home), these interlinking environ-
ments (such as workplace and/or social networks of the parent) can
affect children’s development.
6.2 | Correlations between parent and child domain
stress and infant development
For mothers, higher stress related to parenting competence was
correlated with greater risk of delay in personal-social development. A
lack of perceived competence would be expected for the first-time
parents in our study for numerous reasons, including: (a) feeling that
some things were out of their control such as having a late preterm infant
in NICU (Song, Kim, & Ahn, 2015): and (b) feeling that their parenting role
was not rewarding (Nakamura et al., 2015). For many first-time mothers,
becoming a parent decreased their feelings of competence and
increased their stress related to managing day-to-day problems and
coping with more challenges than they experienced before becoming
mothers (De Caroli & Sagone, 2014). First-time parents may be unaware
of how to foster personal-social skills in young infants. Increased
parenting stress can decrease parenting competence in mothers,
whereas parental engagement and confidence increased when mothers
view their parenting positively (Berryhill, 2016).
Higher parenting stress related to health was related to poorer
gross motor abilities. For mothers, increased stress related to health
may stem from the physical demands of caring for a late preterm infant.
Late preterm infants may have disorganized sleep-awake cycles
(Barratt et al., 1992), and breast-feeding difficulties (Nagulesapillai
et al., 2013). Indeed, 24% of the mothers rated stress related to their
health in the clinical range; this may result in less energy available to
foster their child’s development. Bronfenbrenner and Morris (2006)
emphasized the importance of external support for new mothers such
as relatives, neighbors, churches, and child programs with potential to
contribute to healthy families and children’s development.
Higher parenting stress related to a lack of positive reinforcement
from their infant was related to greater risk of delay in gross motor and
personal-social domains. Higher parenting stress related to mood, or
perceptions of high need from their infant, including frequent crying,
was related to greater risk of delay in infants’ communication and
personal-social development. Of note, 24% of mothers and 19% of
fathers reported stress related to their infants’ mood that was in the
clinical range. Positive experiences in early childhood, such as
reciprocal or “serve and return” interactions with parents, family
members, and primary caregivers, builds healthy brain architecture
(Fox, Levitt, & Nelson, 2010). Yet for late preterm infants, these serve
8 |
and return interactions can be difficult for parents when the child is
irritable and difficult to soothe.
Higher parenting stress related to the acceptability of their infant, or
the lack of alignment of the infant’s characteristics with their expectations,
was associated with greater risk of delay in all ASQ-2 Domains except
Gross Motor. This mismatch of expectations and reality may stem from
characteristics of late preterm infants who are smaller, may have health
problems initially, and acquire skills based upon their gestational age rather
than the chronological age. Gray, Edwards, O’Callaghan, & Cuskelly (2012)
identified greater parenting stress in mothers of preterm compared to
mothers of term infants, especially in the parent-child dysfunctional
interaction subscale of the PSI-Short Form, a subscale similar to the PSI-3
Acceptability subscale (Abidin, 1995).
6.3 | Maternal subscale scores predicting infant
development
We investigated the relationships between demographic character-
istics and PSI-3 subscales on child development. For infants,
gestational age was a significant predictor of communication
development. This finding is consistent with studies showing an
inverse relationship of gestational age with infants’ developmental
outcomes (Kerstjens et al., 2012). Male sex was also a significant
predictor of increased risk of delay in communication development. In
a similar study (Patra, Greene, Patel, & Meier, 2016), lower language
scores were found in male infants up to the age of 20 months.
For mothers, higher levels of education predicted decreased risk of
delay only in personal-social development. Patra et al. (2016) reported
that higher maternal education was the best predictor of positive child
development. In our study, older maternal age predicted increased risk
of delay in personal-social development. Bornstein et al. (2006) reported
that older mothers were more perceptive of their term infants’ behaviors
than younger mothers, perceived their infants as more difficult, and/or
had more difficulty adjusting to motherhood. Support from extended
family decreased with increasing maternal age, but older mothers
communicated more with their infants than younger mothers (Bornstein
et al., 2006). In contrast, a study of Australian women in a metropolitan
area, reported that maternal psychological maturity, increased with age,
and was associated with positive adaptation to parenthood in the early
months (Camberis, McMahon, Gibson, & Boivin, 2014).
