Being a mother of preterm multiples in the context of socioeconomic disadvantage: perceived stress and psychological symptoms / Ser mãe de múltiplos prematuros no contexto de desvantagem socioeconômica: estresse percebido e sintomas psicológicos

Abstract Objective: This study aimed to examine the differences between mothers of preterm multiples and mothers of preterm singletons regarding perceived stress and maternal psychological symptoms, and to explore the putative adverse amplified effect of socioeconomic disadvantage. Method: Ninety-five mothers of 1-year-olds born preterm participated in this cross-sectional study. Data collection was carried out in two public hospitals from Northern Portugal. To assess maternal perceived daily stress and psychological symptoms, mothers completed two questionnaires. Mothers reported on socioeconomic factors, including family poverty, parent unemployment, and low education, and two groups of family socioeconomic disadvantage were created. A child medical risk index was calculated. Results: Results indicated that mothers of preterm multiples reported higher levels of stress than mothers of preterm singletons. Moreover, and specifically regarding psychological functioning, mothers of preterm multiples reported more symptoms than mothers of preterm singletons, but only when living in a context of socioeconomic adversity. Conclusions: The results of the present study have important implications for practice. Mothers of preterm multiples are at higher risk to present mental health difficulties, in comparison to mothers of singletons, especially when exposed to socioeconomic adversities. The development of psychosocial intervention programs and public policies are of decisive importance in helping mothers of multiples adjust to parenthood.

Resumo Objetivo: Examinar as diferenças entre mães de múltiplos prematuros e mães de filhos únicos prematuros a respeito de estresse percebido e sintomas psicológicos maternos e explorar o efeito adverso amplificado putativo da desvantagem socioeconômica. Método: Participaram deste estudo transversal 95 mães de crianças de um ano nascidas prematuras. A coleta de dados foi feita em dois hospitais públicos do norte de Portugal. Para avaliar o estresse diário percebido e os sintomas psicológicos maternos, as mães responderam dois questionários. As mães relataram fatores socioeconômicos, incluindo pobreza familiar, desemprego dos pais e baixo nível de escolaridade, e foram criados dois grupos de desvantagem socioeconômica familiar. Foi calculado um índice de risco médico infantil. Resultados: Os resultados indicaram que as mães de múltiplos prematuros relataram maiores níveis de estresse do que as mães de filhos únicos prematuros. Além disso e especificamente com relação ao funcionamento psicológico, as mães de múltiplos prematuros relataram mais sintomas do que as mães de filhos únicos prematuros, porém apenas quando moravam em um contexto de adversidade socioeconômica. Conclusões: Os resultados deste estudo possuem importantes implicações para a prática. As mães de múltiplos prematuros apresentam maior risco de dificuldades de saúde mental, em comparação a mães de filhos únicos, principalmente quando expostas a adversidades socioeconômicas. O desenvolvimento de programas de intervenção psicossocial e políticas públicas é de importância decisiva ao ajudar as mães de filhos múltiplos a se ajustarem à maternidade.

Being a mother of preterm multiples in the context of socioeconomic disadvantage: perceived stress and psychological symptoms.

OBJECTIVE: This study aimed to examine the differences between mothers of preterm multiples and mothers of preterm singletons regarding perceived stress and maternal psychological symptoms, and to explore the putative adverse amplified effect of socioeconomic disadvantage. METHOD: Ninety-five mothers of 1-year-olds born preterm participated in this cross-sectional study. Data collection was carried out in two public hospitals from Northern Portugal. To assess maternal perceived daily stress and psychological symptoms, mothers completed two questionnaires. Mothers reported on socioeconomic factors, including family poverty, parent unemployment, and low education, and two groups of family socioeconomic disadvantage were created. A child medical risk index was calculated. RESULTS: Results indicated that mothers of preterm multiples reported higher levels of stress than mothers of preterm singletons. Moreover, and specifically regarding psychological functioning, mothers of preterm multiples reported more symptoms than mothers of preterm singletons, but only when living in a context of socioeconomic adversity. CONCLUSIONS: The results of the present study have important implications for practice. Mothers of preterm multiples are at higher risk to present mental health difficulties, in comparison to mothers of singletons, especially when exposed to socioeconomic adversities. The development of psychosocial intervention programs and public policies are of decisive importance in helping mothers of multiples adjust to parenthood.

Value of Chest Radiographic Pattern in RSV Disease of the Newborn: A Multicenter Retrospective Cohort Study.

Respiratory syncytial virus (RSV) lower respiratory tract infection is the most common viral respiratory infection in infants. Several authors have sought to determine which risk factors are the best predictors for severe RSV disease. Our aim was to evaluate if a specific chest radiographic pattern in RSV disease can predict the disease severity. We conducted a multicenter retrospective cohort study in term and preterm neonates with confirmed lower respiratory tract RSV infection, admitted to neonatal intensive care units (NICU) from 2000 to 2010. To determine which factors independently predicted the outcomes, multivariate logistic regression analysis was performed. A total of 259 term and preterm neonates were enrolled. Patients with a consolidation pattern on the chest radiograph at admission (n = 101) had greater need for invasive mechanical ventilation (OR: 2.5; P = .015), respiratory support (OR: 2.3; P = .005), supplemental oxygen (OR: 3.0; P = .008), and prolonged stay in the NICU (>7 days) (OR: 1.8; P = .025). Newborns with a consolidation pattern on admission chest radiograph had a more severe disease course, with greater risk of invasive mechanical ventilation, respiratory support, supplemental oxygen, and prolonged hospitalization.