Health-related quality of life of mothers of very low birth weight children at the age of five: results from the Newborn Lung Project Statewide Cohort Study.

PURPOSE: This study aimed to determine the health-related quality of life (HRQoL) in mothers of 5-year-old very low birth weight (VLBW) and normal birth weight (NBW) children, with a focus on the role of stress. METHODS: This cohort study is ancillary to the Newborn Lung Project. A telephone interview collected information on symptoms of stress and HRQoL from 297 mothers of VLBW children and 290 mothers of NBW children who were enrolled in the Newborn Lung Project Statewide Cohort Study. Staged multiple regression analyses were used to evaluate the relationship between caregiver status and maternal HRQoL and the role stress played in this relationship. Additional multiple regression analyses were also used to evaluate the correlates of poor maternal HRQoL among VLBW mothers. RESULTS: Mothers of VLBW children experienced worse physical and mental HRQoL than mothers of NBW children. Adjusted analyses showed that physical HRQoL was significantly different between these mothers (ß: -1.87, P = 0.001); this relationship was attenuated by maternal stress. Among the mothers of VLBW children, stress significantly contributed to adverse HRQoL outcomes when children were aged five. Child behavior problems at the age of two were also associated with worse subsequent maternal mental HRQoL (ß: -0.18, P = 0.004), while each week of neonatal intensive care unit stay was associated with worse physical HRQoL (ß: -0.26, P = 0.02). CONCLUSIONS: Caring for a VLBW child is negatively associated with the HRQoL of mothers; this relationship might be, in part, explained by maternal stress. Addressing maternal stress may be an important way to improve long-term HRQoL.

Stress-mediated quality of life outcomes in parents of childhood cancer and brain tumor survivors: a case-control study.

PURPOSE: To determine if caring for a child with cancer or a brain tumor affects parental health and mental health and if and to what extent stress mediates the relationship between case status and parental quality of life. METHODS: In person interviewer-assisted surveys were administered to 74 case dyads (children diagnosed with cancer or a brain tumor and their parents) and 129 control dyads (children without health problems and their parents from a community sample) to assess health-related quality of life and perceived levels of stress. RESULTS: Parents of children with cancer or a brain tumor had significantly worse health-related quality of life, including worse overall mental health. Overall physical health was no different between cases and controls. Staged multivariate analysis revealed that worse health-related quality of life is completely mediated by perceived stress in these parents. CONCLUSIONS: The experience of caring for a child with cancer is not in itself related to poor quality of life, but is related to an increased level of stress that may adversely impact parental mental health and quality of life.

The prevalence and determinants of antepartum mental health problems among women in the USA: a nationally representative population-based study.

Mental health problems disproportionately affect women, particularly during childbearing years. We sought to estimate the prevalence of antepartum mental health problems and determine potential risk factors in a representative USA population. We examined data on 3,051 pregnant women from 11 panels of the 1996-2006 Medical Expenditure Panel Survey. Poor antepartum mental health was defined by self report of mental health conditions or symptoms or a mental health rating of "fair" or "poor." Multivariate regression analyses modeled the odds of poor antepartum mental health; 7.8% of women reported poor antepartum mental health. A history of mental health problems increased the odds of poor antepartum mental health by a factor of 8.45 (95% CI, 6.01-11.88). Multivariate analyses were stratified by history of mental health problems. Significant factors among both groups included never being married and self-reported fair/poor health status. This study identifies key risk factors associated with antepartum mental health problems in a nationally representative sample of pregnant women. Women with low social support, in poor health, or with a history of poor mental health are at an increased risk of having antepartum mental health problems. Understanding these risk factors is critical to improve the long-term health of women and their children.

Poor prepregnancy and antepartum mental health predicts postpartum mental health problems among US women: a nationally representative population-based study.

PURPOSE: Mental health problems disproportionately affect women, particularly during the childbearing years. However, there is a paucity of research on the determinants of postpartum mental health problems using representative US populations. Taking a life course perspective, we determined the potential risk factors for postpartum mental health problems, with a particular focus on the role of mental health before and during pregnancy. METHODS: We examined data on 1,863 mothers from 11 panels of the 1996-2006 Medical Expenditure Panel Survey. Poor postpartum mental health was defined using self-reports of mental health conditions, symptoms of mental health conditions, or global mental health ratings of "fair" or "poor." RESULTS: Of the women included, 9.5% reported experiencing postpartum mental health problems, with over half of these women reporting a history of poor mental health. Poor prepregnancy mental health and poor antepartum mental health both independently increased the odds of having postpartum mental health problems. Staged multivariate analyses revealed that poor antepartum mental health attenuated the relationship between prepregnancy and postpartum mental health problems. Additionally, significant disparities exist in women's report of postpartum mental health status. CONCLUSION: Although poor antepartum mental health is the strongest predictor of postpartum mental health problems, prepregnancy mental health is also important. Accordingly, health care providers should identify, treat, and follow women with a history of poor mental health because they are particularly susceptible to postpartum mental health problems. This will ensure that women and their children are in the best possible health and mental health during the postpartum period and beyond.