It is important to consider why fathers’ perceptions of parenting
stress were not significantly associated with infant development for this
sample of late preterm infants. One explanation is that mothers are often
the primary caregivers for young infants and fathers’ perceptions may
have more indirect relationships to infant development at 4 months
corrected age. Bronfenbrenner, Alvarez, & Henderson (1984) referred to
different perceptions of a child related to work status of each parent
within the family system. If fathers were actively engaged as their child’s
primary caregivers, their perceptions of stress and subsequent infant
development may have been different, as found in a previous study
(Benzies et al., 2004). In a Swedish study of early parenting stress, mothers
experienced higher levels of stress in competence, role restriction, spousal
MUGHAL ET AL.
relationships, and health than did fathers, who experienced higher levels
of stress in social isolation (Widarsson et al., 2013).
Limitations of our study include the concurrent assessment of
stress and development, as stress levels during earlier periods when
that development was happening were unavailable. Stress may have
been much greater earlier in the infant’s life. Some models explained a
small proportion of the total variance, leaving a large proportion of the
variance unexplained. Additional variables such as psychosocial factors
(e.g., depression), perinatal complications, and breastfeeding rates may
have increased the amount of variance explained if available, but we
could not have included them in the model because of the small
sample. This sample was highly educated, with high income, and mostly
English-speaking, therefore caution should be taken when generalizing
results to other samples.
7 | IMPLICATIONS FOR PRACTICE AND
FU TU RE RESEARC H
Experiences of stress differed for mothers and fathers. Therefore,
we need to tailor supports accordingly. Parenting support and
education, including strategies for stress management, should be
offered in-hospital, at the first community health nurse home visit,
and in post-natal parenting classes for parents of late preterm
infants. It is essential to educate new mothers and fathers about
realistic expectations of parenting a late preterm infant. Late preterm
infant behaviors include more frequent crying, decreased parent-
child interaction and bonding, and infants not meeting expectations
(such as physical or emotional characteristics) in comparison to a
term infant. We recommend further research using longitudinal
designs and observational measures of infant development and to
examine, with larger samples, the effects of dimensions of parenting
stress on late preterm infant development.
REFERENCES
Abidin, R. R. (1995). Parenting Stress Index: Professional manual (3rd. ed.).
Odessa, FL: Psychological Assessment Resources.
Ananth, C. V., Friedman, A. M., & Gyamfi-Bannerman, C. (2013).
Epidemiology of moderate preterm, late preterm and early term
delivery. Clinics in Perinatology, 40, 601–610. https://doi.org/
10.1016/j.clp.2013.07.001
Ashiabi, G. S., & O’Neal, K. K. (2015). Child social development in context: An
examination of some propositions in Bronfenbrenner’s bioecological theory.
Sage Open, 5(2), 1–15. https://doi.org/10.1177/2158244015590840
Baron, I. S., Litman, F. R., Ahronovich, M. D., & Baker, R. (2012). Late
preterm birth: A review of medical and neuropsychological childhood
outcomes. Neuropsychology Review, 22, 438–450. https://doi.org/
10.1007/s11065-012-9210-5
Barratt, M. S., Roach, M. A., & Leavitt, L. A. (1992). Early channels of mother-
infant communication: Preterm and term infants. Journal of Child
Psychology and Psychiatry, 33, 1193–1204. https://doi.org/10.1111/
j.1469-7610.1992.tb00938.x
Benzies, K. M., Harrison, M. J., & Magill-Evans, J. (2004). Parenting stress, marital
quality and child behavior problems at age 7 years. Public Health Nursing, 21,
111–121. https://doi.org/10.1111/j.0737-1209. 2004.021204.x
MUGHAL ET AL.
