Patterns of distress in African-American mothers of preterm infants

J Dev Behav Pediatr. 2009 Jun;30(3):193-205. doi: 10.1097/DBP.0b013e3181a7ee53.


Objective: To examine inter-relationships among stress due to infant appearance and behavior in the neonatal intensive care unit (NICU), parental role alteration stress in the NICU, depressive symptoms, state anxiety, posttraumatic stress symptoms, and daily hassles exhibited by African-American mothers of preterm infants and to determine whether there were subgroups of mothers based on patterns of psychological distress.

Method: One hundred seventy-seven African-American mothers completed questionnaires on their psychological distress at enrollment during infant hospitalization and 2, 6, 12, 18, and 24 months after term.

Results: Psychological distress measures were intercorrelated. There were four latent classes of mothers: the low distress class with low scores on all measures; the high NICU-related stress class with high infant appearance and parental role stress and moderate scores on other measures; the high depressive symptoms class with high depressive symptoms and state anxiety and moderately elevated scores on NICU-related stress and posttraumatic stress symptoms; the extreme distress class with the highest means on all measures. Infants in the high stress class were sicker than infants in the other classes. The extreme distress class mothers averaged the lowest educational level. The classes differed on distress measures, worry about the child, and parenting stress through 24 months with the extreme distress class having the highest values.

Conclusion: Although different types of maternal psychological distress were substantially related, there were distinct subgroups of mothers that were identifiable in the NICU. Moreover, these subgroups continued to differ on trajectories of distress and on their perceptions of the infants and parenting through 24 months after term.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Anxiety
  • Bayes Theorem
  • Black or African American / psychology*
  • Depression
  • Education
  • Female
  • Follow-Up Studies
  • Humans
  • Infant, Newborn
  • Infant, Premature*
  • Infant, Very Low Birth Weight
  • Linear Models
  • Mothers / psychology*
  • Socioeconomic Factors
  • Stress Disorders, Post-Traumatic / psychology
  • Stress, Psychological*
  • Surveys and Questionnaires
  • Time Factors