Severity of preterm birth, maternal and paternal anxiety and infant outcomes during the first year of life: a longitudinal study

Severe prematurity is a stressful event for parents, with an increased risk of anxiety symptoms (Pace et al., 2016). Preterm babies or babies of anxious parents are at high risk for developmental delays or impairments (Lean et al., 2018). So far, the investigation, also through longitudinal studies, of the cumulative impact of these two risk factors on babies' outcomes is lacking. Therefore, the aims of this study were to explore the impact of preterm birth and of parental anxiety symptoms on babies' development at 3, 9 and 12 months of infant corrected age. 132 parents of 66 preterm infants (25 Extremely Low Birth Weight-ELBW; 41 Very Low Birth Weight-VLBW) were compared with 162 parents of 81 full-term (FT) infants. Penn State Worry Questionnaire (PSWQ; Meyer et al., 1990) and the Griffiths Mental Development Scales (Griffith, 1996) were used to measure Parents’ anxiety and infants’ development, respectively. A significant interaction between birth weight and time of assessment emerged on PSWQ scores (p=.006): ELBW parents were significantly more anxious than VLBW (p=.006) and FT ones (p=.009), but only at 3 months. No significant effect emerged about maternal and paternal symptoms. Considering infant development as outcome, birth weight significantly interacted with mothers’ and fathers’ PSWQ scores. The presence of maternal anxiety was associated to worse Hearing & Language skills (p=.001) at 3 (p=.04) and 12 months (p=.002), but only for ELBW infants. When fathers were anxious, Eye-hand coordination scores decreased from 3 to 9 and 12 months, but only for ELBW (p=.15; p=.01, respectively) and VLBW infants (p=.006; p=.009, respectively). Results suggest how severe prematurity and the occurrence of early parental anxiety may negatively influence infant development during the first year of life. So, adequate intervention for the care of infant and family’s mental health should include the long-term assessment of both infant development and parental affective state.