Benzies, K. M., Magill-Evans, J., Kurilova, J., Nettel-Aguirre, A., Blahitka, L.,
& Lacaze-Masmonteil, T. (2013). Effects of video-modeling on the
interaction skills of first-time fathers of late preterm infants. Infants &
Young Children, 26, 333–348. https://doi.org/10.1097/IYC.0b01
3e3182a4ed5e
Berryhill, M. B. (2016). Mothers’ parenting stress and engagement: The
mediating role of parental competence. Marriage & Family Review, 52,
461–480. https://doi.org/10.1080/01494929.2015.1113600
Bornstein, M. H., Putnick, D. L., Suwalsky, J. T., & Gini, M. (2006). Maternal
chronological age, prenatal and perinatal history, social support, and
parenting of infants. Child Development, 77, 875–892. https://doi.org/
10.1111/j. 1467-8624. 2006.00908.x
Boyle, C. A., Boulet, S., Schieve, L. A., Cohen, R. A., Blumberg, S. J., Yeargin-
Allsopp, M., . . . Kogan, M. D. (2011). Trends in the prevalence of
developmental disabilities in US children, 1997–2008. Pediatrics, 127,
1034–1042. https://doi.org/10.1542/peds.2010-2989
Brandon, D. H., Tully, K. P., Silva, S. G., Malcolm, W. F., Murtha, A. P., Turner,
B. S., & Holditch-Davis, D. (2011). Emotional responses of mothers of
late-preterm and term infants. Journal of Obstetric, Gynecologic, &
Neonatal Nursing, 40, 719–731. https://doi.org/10.1111/j.1552–
6909.2011.01290.x
Brett, J., Staniszewska, S., Newburn, M., Jones, N., & Taylor, L. (2011).
A systematic mapping review of effective interventions for communi-
cating with, supporting and providing information to parents of preterm
infants. BMJ Open, 1, e000023. https://doi.org/10.1136/bmjopen-
2010-000023.
Bronfenbrenner, U. (1977). Lewinian space and ecological substance.
Journal of Social Issues, 33(4), 199–212. https://doi.org/10.1111/j.
1540-4560. 1977.tb02533.x
Bronfenbrenner, U. (1986). Ecology of the family as a context for human
development: Research perspectives. Developmental Psychology, 22,
723–742. https://doi.org/10.1037/0012-1649.22.6.723
Bronfenbrenner, U. (2005). Making human beings human: Bioecological
perspectives on human development. Thousand Oaks, CA: Sage.
Bronfenbrenner, U., Alvarez, W. F., & Henderson, C. R., Jr (1984). Working
and watching: Maternal employment status and parents’ perceptions of
their three-year-old children. Child Development, 55, 1362–1378.
https://doi.org/10.2307/1130006
Bronfenbrenner, U., & Morris, P. A. (2006). The bioecological model of
human development. In W. Damon, R. M. Lerner & R. M. Lerner (Eds.),
Handbook of child psychology: Theoretical models of human development
(6th ed., Vol. I, pp. 793–828). Hoboken, NJ: Wiley.
Camberis, A.-L., McMahon, C. A., Gibson, F. L., & Boivin, J. (2014).
Age, psychological maturity, and the transition to motherhood
among English-speaking Australian women in a metropolitan area.
Developmental Psychology, 50, 2154. https://doi.org/10.1037/a00
37301
Coletti, M. F., Caravale, B., Gasparini, C., Franco, F., Campi, F., & Dotta, A.
(2015). One-year neurodevelopmental outcome of very and late
preterm infants: Risk factors and correlation with maternal stress.
Infant Behavior Development, 39, 11–20. https://doi.org/10.1016/j.
infbeh.2015.01.003
De Caroli, M. E., & Sagone, E. (2014). The experience of pre-and post-
partum in relation to support, stress, and parenthood representation.
Procedia-Social and Behavioral Sciences, 116, 697–702. https://doi.org/
10.1016/j.sbspro.2014.01.282
Dix, T., & Yan, N. (2014). Mothers’ depressive symptoms and infant
negative emotionality in the prediction of child adjustment at age 3:
Testing the maternal reactivity and child vulnerability hypotheses.
Development and Psychopathology, 26, 111–124. https://doi.org/
10.1017/s0954579413000898
Dunkel Schetter, C., & Tanner, L. (2012). Anxiety, depression and stress in
pregnancy: Implications for mothers, children, research, and practice.
Current Opinion in Psychiatry, 25, 141–148. https://doi.org/10.1097/
YCO.0b013e3283503680
| 9
Engle, W. A. (2006). A recommendation for the definition of “late preterm” (near-
term) and the birth weight-gestational age classification system. Seminars in
Perinatology, 30, 2–7. https://doi.org/10.1053/j.semperi.2006.01.007
Engle, W. A., Tomashek, K. M., Wallman, C., & Committee on Fetus and
Newborn (2007). “Late preterm” infants: A population at risk. Pediatrics,
120, 1390–1401. https://doi.org/10.1542/peds.2007-2952
Fox, S. E., Levitt, P., & Nelson, C. A. (2010). How the timing and quality of early
experiences influence the development of brain architecture. Child Develop-
ment, 81, 28–40. https://doi.org/10.1111/j.1467-8624.2009.01380.x
Gray, P. H., Edwards, D. M., O’Callaghan, M. J., & Cuskelly, M. (2012).
Parenting stress in mothers of preterm infants during early infancy. Early
Human Development, 88, 45–49. https://doi.org/10.1016/j.
earlhumdev.2011.06.014
Hildingsson, I., & Thomas, J. (2014). Parental stress in mothers and fathers
one year after birth. Journal of Reproductive and Infant Psychology, 32,
41–56. https://doi.org/10.1080/02646838.2013.840882
Hostinar, C. E., & Gunnar, M. R. (2015). Social support can buffer against stress
and shape brain activity. The American Journal of Bioethics Neuroscience,
6(3), 34–42. https://doi.org/10.1080/21507740.2015.1047054
Kerstjens, J. M., de Winter, A. F., Bocca-Tjeertes, I. F., Bos, A. F., &
Reijneveld, S. A. (2012). Risk of developmental delay increases
exponentially as gestational age of preterm infants decreases: A cohort
study at age 4 years. Developmental Medicine and Child Neurology, 54,
1096–1101. https://doi.org/10.1111/j. 1469-8749. 2012.04423.x
Kim, P., Mayes, L., Feldman, R., Leckman, J. F., & Swain, J. E. (2013). Early
postpartum parental preoccupation and positive parenting thoughts:
Relationship with parent-infant interaction. Infant Mental Health
Journal, 34, 104–116. https://doi.org/10.1002/imhj.21359
Landsem, I. P., Handegard, B. H., Tunby, J., Ulvund, S. E., & Ronning, J. A.
(2014). Early intervention program reduces stress in parents of
preterms during childhood: A randomized controlled trial. Trials, 15,
387. https://doi.org/10.1186/1745-6215-15-387
Ludwig, S. M. (2007). Oral feeding and the late preterm infant. Newborn and Infant
Nursing Reviews, 7(2), 72–75. https://doi.org/10.1053/j.nainr.2007.05.005.
McGowan, J., Alderdice, F., Holmes, V., & Johnston, L. (2011). Early
childhood development of late-preterm infants: A systematic review.
Pediatrics, 127, 1111–1124. https://doi.org/10.1542/peds.2010-
2257
Muller-Nix, C., Forcada-Guex, M., Pierrehumbert, B., Jaunin, L., Borghini, A.,
& Ansermet, F. (2004). Prematurity, maternal stress and mother-child
interactions. Early Human Development, 79, 145–158. https://doi.org/
10.1016/j.earlhumdev.2004.05.002
Munakata, S., Okada, T., Okahashi, A., Yoshikawa, K., Usukura, Y.,
Makimoto, M., . . . Okuhata, Y. (2013). Gray matter volumetric MRI
differences late-preterm and term infants. Brain and Development, 35,
10–16. https://doi.org/10.1016/j.braindev.2011.12.011
Nagulesapillai, T., McDonald, S. W., Fenton, T. R., Mercader, H. F. G., &
Tough, S. C. (2013). Breastfeeding difficulties and exclusivity among late
preterm and term infants: results from the All Our Babies study.
Canadian Journal of Public Health, 104, e351–e356.
Nakamura, Y., Takeishi, Y., Ito, N., Ito, M., Atogami, F., & Yoshizawa, T.
(2015). Comfort with motherhood in late pregnancy facilitates maternal
role attainment in early postpartum. The Tohoku Journal of Experimental
Medicine, 235(1), 53–59. https://doi.org/10.1620/tjem.235.53
Neece, C. L., Green, S. A., & Baker, B. L. (2012). Parenting stress and child
behavior problems: A transactional relationship across time. American
Journal on Intellectual and Developmental Disabilities, 117, 48–66.
https://doi.org/10.1352/1944-7558-117. 1.48
Patra, K., Greene, M. M., Patel, A. L., & Meier, P. (2016). Maternal education
level predicts cognitive, language, and motor outcome in preterm
infants in the second year of life. American Journal of Perinatology, 33,
738–744. https://doi.org/10.1055/s-0036-1572532
Potijk, M. R., de Winter, A. F., Bos, A. F., Kerstjens, J. M., & Reijneveld, S. A.
(2015). Co-occurrence of developmental and behavioural problems in
moderate to late preterm-born children. Archives of Disease in
10 | MUGHAL
Childhood, 101, 217–222. https://doi.org/10.1136/archdischild-2015-
308958
Public Health Agency of Canada. (2013). Perinatal health indicators for
Canada 2013: A report from the Canadian Perinatal Surveillance System.
Ottawa, ON: Public Health Agency of Canada, Government of Canada.
Raby, K. L., Lawler, J. M., Shlafer, R. J., Hesemeyer, P. S., Collins, W. A., &
Sroufe, L. A. (2015). The interpersonal antecedents of supportive
parenting: A prospective, longitudinal study from infancy to adulthood.
Developmental Psychology, 51, 115–123. https://doi.org/10.1037/
a0038336
Ravn, I. H., Lindemann, R., Smeby, N. A., Bunch, E. H., Sandvik, L., & Smith, L.
(2012). Stress in fathers of moderately and late preterm infants: A
randomised controlled trial. Early Child Development and Care, 182,
537–552. https://doi.org/10.1080/03004430.2011.564279
Rose, R., & Engle, W. A. (2017). Optimizing care and outcomes for late
preterm neonates. Current Treatment Options in Pediatrics, 3(1), 32–43.
https://doi.org/10.1007/s40746-017-0074-z
Rutherford, H. J. V., Goldberg, B., Luyten, P., Bridgett, D. J., & Mayes, L. C.
(2013). Parental reflective functioning is associated with tolerance of
infant distress but not general distress: Evidence for a specific
relationship using a simulated baby paradigm. Infant Behavior and
Development, 36, 635–641. https://doi.org/10.1016/j.infbeh.
2013.06.008
Sahni, R., & Polin, R. A. (2013). Physiologic underpinnings for clinical
problems in moderately preterm and late preterm infants. Clinics in
Perinatology, 40, 645–663. https://doi.org/10.1016/j.clp.2013.07.012
Samra, H. A., McGrath, J. M., & Wehbe, M. (2011). An integrated review of
developmental outcomes and late-preterm birth. Journal of Obstetric,
Gynecologic, and Neonatal Nursing, 40, 399–411. https://doi.org/
10.1111/j.1552–6909.2011.01270.x
Singer, L. T., Salvator, A., Guo, S., Collin, M., Lilien, L., & Baley, J. (1999).
Maternal psychological distress and parenting stress after the birth of a
very low-birth-weight infant. JAMA: The Journal of the American Medical
Association, 281, 799–805. https://doi.org/10.1001/jama.281.9.799
Slagt, M., Deković, M., de Haan, A. D., van den Akker, A. L., & Prinzie, P.
(2012). Longitudinal associations between mothers’ and fathers’ sense
of competence and children’s externalizing problems: The mediating
role of parenting. Developmental Psychology, 48, 1554–1562. https://
doi.org/10.1037/a0027719
Song, J. E., Kim, T., & Ahn, J. A. (2015). A systematic review of psychosocial
interventions for women with postpartum stress. Journal of Obstetric,
Gynecologic, and Neonatal Nursing, 44, 183–192. https://doi.org/
10.1111/1552-6909.12541
Spinelli, M., Poehlmann, J., & Bolt, D. (2013). Predictors of parenting stress
trajectories in premature infant-mother dyads. Journal of Family
Psychology, 27, 873–883. https://doi.org/10.1037/a0034652
View publication stats
ET AL.
Squires, J., Potter, L., & Bricker, D. D. (1999). The ASQ user’s guide: A parent-
completed, child-monitoring system (2nd ed.). Baltimore, MD: Paul H. Brookes.
Sutcliffe, A. G., Barnes, J., Belsky, J., Gardiner, J., & Melhuish, E. (2012). The
health and development of children born to older mothers in the United
Kingdom: Observational study using longitudinal cohort data. British
Medical Journal, 345, e5116. https://doi.org/10.1136/bmj.e5116
Tandberg, B. S., Sandtrø, H. P., Vårdal, M., & Rønnestad, A. (2013). Parents
of preterm evaluation of stress and nursing support. Journal of Neonatal
Nursing, 19, 317–326. https://doi.org/10.1016/j.jnn.2013.01.008
Teune, M. J., Bakhuizen, S., Gyamfi Bannerman, C., Opmeer, B. C., van Kaam, A. H.,
van Wassenaer, A. G., . . . Mol, B. W. J. (2011). A systematic review of severe
morbidity in infants born late preterm. American Journal of Obstetrics and
Gynecology, 205, 374. https://doi.org/10.1016/j.ajog.2011.07.015
Tharner, A., Luijk, M. P., van IJzendoorn, M. H., Bakermans-Kranenburg,
M. J., Jaddoe, V. W., Hofman, A., . . . Tiemeier, H. (2012). Infant
attachment, parenting stress, and child emotional and behavioral
problems at age 3 years. Parenting, 12, 261–281. https://doi.org/
10.1080/15295192.2012.709150
Treyvaud, K. (2014). Parent and family outcomes following very preterm or
very low birth weight birth: A review. Seminars in Fetal and Neonatal
Medicine, 19, 131–135. https://doi.org/10.1016/j.siny.2013.10.008
Treyvaud, K., Doyle, L. W., Lee, K. J., Roberts, G., Cheong, J. L., Inder, T. E., &
Anderson, P. J. (2011). Family functioning, burden and parenting stress
2 years after very preterm birth. Early Human Development, 87,
427–431. https://doi.org/10.1016/j.earlhumdev.2011.03.008
Widarsson, M., Engström, G., Rosenblad, A., Kerstis, B., Edlund, B., &
Lundberg, P. (2013). Parental stress in early parenthood among mothers
and fathers in Sweden. Scandinavian Journal of Caring Sciences, 27,
839–847. https://doi.org/10.1111/j.1471-6712.2012.01088.x
Wigfall, V. G., Brannen, J., Mooney, A., & Parutis, V. (2013). Finding the right
man: Recruiting fathers in inter-generational families across ethnic
groups. Qualitative Research, 13, 591–607. https://doi.org/10.1177/
1468794112446109
Wong, J. J., Roubinov, D. S., Gonzales, N. A., Dumka, L. E., & Millsap, R. E.
(2013). Father enrollment and participation in a parenting intervention:
Personal and contextual predictors. Family Process, 52, 440–454.
https://doi.org/10.1111/famp.12024
How to cite this article: Mughal MK, Ginn CS, Magill-Evans
J, Benzies KM. Parenting stress and development of late
preterm infants at 4 months corrected age. Res Nurs Health.
2017;1–10. https://doi.org/10.1002/nur.21809